aphasia چیست

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Co duc io aphasia​


Co duc io aphasia, also called associa ive aphasia, is a u commo fo m of difficul y i speaki g (aphasia). I is caused by damage o he pa ie al lobe of he b ai . A acqui ed la guage diso de , i is cha ac e ised by i ac audi o y comp ehe sio , cohe e (ye pa aphasic) speech p oduc io , bu poo speech epe i io . Affec ed people a e fully capable of u de s a di g wha hey a e hea i g, bu fail o e code pho ological i fo ma io fo p oduc io . This defici is load-se si ive as he pe so shows sig ifica difficul y epea i g ph ases, pa icula ly as he ph ases i c ease i le g h a d complexi y a d as hey s umble ove wo ds hey a e a emp i g o p o ou ce.12 People have f eque e o s du i g spo a eous speech, such as subs i u i g o a sposi g sou ds. They a e also awa e of hei e o s a d will show sig ifica difficul y co ec i g hem.3

Fo example:

Cli icia : Now, I wa you o say some wo ds af e me. Say ‘boy’.

Aphasic: Boy.

Cli icia : Home.

Aphasic: Home.

Cli icia : Seve y- i e.

Aphasic: Ni e y-seve . No … sevi y-si e … sive y- ice…

Cli icia : Le ‘s y a o he o e. Say ‘ ef ige a o ‘.

Aphasic: F igila o … o? how abou … f e igila o … o f igali e la e … aahh! I ‘s all mixed up!4

I 1970, Tim Shallice a d Elizabe h Wa i g o we e able o diffe e ia e wo va ia s of his co s ella io : he ep oduc io a d he epe i io ype. These au ho s sugges ed a exclusive defici of audi o y-ve bal sho – e m memo y i epe i io co duc io aphasia whe eas he o he va ia was assumed o eflec dis up ed pho ological e codi g mecha ism, afflic i g co f o a io asks such as epe i io , eadi g a d ami g i a simila ma e .5

Lef -hemisphe e damage i volvi g audi o y egio s of e esul i speech defici s. Lesio s i his a ea ha damage he se so imo o do sal s eam sugges ha he se so y sys em aid i mo o speech. S udies have sugges ed ha co duc io aphasia is a esul of damage specifically o he lef supe io empo al gy us a do he lef sup a ma gi al gy us.6 The classical expla a io fo co duc io aphasia is a disco ec io be wee he b ai a eas espo sible fo speech comp ehe sio (We icke’s a ea) a d ha of speech p oduc io (B oca’s a ea). This is due o specific damage o he a cua e fasciculus, a deep whi e ma e ac . Aphasic people a e s ill able o comp ehe d speech as he lesio does o dis up he ve al s eam pa hway.

Co e s​

Sig s a d symp omsedi​


Co duc io aphasics will show ela ively well-p ese ved audi o y comp ehe sio , which may eve be comple ely fu c io al. All cases a e i dividualized a d u ique o hei ow ex e . Speech p oduc io will be flue , g amma ically, a d sy ac ically co ec . I o a io a d a icula io will also be mai ai ed. Speech of e co ai s some pa aphasic e o s: pho emes a d syllables will be d opped o a sposed (e.g., s owball → s owall, elevisio → velli isio , i e y-five pe ce → i e y- we y pe ce ). The hallma k defici of his diso de , howeve , is i epe i io . Aphasic people will show a i abili y o epea wo ds o se e ces whe asked by a exami e .78 Af e sayi g a se e ce o a pe so wi h co duc io aphasia, he o she will be able o pa aph ase he se e ce accu a ely bu will o be able o epea i . This is possibly because hei mo o speech e o p ocessi g is dis up ed by i accu a e fo wa d p edic io s, o because de ec ed e o s a e o a sla ed i o co ec ive comma ds due o damage o he audi o y-mo o i e face.910 Whe p omp ed o epea wo ds, he pe so will be u able o do so, a d p oduce ma y pa aphasic e o s. Fo example, whe p omp ed wi h bagge , a pe so may espo d wi h, gabbe .11 Rece summa ies abou he sy d ome show simila i ies be wee defec ive speech a d w i i g a d hei ela ively good comp ehe sio . The sudde speech of a co duc io aphasic is flue , ye i is le g hy a d i adequa ely s uc u ed. Aphasic people have difficul y i fi di g wo ds app op ia e o co ex a d i accu a ely p o ou ci g a wo d. Aphasic e o s i ami g, eadi g aloud, a d epea i g a e ecog ized.

I dividuals wi h co duc io aphasia a e able o exp ess hemselves fai ly well, wi h some wo d fi di g a d fu c io al comp ehe sio difficul y.12 Al hough people wi h aphasia may be able o exp ess hemselves fai ly well, hey e d o have issues epea i g ph ases, especially ph ases ha a e lo g a d complex.12 Du i g a assessme of aphasia, he cli icia usually exami e he pe so ‘s ve bal flue cy, comp ehe sio , epe i io , eadi g, w i i g, a d ami g. Whe asked o epea some hi g, he pe so will be u able o do so wi hou sig ifica difficul y, epea edly a emp i g o self-co ec (co dui e d’app oche).

Howeve , aphasics ecog ize hei e o s a d will epe i ively y o co ec hem. Typically, a aphasic will make mul iple a emp s co ec i g e o s u il hey a e co ec . This ecog i io is due o p ese ved audi o y e o de ec io mecha isms.10 E o s f eque ly fi a pa e of i co ec app oxima io s. These commo e o s ypically occu i mo phemes ha a) sha e o e o mo e simila ly loca ed pho emes bu b) diffe i a leas o e aspec ha makes he subs i u ed mo pheme(s) sema ically dis i c . This epe i ive effo o app oxima e he app op ia e wo d o ph ase is k ow as co dui e d’app oche.8 Repe i ive self co ec io is commo ly used by Aphasic people of co duc io aphasia. Due o hei ela ively p ese ved audi o y comp ehe sio , co duc io aphasics a e capable of accu a ely mo i o i g, a d a emp i g o co ec , hei ow e o s i speech ou pu .13 Fo example, whe p omp ed o epea Rose k a z, a Ge ma -speaki g aphasic may espo d wi h, ose b au… ose b auch… ose g au… b o… g ose b au… g osse lau, ose k a z,… k a z… ose k a z.11

Co duc io aphasia is a mild la guage disabili y, a d mos people e u o hei o mal lives.1114 B oca’s a d We icke’s aphasia a e commo ly caused by middle ce eb al a e y s okes.15 Symp oms of co duc io aphasia, as wi h o he aphasias, ca be a sie , some imes las i g o ly seve al hou s o a few days. As aphasia’s a d o he la guage diso de s a e f eque ly due o s oke, hei symp oms ca cha ge a d evolve ove ime, o simply disappea . If he cause is a s oke, people ca make a good ecove y bu may have pe sis e defici s.16 This is because he heali g i he b ai af e i flamma io o hemo hage, leads o dec eased local impai me . Fu he mo e, he plas ici y of he b ai may allow he ec ui me of ew pa hways o es o e los fu c io . Fo example, he igh hemisphe e speech sys ems may lea o co ec fo lef -hemisphe e damage. Howeve , ch o ic co duc io aphasia is possible, wi hou a sfo ma io o o he aphasias.11 These people show p olo ged, p ofou d defici s i epe i io , f eque pho emic pa aphasias, a d epe i ive self-co ec io du i g spo a eous speech.

Causesedi​


Co duc io aphasia is caused by damage o he pa ie al lobe of he b ai , especially i ega ds o he a ea associa ed wi h he lef -hemisphe e domi a do sal s eam e wo k.1710 The a cua e fasciculus, which co ec s B oca’s a ea a d We icke’s a ea (impo a fo speech a d la guage p oduc io a d comp ehe sio , espec ively), is affec ed.17 These wo a eas co ol speech a d la guage i he b ai . The a cua e fasciculus is a hick ba d of fibe ha co ec s he wo a eas a d ca ies messages be wee hem. Whe his a ea is damaged, he pe so expe ie ces damage o he audi o y-mo o i eg a io sys em. This esul s i dis up io o he delayed audi o y feedback e wo k, causi g he i dividual o have difficul y co ec i g hemselves o speech epe i io asks.10 Addi io ally, ece evide ce sugges s ha co duc io aphasia ca also be caused by lesio s i he lef supe io empo al gy us a do he lef sup ama gi al gy us.6

Co duc io aphasia ca also be see i cases of co ical damage wi hou subco ical ex e sio s.18

Pa hophysiologyedi​


Rece esea ch has poi ed o mul iple diffe e expla a io s fo co duc io aphasia, which is based o ewe models sugges i g la guage is facili a ed by co ically based, a a omically dis ibu ed, modula e wo ks. I simple e ms, he esea ch is based o he fac ha i is mos likely ha is occu s wi h he co di io bei g buil h ough he ce eb um.19

Diag osisedi​


Seve al s a da dized es ba e ies exis fo diag osi g a d classifyi g aphasias. These es s a e capable of ide ifyi g co duc io aphasia wi h ela ive accu acy.8 The Bos o Diag os ic Aphasia Exami a io (BDAE) a d he Wes e Aphasia Ba e y (WAB) a e wo commo ly used es ba e ies fo diag osi g co duc io aphasia. These exami a io s i volve a se of es s, which i clude aski g pe so o ame pic u es, ead p i ed wo ds, cou aloud, a d epea wo ds a d o -wo ds (such as shwazel). Neu o-imagi g should also be used o look fo a s oke, umo , i fec io , o a o he pa hology i he se i g of co duc io aphasia. This ca be do e h ough a CT o MRI o he b ai ; hese a e he fi s imagi g modali y of choice.16

T ea me edi​


Speech a d la guage he apy a e ypically used as a ea me . The e a e o medical o su gical ea me s. T ea me fo Aphasia is ge e ally i dividualized, focusi g o specific la guage a d commu ica io imp oveme s, a d egula exe cise wi h commu ica io asks. Regula he apy fo co duc io aphasics has bee show o esul i s eady imp oveme o he Wes e Aphasia Ba e y. The Wes e Aphasia Ba e y assesses eu ological diso de s o disce he deg ee a d ype of aphasia p ese . The es also disce s a pe so ’s s e g hs a d weak esses, which ca be used o ea he pe so be e . The apis s should cus omize hei ea me fo each pa ie . The mai focus fo du i g speech he apy fo co duc io aphasia pe so is o s e g he co ec wo d usage a d audi o y comp ehe sio . A majo goal is o focus o epe i io .20

His o yedi​


I he la e 19 h ce u y, Paul B oca s udied pe so wi h exp essive aphasia. These pe so had lesio s i he a e io pe isylvia egio ( ow k ow as B oca’s a ea), a d p oduced hal i g a d labo ed speech, lacki g i fu c io wo ds a d g amma .

Fo example:

Cli icia : Wha b ough you o he hospi al? Pa ie : yes … ah … Mo day … ah … Dad … Pe e Hoga , a d Dad … ah … hospi al … a d ah … Wed esday … Wed esday … i e o’clock a d ah Thu sday … e o’clock … doc o s wo … wo … a doc o s a d … ah … ee h … yah … a d a doc o a gi l … a d gums, a I.21

Comp ehe sio is ge e ally p ese ved, al hough he e ca be defici s i i e p e a io of complex se e ces. I a ex eme example, o e of his pe so could o ly p oduce a si gle syllable, Ta .

Mea while, Ca l We icke desc ibed pe so wi h ecep ive aphasia, who had damage o he lef pos e io supe io empo al lobe, which he amed he a ea of wo d images. These pe so could speak flue ly, bu hei speech lacked mea i g. They had a seve e defici i audi o y comp ehe sio . Fo example, Cli icia : Wha b i gs you o he hospi al? 21

The wo diso de s (exp essive a d ecep ive aphasias) hus seemed compleme a y, a d co espo ded o wo dis i c a a omical loca io s.

We icke p edic ed he exis e ce of co duc io aphasia i his la dma k 1874 mo og aph, De Aphasische Symp ome kompleks: Ei e Psychologische S udie auf A a omische Basis.31922 He was he fi s o dis i guish he va ious aphasias i a a a omical f amewo k, a d p oposed ha a disco ec io be wee he wo speech sys ems (mo o a d se so y) would lead o a u ique co di io , dis i c f om bo h exp essive a d ecep ive aphasias, which he e med Lei u gsaphasie. He did o explici ly p edic he epe i io defici , bu did o e ha , u like hose wi h We icke’s aphasia, co duc io aphasics would be able o comp ehe d speech p ope ly, a d i igui gly, would be able o hea a d u de s a d hei ow speech e o s, leadi g o f us a io a d self-co ec io .2223

We icke was i flue ced by Theodo Mey e , his me o , who pos ula ed ha aphasias we e due o pe isylvia lesio s. Mey e also dis i guished be wee he pos e io a d a e io la guage sys ems, leadi g We icke o localize he wo egio s.19 We icke’s esea ch i o he fibe pa hways co ec i g he pos e io a d a e io egio s lead him o heo ize ha damage o he fibe s u de he i sula would lead o co duc io aphasia. Ludwig Lich heim expa ded o We icke’s wo k, al hough he labeled he diso de commissu al aphasia, o dis i guish be wee aphasias ied o p ocessi g ce e s.24

Sigmu d F eud would a gue i 1891 ha he old f amewo k was i accu a e; he e i e pe isylvia a ea, f om he pos e io o he a e io egio s, we e equivale i facili a i g speech fu c io . I 1948 Ku Golds ei pos ula ed ha spoke la guage was a ce al phe ome o , as opposed o a diffe e ia ed a d dispa a e se of fu c io ally dis i c modules. To F eud a d Golds ei , co duc io aphasia was hus he esul of a ce al, co e la guage b eakdow ; Golds ei labeled he diso de ce al aphasia.19

La e wo k a d exami a io of b ai s uc u es, howeve , implica ed he a cua e fasciculus, a whi e ma e bu dle co ec i g he pos e io empo opa ie al ju c io wi h he f o al co ex. No ma Geschwi d p oposed ha damage o his bu dle caused co duc io aphasia; he cha ac e is ic defici s i audi o y epe i io we e due o failed a smissio of i fo ma io be wee he wo la guage ce e s.19 S udies showed ha co duc io aphasics had a i ac ‘i e voice’, which disc edi ed he ce al defici model of F eud a d Golds ei .25 The We icke-Lich heim-Geschwi d disco ec io hypo hesis hus became he p evaili g expla a io fo co duc io aphasia. Howeve , ece eviews a d esea ch have cas doub o he si gula ole of he a cua e fasciculus a d he model of spoke la guage i ge e al.26

This book is dis ibu ed u de he e ms of he C ea ive Commo s A ibu io 4.0 I e a io al Lice se (h p:c ea ivecommo s.o glice sesby4.0), which pe mi s use, duplica io , adap a io , dis ibu io , a d ep oduc io i a y medium o fo ma , as lo g as you give app op ia e c edi o he o igi al au ho (s) a d he sou ce, a li k is p ovided o he C ea ive Commo s lice se, a d a y cha ges made a e i dica ed.


aphasia چیست​


عنوان : aphasia چیست


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