Broca motor aphasia. What is the essence of the disease - Broca's aphasia? Broca's motor aphasia and Wernicke's zone

Broca's aphasia

Speech impairment caused by damage to Broca's area. Problems arise mainly with pronunciation, and language comprehension suffers to a much lesser extent. Some aspects of this type of aphasia (for example) make it difficult for others to understand the patient's speech.

Broca's aphasia leads to three main speech defects:

Agrammatism: it is difficult for the patient to use various grammatically significant prepositions and articles, he gets confused in tenses and cases.

Anomia: it is difficult for the patient to search the right words, which leads to tongue deafness and a general slowdown in speech. Difficulty articulation: Mispronunciation of words where sounds are often in the wrong order.

A synonym is sensory aphasia. Damage to the Wernicke area in the brain leads to problems in processing and understanding speech stimuli, although speech reproduction remains relatively normal (see also Broca's Aphasia).

Psychology. AND I. Reference dictionary / Per. from English K. S. Tkachenko. - M .: FAIR-PRESS... Mike Cordwell. 2000.

See what "Broca's Aphasia" is in other dictionaries:

Broca's aphasia- Expressive aphasia Broca and Wernicke Areas ... Wikipedia

BROCK APHASIA- The type of aphasia that occurs, as expected, i as a result of the defeat of Broca's area. A patient who is given such agnosis usually produces very little speech production, and what is being produced is usually pronounced slowly, with very poor ... ... Explanatory dictionary in psychology

Broca's aphasia- see Aphasia motor ... Comprehensive Medical Dictionary

Broca's aphasia- See Aphasia, motor efferent ...

Aphasia- ICD 10 F80.080.0 F80.280.2, R47.047.0 ICD 9 ... Wikipedia

- (English Broca s area; by the name of the French anthropologist and surgeon P. Brock) a section of the cerebral cortex located in the posterior inferior part of the third frontal gyrus of the left hemisphere (in right-handers), which provides the motor organization of speech. With the defeat of B. c. ... ...

See Broca's Aphasia Psychology. A Ya. Dictionary reference book / Per. from English K. S. Tkachenko. M .: FAIR PRESS. Mike Cordwell. 2000 ... Big psychological encyclopedia

Aphasia Wernicke- Receptive aphasia of Broca and Wernicke areas ICD 10 ... Wikipedia

Motor aphasia- slurred speech caused by a central impairment of sound pronunciation (anarthria). Typical, in addition, are the telegraphic style of speech (phrases consisting of 2 3 words, usually composed of verbs and nouns), agrammataphasia (loss ... ... Encyclopedic Dictionary of Psychology and Pedagogy

Motor efferent aphasia- Syn .: Aphasia Broca. The consequence of damage to the region of the lower parts of the premotor zone in the posterior part of the inferior frontal gyrus (Broca's zone, cortical fields 44 and 45). At the same time, expressive speech is upset, the grammatical structure of the spoken is violated ... Encyclopedic Dictionary of Psychology and Pedagogy

Etiology

Broca's aphasia develops in the presence of damage in the center of Broca, which is located in the left frontal lobe in the inferior frontal gyrus.

The factors provoking the development of motor aphasia may be acute or chronic circulatory disorders of the middle cerebral artery, in the basin of the superior frontal (Roland) branch. More rare causes of Broca's aphasia are hemorrhages, neoplasms, degenerative, inflammatory processes, metastatic lesions, subdural hematoma, encephalitis, traumatic damage to the frontal lobe of the brain.

Broca's aphasia is characterized by a disorder in pronunciation, speech, while understanding of spoken and written speech disturbed to a slightly lesser degree. There are three main speech defects that characterize Broca's aphasia:

Agrammatism - it is difficult for the patient to use various grammatically significant prepositions and articles. It is also noticeable that the patient finds it difficult to express times and cases.

Anomie. The patient finds it difficult to find the necessary words. As a result, speech becomes inarticulate, slowed down.

Difficulty articulation is characterized by incorrect pronunciation of words. In this case, the sounds, syllables, letters that make up the words are often arranged in the wrong order.

Patients with Broca's aphasia can pronounce short, meaningful phrases. But these phrases are difficult for others to perceive. In addition, the manifestations of aphasia in patients may be accompanied by weakness and paralysis of the upper and lower extremities on the right. This is explained by the close location to Broca's center in the frontal lobe of the cerebral cortex of the centers responsible for voluntary movements.

There are several degrees of severity of motor aphasia.

Mild severity is characterized by moderate impairment of the ability to write and speak. At the same time, the understanding of any speech is slightly impaired.

But with a more thorough examination, almost all patients reveal disorders of varying severity in the patient's understanding of speech (for example, complex oral commands). Cases are described when a patient suffering from Broca's aphasia is temporarily unable to reproduce speech, while the understanding of written and oral speech is preserved. This condition is called afemia.

With a more severe severity of Broca's aphasia, a significant disorder of the patient's oral speech is observed, and it is also difficult for the patient to understand spoken and written speech.

When the patient is recovering, stereotypical phrases may appear in his speech, repeated as an answer to all questions. Or, a slow, irregular, grammatically incorrect speech that requires significant effort is formed. At the same time, there are no official words in speech - prepositions, conjunctions, as well as fluency, intonation.

Recovery of speech often takes a long time. Sometimes it takes up to 2 years. You need to start speech recovery as early as possible.

The effectiveness of speech restoration is influenced by many factors - the cause of the brain damage, the location of the brain damage, the depth and extent of the damage, the health status and age of the patient. In the therapy of aphasia, the participation of the patient's loved ones is important.

Simplify speech using simple, short sentences

Repeat sentence keywords as needed

Maintaining the usual communication style, not talking like a weak-minded or a small child Actively involving the patient in the conversation

Use of all types of communication - speech, sign language

Do not correct the patient when talking

Give the patient the right time to pronounce the sentence. Other approaches to speech restoration are also used, for example, the use of special computer programs with exercises for patients with aphasia.

Speech depends on many mechanisms that are formed in the first 20 years of life and are closely associated with certain parts of the cerebral hemispheres. Pathological processes or damage to the areas of the brain responsible for speech causes aphasia - a speech disorder. In each hemisphere, the functions responsible for speech are motor and sensory. For example, damage to the premotor area of ​​the cortex, which is responsible for movement, leads to the development of afferent or efferent motor aphasia.

Cortical pathology auditory analyzer leads to sensory speech impairment. Motor and sensory aphasias are transcortical pathologies. In other words, disorders that occur when signals pass through the cerebral cortex. Motor changes are due to a decrease in the activity of speaking and writing, sensory - understanding of speech.

Broca's motor aphasia

Broca's motor aphasia has 3 types of disorders:

1. Afferent speech impairment. Refers to light forms. The patient speaks fluently without pauses. Examination reveals reading defects and incorrect articulation.
2. Efferent speech impairment. A severe form in which the patient utters incoherent phrases at long intervals or is silent. Gross violations of written language are noted. The patient may have difficulty reading.
3. Sensory-motor aphasia. Complete disorder of understanding and pronunciation of speaking and writing.

The causes of motor aphasia are:

• embolism of the superior branch of the cerebral artery;
• hemorrhage;
• injury;
• inflammation;
• tumors;
• degenerative processes (, Pika).

Mostly motor aphasia occurs after a stroke. With a mild form, patients have moderate impairments in the ability to speak and write, but the understanding of what is said and written suffers minimally. Only when examining with the execution of complex commands, deviations are revealed.

In some cases, the patient loses his speech for a short period, but at the same time understands others and can comprehend the read text. As a rule, this state is replaced by impoverished speech. The patient pronounces words with effort, while being aware of pronunciation defects.

He cannot perform arbitrary movements of his tongue and lips on command, despite the fact that automatic movements are preserved in them. On examination, weakness of the muscles of the lower right part of the face, right arm and hand is determined. With mild disorders, speech is fully or partially restored.

With severe disorders, the patient cannot speak and understand speech normally. When recovering during treatment, the patient responds only with formulaic phrases in response to all the questions that are asked to him. In other cases, slow speech appears, which is pronounced with effort. Usually the pronunciation of phrases is grammatically incorrect, without prepositions and conjunctions. The patient speaks without intonation and fluency.

Motor speech disorders in children

Motor aphasia in children is manifested by a violation of speaking and writing. The child has a fully preserved hearing aid, he understands what he is being told, but cannot answer. Understanding someone else's speech is limited to simple phrases and ordinary words.

More complex sentences that are not related to the child's life are not perceived. With a mild course of pathology, some vocabulary is preserved, with the help of which the child tries to communicate with others. A severe course proceeds with complete impairment or absence of speech.

The obvious signs of a child's motor speech disorders include:

• grammatically incorrect speech (without endings, prepositions);
• distortion of words;
• rearrangement of sounds;
• replacement of words that are not suitable in meaning, but similar in pronunciation;
• chaotic insertion of various short words during the pronunciation of speech (embolophrasia).

With embolophrasia, it is difficult for a child to write a dictation and it is impossible to write an essay. It is easy to rewrite text or write simple understandable phrases. Almost always, with motor speech disorders, reading difficulties are encountered.

The child can put letters into words, but at the same time, he does not understand what he has read. The prognosis of the disease depends on how severe the damage to the cerebral cortex is and on the development of the child before the onset of pathology.

Treatment of motor aphasia

Before prescribing a treatment for motor aphasia, an objective diagnosis is carried out. The patient is examined by neuropsychologists, speech therapists, and neuropathologists. To determine the cause of the pathology, the following examinations are shown:

• MRA (magnetic resonance angiography);
• dopplerography;
• spinal puncture.

After motor aphasia is diagnosed, treatment is prescribed. Patients are prescribed medications:

• means for cerebral circulation (Cavinton, Tsinarizin, Actovegin, Vinpocetine);
• means for reducing muscle tone (Mydocalm, Baclofen, magnesium preparations);
• antidepressants;
• nootropic drugs to improve brain activity (Gliatillin, Piracetam);
• tonic medicines (caffeine);
• anticholinesterase drugs to improve the transmission of arousal to nervous system(Galantamine).

Non-drug treatments include:

• speech therapy methods of correction;
• physiotherapy procedures;
• psychotherapy.

Important! Self-correction at home can lead to irreversible speech impairments or stuttering.

In extreme cases, the question of surgical intervention (the imposition of an extra-intracranial microanastomosis) is raised to improve cerebral circulation.

Forms of sensory aphasia

The most common causes of pathology are embolism of the posterior temporal or middle cerebral artery, encephalitis, brain contusion, tumor. The following sensory forms of aphasia are distinguished:

1. Semantic. Patients do not perceive complex phrases.
2. Conductor. Difficulty repeating phrases after the doctor or reading.
3. Amnestic. Patients have difficulties in the construction and recognition of words.
4. Acoustic-mnestic. Patients cannot form words. Speech is sparse, consisting mainly of pronouns.
5. Optical-mnestic. Patients can recognize objects, but have difficulty remembering their names.

The main manifestations of pathology:

• while maintaining vision and hearing, patients do not understand spoken and written speech;
• patients fluently mispronounce words and phrases (meaningless fast speech);
• reading and writing disorders;
• emotional activity, irritability;
• visual impairment.

Often, the disease is progressive. Long-term treatment includes classes with a speech therapist, physiotherapy exercises, massage, physiotherapy, psychotherapy. The complex of therapeutic measures include those that improve cerebral circulation, metabolism.

Aphasia is a neurological disorder that is loss, expressed in the inability to both speak and understand speech. Depending on the symptomatology, they are distinguished different kinds aphasia. In this article, we will tell you aboutaphasias Brocaalso known as efferent motor aphasia. How does Broca's aphasia proceed and what are its causes? Broca's aphasia is characterized by communication problems of moderate to high severity associated with the absence of or.

Broca's aphasia

Speech impairment: what is Broca's aphasia

Broca's aphasia affects spoken language. A characteristic feature of this aphasia is the inability of a person to speak fluently and freely express their thoughts, as well as form whole sentences. The person also has problems with articulation. At the same time, the ability to understand speech is preserved or impaired much less.

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There are four systems or components of the language:

• Phonological system: responsible for the brain's processing of an acoustic signal, presented in the form of words and syllables
• Morphological system: properties and relationships of the language system as a whole, affecting the structure of words through the correct combination of their constituent morphemes
• Syntax system: guarantees the consistency and consistency of the combination of words in phrases and speech
• Semantic or lexical system: is a system of language vocabulary, i.e. a set of concepts and ideas.

According to the classical model, aphasias are classified according to the location of the brain damage. Thus, Broca's aphasia is caused by the defeat of the person in frontal lobe motor speech center - Brock's Center. The Broca Center is responsible for various functions related to speech: the order of phonemes in words, the organization of words in a sentence (syntax), semantic integration, and motor organization of speech.

Diagnosis of Broca's aphasia

To detect Broca's aphasia, you can use various neuropsychological testing tools, both general and specific for detecting aphasia. When performing any neuropsychological testing, including the Broca's aphasia test, there are two criteria to consider that may affect verbal communication:

1. The level of education: when assessing, it is necessary to take into account the educational level of the person.
2. Etiology and degree of damage: the patient may have cognitive deficits associated with diffuse impairments, such as memory or attention, that negatively affect communication skills.

Diagnosis of Broca's aphasia is based on the study of various aspects of speech. It is necessary to study which of these aspects is impaired, and, depending on this, identify the type of aphasia. Currently, more attention is paid to the symptoms of aphasia, which need to be corrected, rather than the classification of the syndrome itself. Areas of study are:

Spontaneous speech in Broca's aphasia

It's about the ability to initiate and maintain a conversation. Spontaneous speech is assessed by such a parameter as fluency... Wherein:

• Not fluent, slow speech: it is difficult for a person to pronounce words, he is able to speak only in short phrases, making considerable efforts during articulation, while he quickly gets tired. His speech becomes characteristic dysprosody(violation of rhythm, semantic and syntactic stress, monotony) and the presence agrammatisms(violations in the construction of syntactic structures).
• Fluent or too fluent speech: Normal or fast (more than 200 words per minute) pronunciation of words, accompanied by normal articulation and stress. In this case, violations known as paraphasias, affect the content of the speech. Paraphasias are symmetric (an erroneous word is used that belongs to the same category as the desired one) and phonological (phonetic errors, for example, when a person confuses letters or syllables in a word).

Broca's aphasia is characterized by slow, inarticulate speech.

Understanding in Broca's aphasia

It is difficult to assess the understanding of speech in this type of aphasia, since errors in answering or incorrect answers may be associated not with problems of understanding speech, but with pronunciation difficulties. Therefore, the assessment uses tools that do not require the test taker to speak. Diagnostic criterion in this case, it is whether the ability to understand speech is retained or not. It persists in patients with Broca's aphasia.

Repetition in Broca's aphasia

It consists in the ability to decipher auditory information, find the appropriate phonological code and reproduce what was heard. If any of these processes are broken, the repetition will also be incorrect. Through the repetition of letters, words, pseudowords (fictional words) and phrases, it is studied whether there are problems with repetition (characteristic of Broca's aphasia) or this ability is not impaired.

Memory for names with Broca's aphasia

This is the ability to call objects by their proper names, i.e. access to vocabulary and finding a specific linguistic element. Patients with Broca's aphasia have significant difficulty with this, this disorder is known as anomie(loss of ability to name objects).

Automatic sequences for Broca's aphasia

Automatic sequences are a basic linguistic skill that involves pronouncing well-known sequences such as numbers, months, etc. It can also be catch phrases or proverbs. Automatic speech can persist in most aphasias, even severe ones.

Signs and symptoms of Broca's aphasia

After we have reviewed the areas that are being studied for the diagnosis of aphasia, we highlight specific symptoms characteristic of Broca's aphasia:

1. Slow speech: The patient speaks slowly, using few words, and gets tired quickly.
2. Anomie: Difficulty naming items.
3. Agrammatism: inability to correctly construct completed sentences and phrases.
4. Repetition difficulties: understand what they are being told, but cannot repeat what they have heard.
5. Awareness of scarcity: with other types of aphasia, a person may not understand that he makes mistakes, it seems to him that his speech is correct. In Broca's aphasia, patients are aware that they are experiencing difficulties because they are very tired of speaking.

In addition to these symptoms, Broca's aphasia may be accompanied by neurological symptoms:

• Orofacial apraxia: an inability to control mouth and face movements that is not caused by physical causes.
• Unilateral paresis: weakness, decreased strength in one side of the body.
• Hemiplegia: paralysis of one side of the body.
• Impaired reading and writing ability.

Causes of Broca's aphasia

Generally, the most common cause of Broca's aphasia is ischemic stroke(cerebral hemorrhage) in the left hemisphere of the brain (believed to be responsible for speech). Also, Broca's aphasia can develop after traumatic brain injury(TBI) or due to brain tumors.

In addition, symptoms of Broca's aphasia are observed in other neurodegenerative diseases:

• Primary progressive aphasia: progressive speech impairment. Initially, a person with this disorder does not show other signs of dementia. Slow speech, the presence of agrammatism and anomie are characteristic.
• Alzheimer's disease: in addition to the typical symptoms of cognitive impairment characteristic of this disease (memory and attention deficit, disorientation, etc.), a person with Alzheimer's disease has difficulty speaking, anomie, using general terms or circumlocutions (not directly related to words with which he tries to express a thought, because he cannot do it briefly).
• Parkinson's disease: speech slowdown, low syntactic complexity, and, often, agrammatism are characteristic.

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Rehabilitation for Broca's aphasia

Rehabilitation or restoration of abilities with Broca's aphasia depends on the severity of the initial symptoms. At the initial stage of the disease, it is possible to restore and reorganize some parts of the brain, thus compensating for the deficit in cognitive abilities. Objectives rehabilitation for Broca's aphasia are.

Broca's aphasia is damage to a region of the brain called the "Broca center". It is located in the left frontal lobe in the inferior frontal gyrus. What factors provoke the development of this disease?

It can be an acute or chronic circulatory disorder of the middle cerebral artery in the basin of the superior frontal branch. Rare factors causing this disease can be hemorrhages, degenerative or inflammatory processes, neoplasms, subdural hematoma, metastatic lesions, traumatic damage to the frontal lobe of the brain, encephalitis.

Impaired speech of the patient

The disease manifests itself in a violation of speech and its pronunciation by the patient. At the same time, he quite normally perceives spoken and written speech. What speech defects can be traced in the patient?

• Agrammatism is a violation of the grammar of speech. So, it is difficult for the patient to express time and cases, as well as to use articles and prepositions in speech.
• Anomia is the inability to find words quickly. So, the patient is not able to remember the word or find the right one for a long time, as a result of which his speech becomes slow and incomplete.
• Wrong pronunciation of words. The patient incorrectly arranges sounds, letters, syllables in the words that he pronounces.

Usually patients with Broca's aphasia say short phrases, but even they become not always clear to the listener. Often, speech impairment is accompanied by weakness and paralysis of the upper and lower extremities on the right side. This is due to the fact that Broca's center is close to the region of the brain responsible for voluntary movements.

Severity of motor aphasia

Like any disease, this disorder also has its own severity of motor aphasia:

• A mild degree is characterized by a moderate disorder in speaking and writing skills. At the same time, the perception of someone else's speech is practically not impaired. However, with a thorough study of patients, you can find out that they all do not understand speech, especially complex commands. Afemia is when the patient cannot reproduce speech himself for some time, but understands someone else's speech well.
• A severe degree is characterized by a significant disorder in the patient to reproduce himself oral speech, which is accompanied by a lack of understanding of spoken and written speech from the outside.

With a significant improvement in the patient's condition, speech activity, which includes pronouncing stereotypical phrases as typical answers to typical questions. His speech becomes slow, sluggish, and requires considerable effort. The grammar remains incorrect. In speech, official words (conjunctions, prepositions) often continue to be absent.

Treatment

It takes a long time to recover speech skills. But the sooner you start, the sooner you finish. The recovery processes are influenced by the degree of brain damage, its treatment, the state of health, the age of the patient. Recommended Active participation relatives in the patient's life.

In this case, it is desirable:

• Talk to a sick person as if he were healthy. There is no need to focus on his illness again.
• Actively involve him in the conversation.
• Use short and simple sentences.
• Repeat some key phrases. This allows them to be better remembered and understood.
• Use sign language.
• Do not correct the patient's speech.
• Give the person with Broca's aphasia the necessary time to pronounce the words. It takes patience from those around you.