Wernicke’s & Broca's aphasiaWernicke’s aphasiaIntroductionShort samples of Wernicke’s aphasiaA long sample of Wernicke’s aphasiaPhonemic paraphasia & neologismWernicke's aphasia on YouTubeSemantic paraphasiaCircumlocutionSlide 10Logorrhea, press of speechSlide 12ReadingAphasia checklist: Wernicke’sThe effect of WA on cerebral functionBroca's aphasiaDescribe this picture (silently!)Broca's aphasia sample #1Broca's aphasia sample #2Broca's aphasia on YouTubeBackground: word classesBackground: morphologyBreakdowns in grammarThe overall resultReversible sentencesRepetition of one's own speechSummary of main symptomsBroca's aphasia checklistWernicke’s & Broca's aphasiaBrain & LanguageLING 411/412/489NSCI 411/611/489/689Harry HowardTulane UniversityWernicke’s aphasiaaka posterior aphasia aka receptive aphasia01/14/19 Brain & Language, Harry Howard, Tulane University 3IntroductionImagine your favorite doctor joke. They usually begin with “a guy walks into a doctor’s office …”Now imagine that the guy, or woman, is a patient with Wernicke’s aphasia …01/14/19 Brain & Language, Harry Howard, Tulane University 4Short samples of Wernicke’s aphasiaClinician: “Tell me where you live.”Patient: “Well, it’s a meender place and it has two … two of them. For dreaming and pinding after supper. And up and down. Four of down and three of up …” (Brookshire 2003:155)Clinician: “What’s the weather like today?”Patient: “Fully under the jimjam and on the altigrabber.” (Brookshire 2003:155)What is broken? What is preserved?01/14/19 Brain & Language, Harry Howard, Tulane University 5A long sample of Wernicke’s aphasiaPatient is asked what brought him to the hospital.“Is this some of the work that we work as we did before? … All right … From when wine [why] I’m here. What’s wrong with me because I … was myself until the taenz took something about the time between me and my regular time in that time and they took the time in that time here and that’s when the the time took around here and saw me around in it’s started with me no time and I bekan [began] work of nothing else that’s the way the doctor find me that way…” (Obler & Gjerlow 1999:43)01/14/19 Brain & Language, Harry Howard, Tulane University 6Phonemic paraphasia & neologismErrors in the selection of phonemes include addition, omission, or change in position. For instance, Damasio (1992:535) citestrable for table pymarid for pyramid. Clearly, the more such phonemic paraphasias accumulate in a word, the harder it is to understand it, to the extent that the intended word may become unidentifiable. This is the point of neologism, illustrated in another of Damasio’s examples:hipidomateous for hippopotamus.Patients with severe Wernicke’s aphasia may produce strings of neologisms with a sprinkling of connecting words, known as jargon01/14/19 Brain & Language, Harry Howard, Tulane University 7Wernicke's aphasia on YouTubehttp://www.youtube.com/watch?v=B-LD5jzXpLE01/14/19 Brain & Language, Harry Howard, Tulane University 8Semantic paraphasiaA patient with damage to Wernicke’s region may also fail to select the proper words with which to convey her ideas, though this deficit can be compensated for by the usage of paraphrases. Such semantic paraphasias (or empty speech) are often quite simple, such as relying on generic terms like thing or stuff to stand in for the more specific words that do not spring to mind. Other times, they become quite elaborate. Kandel (1995:640) cites the example of a Wernicke’s patient who was asked where he lived and answered:“I came there before here and returned there.” “A patient with moderate Wernicke’s aphasia was attempting to explain what he had done on a shopping trip the previous day. He concluded with,‘I went down to the thing to do the other one and she was only the last one that ever did it, so I never did.’” (Brookshire 2003:155)01/14/19 Brain & Language, Harry Howard, Tulane University 9CircumlocutionSome Wernicke’s patients talk around missing words, a behavior called circumlocution.A patient with moderate Wernicke’s aphasia was attempting to tell the examiner what she had had for breakfast that morning:Patient: “This morning for – that meal – the first thing this morning – what I ate – I dined on – chickens, but little – and pig – pork – hen fruit and some bacon, I guess.” (Brookshire 2003:156)01/14/19 Brain & Language, Harry Howard, Tulane University 10Wernicke's aphasia on YouTubehttp://www.youtube.com/watch?v=aVhYN7NTIKU01/14/19 Brain & Language, Harry Howard, Tulane University 11Logorrhea, press of speechThe ease with which Wernicke’s patients produce speech, their circumlocution, and their deficient self-monitoring may contribute to their inclination to run on when they talk. Such an overabundance of speech is referred to as logorrhea or press of speech. Clinician: “Tell me what you do with a comb.”01/14/19 Brain & Language, Harry Howard, Tulane University 12Logorrhea, press of speechPatient: “What do I do with a comb … what I do with a comb. Well a comb is a utensil or some such thing that can be used for arranging and rearranging the hair on the head both by men and by women. One could also make music with it by putting a piece of paper behind and blowing through it. Sometimes it could be used in art – in sculpture, for example, to make a series of lines in soft clay. It’s usually made of plastic and usually black, although it comes in other colors. It is carried in the pocket or until it’s needed, when it is taken out and used, then put back in the pocket. Is that what you had in mind?” (Brookshire 2003:155)01/14/19 Brain & Language, Harry Howard, Tulane University 13ReadingReading can also be disrupted?Why?Because reading connects to speech for the pronunciation of letters and the storage of words01/14/19 Brain & Language, Harry Howard, Tulane University 14Aphasia checklist: Wernicke’sa) comprehension of spoken materialb) comprehension of written materialc) segmental phonology d) word selectione) word semanticsf) fluency (production of speech)g) production of writingh) use function wordsi) grammaticalityj) repetition of what others sayk) conversational proficiency, e.g. turn takingl) concern about impairmentm) concern about errorsn) short-term retention &