Adult Aphasia: Recent Research
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What Is Aphasia?
Aphasia
(uh-fay'-zhuh) is a communication disorder that can affect a
person's ability to use and understand spoken or written words. It
results from damage to the side of the brain dominant for language.
For most people, this is the left side. Aphasia usually occurs
suddenly and often results from a stroke or head injury, but it can
also develop slowly because of a brain tumor, an infection, or
dementia.
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Types of Aphasia
There are many different classification systems for aphasia and
many different types of aphasia within each system. Some systems are
based primarily on the location of the lesion, while others are
based solely on the person's behavior. One system adopted by the
National Aphasia Association divides aphasia into two broad
categories: fluent and non-fluent aphasia.
People with fluent aphasia have problems understanding spoken and
written language. This type is also known as sensory, posterior, or
Wernicke's aphasia.
People with non-fluent aphasia have difficulty communicating
orally and in writing. This type of aphasia is also called motor,
anterior, or Broca's aphasia. Within the non-fluent category is the
most severe type, called global aphasia. People with this type have
difficulty both expressing and understanding written and oral
communication.
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Aphasia Treatment
In general, treatment strives to improve a person's ability to
communicate. The most effective treatment begins early in the
recovery process and is maintained consistently over time. Major
factors that influence the amount of improvement include the cause
of the brain damage, the area of the brain that was damaged, the
extent of the injury, and the person's general health.
Usually a speech-language
pathologist works with other rehabilitation and medical
professionals, such as physicians, nurses, neuropsychologists,
occupational therapists, physical therapists, and social workers, as
well as families, to provide a comprehensive evaluation and
treatment plan for the person with aphasia.
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Aphasia Research at NIDCD
The National Institute on Deafness and Other Communication
Disorders (NIDCD) is one of the Institutes of the National
Institutes of Health. The NIDCD supports and conducts biomedical and
behavioral research and research training on normal and disordered
processes of hearing, balance, smell, taste, voice, speech, and
language. Currently supported aphasia research focuses on
evaluating, characterizing, and treating the disorder, as well as on
improving the understanding of the relationship between the language
disorder and the brain.
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New Approaches to Evaluation
Scientists are attempting to reveal the underlying problems that
cause specific aphasia symptoms. The goal is to understand how
injury to a particular brain structure impairs specific portions of
a person's language process. The results could be useful in treating
many types of aphasia, since the underlying cause can vary.
Other research is attempting to develop a model of sentence
comprehension and production that can help provide a functional
explanation for aphasia symptoms. These studies look at how
difficulties in word representations and processes contribute to
problems with sentence production and comprehension so that specific
symptoms can be traced back to identifiable processing deficits.
This would help focus treatment on the responsible word processes or
representations.
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New Approaches to Characterization
Since the same types of aphasia look different from one language
to another, some scientists are attempting to distinguish between
universal symptoms of the disorder and those that are language
specific. Others are examining how people with aphasia maintain
their knowledge of a language, but seem to have difficulty accessing
that knowledge. Scientists are also comparing aspects of language
that are at risk or are protected within and across language types
and assessing the effect of stress on language _expression_ in people
without aphasia. These studies may help with the development of
tests tailored to specific characteristics of individual languages
and in clinical services to bilingual communities.
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New Therapeutic Approaches
Pharmacotherapy is a new, experimental approach to treating
aphasia. Some studies are testing how drugs can be used in
combination with speech therapy to improve recovery of various
language functions by increasing the task-related flow of activation
in the left hemisphere of the brain. These studies indicate that
drugs may help improve aphasia in acute stroke and as an adjuvant to
language therapy in postacute and chronic aphasia.
Other treatment approaches use computers to improve the language
abilities of people with aphasia. Studies have shown that
computer-assisted therapy can help people with aphasia retrieve and
produce verbs. People who have auditory problems perceiving the
difference between phonemes can benefit from computers, which can be
used for speech-therapeutic auditory discrimination exercises.
Researchers are also looking at how treatment of other cognitive
deficits involving attention and memory can improve communication
deficits.
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A Closer Look at the Brain
To understand recovery processes in the brain, some researchers
are attempting to use functional MRI (magnetic resonance imaging) to
uncover the anatomical organization of the human brain regions
involved in comprehending words and sentences. This type of research
may improve understanding of how these areas reorganize after focal
brain injury. The results could have implications for both the basic
understanding of brain function and the diagnosis and treatment of
neurological diseases.
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About the Recent Research Series
This series is intended to inform health professionals, patients,
and the public about progress in understanding the normal and
disordered processes of human communication through recent advances
made by NIDCD-supported scientists in each of the Institute's seven
program areas: hearing, balance, smell, taste, voice, speech, and
language.
If you have any other questions, please call the NIDCD
Information Clearinghouse. Here are several ways to contact us:
Toll-free: (800) 241-1044
Toll-free TTY: (800)
241-1055
Address: 1 Communication Avenue, Bethesda, MD
20892-3456
E-mail: [EMAIL PROTECTED]
Internet: http://www.nidcd.nih.gov/
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For More Information
You can contact other groups as well for more information on
aphasia:
Academy of Neurologic Communicative
Disorders
and Sciences
P.O. Box 26532
Minneapolis, MN
55426
E-mail: [EMAIL PROTECTED]
Internet:
www.duq.edu/ancds
American Speech-Language-Hearing
Association
10801 Rockville Pike
Rockville, MD 20852
Voice/TTY: (301) 897-5700
Toll-free: (800)
638-8255
Fax: (301) 897-7355
E-mail: [EMAIL PROTECTED]
Internet:
http://www.asha.org/
Aphasia Hope Foundation
2436 West 137th
Street
Leawood, KS 66224
Voice: (913) 402-8306
Toll-free:
(866) 449-5804
Fax: (913) 402-8315
Internet: http://www.aphasiahope.org/
National Aphasia Association
29 John Street,
Suite 1103
New York, NY 10038
Toll-free: (800)
922-4622
Fax: (212) 267-2812
E-mail: [EMAIL PROTECTED]
Internet: http://www.aphasia.org/
NIH Pub. No. 01-4257
June 2001
Updated February 2002
For more information, contact the NIDCD
Information Clearinghouse.
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