A Comprehensive Overview of Broca’s Aphasia after Ischemic Stroke

Aphasia denotes an acquired central disorder of language, which alters patient’s ability of understanding and/or producing spoken and written language. The main cause of aphasia is represented by ischemic stroke. The language disturbances are frequently combined into aphasic syndromes, contained in different vascular syndromes, which may suffer evolution/involution in the acute stage of ischemic stroke. The main determining factor of the vascular aphasia’s form is the infarct location. Broca’s aphasia is a non-fluent aphasia, comprising a wide range of symptoms (articulatory disturbances, paraphasias, agrammatism, anomia, and discrete comprehension disorders of spoken and written language) and is considered the third most common form of acute vascular aphasia, after global and Wernicke’s aphasia. It is caused by a lesion situated in the dominant cerebral hemisphere (the left one in right-handed persons), in those cortical regions vascularized by the superior division of the left middle cerebral artery (Broca’s area, the rolandic operculum, the insular cortex, subjacent white matter, centrum semiovale, the caudate nucleus head, the putamen, and the periventricular areas). The role of this chapter is to present the most important acquirements in the field of language and neurologic examination, diagnosis, and therapy of the patient with Broca’s aphasia secondary to ischemic stroke.

Presence or Absence of the Object Marker “Râ” in the Speech of Aphasic Patients With Agrammatic Broca’s Aphasia

Introduction: The aims and the importance of the study: Regarding the importance of the object marker “râ” as one of the components of Persian sentences and its little investigation in aphasic Persian speakers, we decided to study its usage in the speech of aphasic patients with agrammatic Broca’s aphasia to know whether aphasic Persian speakers use “râ” in comparison to normal Persian speakers. The agrammatic aphasics are known for not using function words (like the object marker “râ”). Materials and Methods: In this experimental-descriptive study, two groups were employed. In the first group, six Persian children with Broca’s aphasia participated as the experimental group. The general linguistic capabilities of these patients were evaluated with the Persian aphasic test by speech therapy specialists. In the second group, six Persian-speaking normal persons participated as the control group. Two similar tests were administered to the aphasic and control groups, inspired by Caplan et al. 's test, to know whether they use “râ”. As there was a difference between the two groups, 1-way ANOVA was utilized to see if this difference was statistically significant. To analyze linguistic data, the approaches of Garman, Saffran, Kolk, Friedman, and Dolfić and Fabijanić were applied. Results: While the control group produced “râ” in all cases, the aphasic group never used it. Conclusion: It seems that using content words (like “nouns and verbs”) may be more vital than using function words (like “râ”).

Comprehension of Complex Structures by Persian-speaking Aphasics: The Role of Cognitive Load

Introduction: So far, many studies have investigated the extent and nature of the grammatical deficit in aphasia. However, to the best of our knowledge, this research is the first in the Persian language to inspect the comprehension of patients with Broca’s aphasia on diverse syntactically complex structures. Materials and Methods: To scrutinize the impact of task on aphasics’ performance, four age-, education- and gender-matched Persian-speaking patients with Broca’s aphasia were compared with their healthy matched controls regarding the two different tasks of grammatical judgment and figurine act-out task. The structures used to examine the subjects’ performance included agentive passive, subject cleft, object cleft, object relative clause, and object experiencer psychological verbs. Results: Our results which supported the trade-off hypothesis, showed that our subjects generally performed better in grammatical judgment task than in figurine act-out task (P≤0.05). Particularly in the second task, as our inner task comparison, the patients’ problems were more severe in object cleft, object experiencer, and object relative clauses: all structures whose interpretations need more cognitive load. Conclusion: Our findings put more weight on the interactive or constraint-based model of language processing.

BROCA APHASIA LANGUAGE IMPAIRMENT IN SARAH SCOTT’S YOUTUBE CHANNEL

Aphasia is a language disorder caused by brain damage and makes the patient lose or impair language skills. One of the diseases which often cause people to experience aphasia is stroke. In this study, the researchers observed the characteristics of language impairment of Sarah Scott. She’s a young woman suffering from Broca's aphasia after stroke. This study employed a qualitative descriptive method on the utterances she produced in SymphUK YouTube channel as the data source. In collecting the data, the researchers watched and transcribed the utterances containing the language disorder. The analysis used the theory of Hallowel (2017) on the characteristics of Broca's aphasia and Ardila (2014) about the linguistics defects in aphasia. The finding shows that the most dominant characteristic was dysnomia, literal (phonemic) paraphasia, and agrammatism among twenty-six utterances. Then, the other characteristics that also appeared were disfluency, repetition, and telegraphic speech. Furthermore, the levels of language-impaired in Sarah Scott were morphemic, morphosyntactic, and phonetic. Thus, the following study should cover more subjects with different age, gender, and language to see whether more variation of characteristics of Broca's aphasia appears in different contexts.

Cost-effectiveness of speech and language therapy plus scalp acupuncture versus speech and language therapy alone for community-based patients with Broca’s aphasia after stroke: a post hoc analysis of data from a randomised controlled trial

ObjectiveThis study aimed to assess the cost-effectiveness of combined scalp acupuncture therapy with speech and language therapy for patients with Broca’s aphasia after stroke.DesignA within-trial cost-effectiveness analysis.SettingsCommunity health centres.SubjectsA total of 203 participants with Broca’s aphasia after stroke who had been randomly assigned to receive scalp acupuncture with speech and language therapy (intervention) or speech and language therapy alone (control).InterventionBoth groups underwent speech and language therapy (30 min per day, 5 days a week, for 4 weeks), while the intervention group simultaneously received scalp acupuncture.Primary outcomesAll outcomes were collected at baseline, and after the 4-week intervention and 12-week follow-up. Cost-effectiveness measures included the Chinese Rehabilitation Research Center Standard Aphasia Examination (CRRCAE) and Boston Diagnostic Aphasia Examination (BDAE). Cost–utility was evaluated using quality-adjusted life-years (QALYs). Incremental cost-effectiveness ratios were expressed, and sensitivity analysis was conducted.ResultsThe total cost to deliver the intervention was €4001.72, whereas it was €4323.57 for the control group. The incremental cost-effectiveness ratios showed that the intervention was cost-effective (€495.1 per BDAE grade gained; €1.8 per CRRCAE score gained; €4597.1 per QALYs gained) relative to the control over the 12 weeks. The intervention had a 56.4% probability of being cost-effective at the ¥50 696 (€6905.87) Gross Domestic Product (GDP) per capita threshold. Sensitivity analyses confirmed the robustness of the results.ConclusionsCompared with speech and language therapy alone, the addition of scalp acupuncture was cost-effective in Chinese communities. As the costs of acupuncture services in China are likely to differ from other countries, these results should be carefully interpreted and remain to be confirmed in other populations.Trial registration numberChiCTR-TRC-13003703.

Syntactic aspects of impaired speech in interface with prosody and information structure

This paper aims at studying how the syntactic component of language develops in the speech of people with Broca’s and Wernicke’s aphasia in interface with prosody and informational structure. The data consists of two short interviews in English with aphasic patients. Broca’s aphasia is characterized by the difficulty in processing and producing syntactic structures. In Wernicke’s aphasia, the semantic component is affected, which ends up generating a disconnected and meaningless speech. It was found that in Broca’s aphasia the patient marked some heads of English in final position – as head-final similar to languages like Japanese – instead of head-first, a common parameter of English. In Wernicke’s aphasia, there were some inadequacies in the use of adjuncts and complements that resulted in semantic anomalies.