Expressive aphasia | |
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Broca's area and Wernicke's area | |
Classification and external resources | |
Specialty | Neurology |
ICD-10 | F80.1 |
ICD-9-CM | 315.31 |
MeSH | D001039 |
Expressive aphasia (non-fluent aphasia) is characterized by partial loss of the ability to produce language (spoken or written), although comprehension generally remains intact. A person with expressive aphasia will exhibit effortful speech. Speech generally includes important content words, but leaves out function words that have only grammatical significance and not real-world meaning, such as prepositions and articles. This is known as "telegraphic speech". The person may still be understood, but sentences will not be grammatical. In very severe forms of Expressive Aphasia, a person may only speak using single word utterances. Comprehension is typically only mildly to moderately impaired in expressive aphasia due to difficulty understanding complex grammar. Expressive aphasia is also known as Broca's aphasia in clinical neuropsychology and agrammatic aphasia in cognitive neuropsychology and is caused by acquired damage to the anterior regions of the brain, such as the left posterior inferior frontal gyrus or inferior frontal operculum, also described as Broca's area (Brodmann area 44 and Brodmann area 45). It is one subset of a larger family of disorders known collectively as aphasia. Expressive aphasia contrasts with receptive aphasia, in which patients are able to speak in grammatical sentences that lack semantic significance, and generally also have trouble with comprehension. Expressive aphasia differs from dysarthria, which is typified by a patient's inability to properly move the muscles of the tongue and mouth to produce speech. Expressive aphasia also differs from apraxia of speech which is a motor disorder characterized by an inability to create and sequence motor plans for speech.
Broca's aphasia is a type of expressive aphasia because speech production is halting and effortful. Damage is typically in the anterior portion of the left hemisphere. Typically, writing is at least as severely impaired as speech. Persons with Broca's aphasia are usually aware of their communication deficits, and are more prone to depression and sometimes catastrophic reactions than are patients with other forms of aphasia.Intonation and stress patterns are deficient. Language is reduced to disjointed words, and sentence construction is poor, omitting function words and inflections (bound morphemes). A person with expressive aphasia might say "Son ... University ... Smart ... Good ... Good ... "Content words (nouns, verbs) may be used in speech, but sentences are difficult to produce due to problems with grammar, resulting in "telegraphic speech." In its more severe form, spoken utterances may be reduced to single words. "The prosody of those with Broca's aphasia is compromised by shortened length of utterances and the presence of self-repairs and disfluencies."