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- 31 March 2022

Aphasia: What it is, Symptoms, Causes and Treatments

Aphasia is a language disorder that can have a very significant impact on people's ability to communicate. It is important to be able to diagnose and treat it as early as possible to increase the chances of recovery.

What is Aphasia?

Aphasia is a disorder that affects human communication in people of all ages, although it is more commonly found in adults over the age of 65. It is a challenging condition that significantly impacts the lives of those who experience it, affecting both the ability to speak and the ability to understand language, both written and spoken.

Aphasia can be described as a set of symptoms that progressively make it more complex to express or comprehend language. This condition is the result of damage to regions of the brain responsible for language functions, located in the left hemisphere of the brain.

Aphasia represents a terrible condition that makes life extremely difficult for those affected. A notable example is the renowned American actor Bruce Willis ― famous for his roles in unforgettable action films such as Die Hard, Pulp Fiction, and The Fifth Element ― who retired from the film industry due to aphasia.

Symptoms of Aphasia

Characteristic symptoms of aphasia can vary widely depending on the underlying cause and the severity of the damage, but some are more recognizable than others. The most common symptoms include:

  • Speaking using short or incomplete sentences

  • Formulating sentences without meaning

  • Substituting one word for another

  • Using unrecognizable words

  • Difficulty finding the right words for expression

  • Difficulty understanding what others say

  • Difficulty comprehending written text

  • Problems with writing

For instance, many people with aphasia struggle to communicate and may use incomprehensible sentences, along with significant difficulty in remembering even common terms. Some forms of aphasia are also characterized by abrupt interruptions in a sentence to look up a term that one has in mind but whose specific word one cannot remember.

Types of Aphasia

Based on the presented symptoms, different types of aphasia can be identified, each characterized by the impairment of specific language components:

  1. Broca's Aphasia: People with Broca's aphasia have difficulty speaking but can understand language.

  2. Wernicke Aphasia: People with Wernicke aphasia have difficulty understanding language but can formulate words and sentences.

  3. Transcortical Aphasia: Those with transcortical aphasia ― either motor or sensory ― exhibit features similar to Broca's and Wernicke aphasia, although symptoms are typically less severe.

  4. Conduction Aphasia: People with conduction aphasia typically have difficulty repeating language but may still be able to speak independently and understand language.

  5. Mixed Aphasia: People with mixed aphasia may have difficulty speaking, comprehending language, or both. It typically presents as a combination of characteristics of Broca's and Wernicke aphasia.

  6. Global Aphasia: Those with global aphasia are unable to speak and understand language, as all four major language modalities are impaired: speaking, comprehending, reading, and writing.

Despite this classification, many individuals with aphasia do not fit perfectly into one of these patterns and exhibit unique language difficulties that need to be carefully evaluated to identify the individual's weaknesses and strengths. This evaluation is crucial for structuring a personalized intervention plan based on the specific characteristics of the disorder.

Causes of Aphasia

Aphasia can result from various causes, with the most common being brain damage caused by a stroke, which involves the rupture or occlusion of a blood vessel in the brain, leading to the death or deterioration of brain cells that control language functions.

Other causes that can lead to a condition of aphasia may include:

  • Dementia, such as Alzheimer's disease;

  • Brain injury from head trauma;

  • Brain tumors;

  • Brain infections;

  • Gunshot wounds.

Depending on the underlying cause of the specific type of Aphasia, the onset of symptoms may be more or less sudden or, in contrast, gradual:

  1. For example, in the case of brain damage caused by a stroke, an acute onset of symptoms is more likely to be found.

  2. On the other hand, in the case of dementia conditions, communication difficulties may develop more gradually and worsen progressively over time.

Treatment of Aphasia

The highly variable nature of aphasia necessarily requires a Precision Diagnosis and Specialized Care approach. Each person must be carefully evaluated based on their specific characteristics, and treatment must be personalized for each patient.

Depending on the extent of the brain damage, the intervention may vary widely. In cases where brain damage is mild, there may be spontaneous recovery of impaired language skills without the need for specific intervention. However, the majority of patients with aphasia require personalized intervention to rehabilitate impaired functions.

While aphasia is more commonly associated with later life, it can affect individuals of all ages. Unfortunately, the condition is often recognized when the extent of damage precludes the possibility of complete recovery. Nevertheless, through appropriate and targeted interventions, it is possible to attempt to slow the progression of the disease and mitigate its negative effects on an individual's life.

Speech Therapy

Speech therapy is the primary mode of intervention for people with aphasia and aims to improve a person's communication skills, attempting to restore language abilities while simultaneously teaching new alternative communication methods.

Pharmacological Therapy

Currently, several studies are underway regarding the use of specific medications for the treatment of aphasia. These include medications capable of enhancing blood flow to the brain, molecules that can enhance brain recovery potential, and medicines that promote the restoration of proper neurotransmitter function in the brain.

Learn more about Pharmacological Therapy options offered by the Istituto di Neuroscienze

Neuromodulation Therapies

In recent years, new treatment modalities for aphasia have emerged and shown promise, even when other intervention methods have obtained no positive benefits. Notable among these are Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS), two innovative, non-invasive, and painless brain stimulation techniques capable of stimulating specific damaged brain regions and restoring their function.

At the Istituto di Neuroscienze, we treat aphasia with Neuromodulation Therapies even in children, with very encouraging results.

Learn more about Neuromodulation Therapies offered by the Istituto di Neuroscienze

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