What is aphasia?
Aphasia is an acquired language disorder caused by damage to or changes in the brain. It can affect speaking, understanding, reading and writing.
How aphasia manifests itself varies greatly from person to person. Some people mainly have difficulty finding words, while others experience problems understanding language, forming sentences, reading or writing. Often, several difficulties occur together.
Aphasia, in itself, says nothing about a person's intelligence. Someone may know exactly what they want to say but have difficulty putting that message into words.
Want to know more? Watch our information videos tailored to patients, healthcare professionals and researchers.
What causes aphasia?
Aphasia can have various causes. The most common cause is a stroke, in which part of the brain is damaged due to an interruption of the blood supply or a brain haemorrhage.
Aphasia can also occur following, for example:
- a traumatic brain injury;
- a brain tumour;
- an infection or another condition affecting the brain.
With these forms of aphasia, the language disorder usually develops relatively suddenly. However, language problems can also develop gradually as a result of a neurodegenerative condition. When language difficulties remain the main problem over a longer period of time, this may indicate primary progressive aphasia (PPA).
What is primary progressive aphasia?
Primary progressive aphasia, or PPA, is a neurological condition in which language abilities gradually deteriorate due to progressive changes in the brain.
Unlike aphasia following, for example, a stroke, the language problems associated with PPA do not begin suddenly but develop gradually. In the early stages, language difficulties are the main symptoms, while other cognitive functions may remain relatively well preserved.
The specific language difficulties vary from person to person. For example, someone may:
- have increasing difficulty finding words;
- have difficulty understanding words or sentences;
- speak less fluently or grammatically;
- have difficulty repeating words and sentences;
- experience changes in reading and writing.
Different forms of PPA
Three main forms of PPA are generally distinguished.
Semantic variant PPA
In this variant, knowledge of the meaning of words and concepts gradually deteriorates. For example, people may still be able to pronounce a word fluently but no longer know what it means.
Non-fluent/agrammatic variant PPA
In this variant, speech often becomes slower and more effortful. Forming grammatically correct sentences may become more difficult. Some people also experience difficulties with the planning and execution of speech movements.
Logopenic variant PPA
In this variant, word-finding difficulties and problems repeating longer words or sentences are often the main features. As a result, speech may frequently be interrupted by pauses while searching for words.
This classification helps describe patterns of language difficulties, but not everyone fits neatly into a single category. The clinical picture may also change as the condition progresses.
Learn more about PPA: watch our information videos tailored to patients, healthcare professionals and researchers.
Aphasia is different for everyone
There is no single typical presentation of aphasia. The difficulties a person experiences depend, among other things, on the cause, which areas of the brain are affected and the severity of the language disorder.
Possible difficulties include:
- difficulty finding words;
- using incorrect words or sounds;
- difficulty forming sentences;
- difficulty understanding spoken language;
- difficulties with reading;
- difficulties with writing;
- difficulty repeating words or sentences.
Severity can range from subtle language difficulties to major limitations in everyday communication.
Diagnosis
Aphasia is diagnosed through a range of assessments. A speech and language therapist may assess, among other things, word finding, speaking, language comprehension, reading, writing and repetition.
Depending on the cause, neurological examination, neuropsychological assessment and brain imaging may also form part of the diagnostic process.
When PPA is suspected, a multidisciplinary assessment is usually required. This involves looking not only at the language profile but also at other cognitive functions and changes in the brain.
Treatment and support
Speech and language therapy plays an important role in aphasia. Treatment is tailored to the person's specific abilities, difficulties and needs. Therapy may focus on, among other things:
- word finding and speaking;
- language comprehension;
- reading and writing;
- communication strategies;
- assistive tools and resources;
- communication with family members and other communication partners.
In aphasia following a stroke or other non-progressive brain injury, language abilities may partially recover. The greatest changes often occur early on, but further improvement may also be possible later.
In PPA, the disease process is progressive. Support therefore focuses not only on practising language skills, but also on supporting communication for as long as possible, making use of preserved abilities, and introducing strategies and assistive tools at an early stage.
For practical information tailored to different audiences, please visit our information videos for patients, healthcare professionals and researchers.
