Aphasia: When There Are No Words

Aliases: Aphasia

Language is tightly bound up with what it means to be a person and it is integral to how we function in the world. It can describe and enlighten, but it can also confuse and deceive. It’s just so… human. Although it feels innate, it’s actually a cultural legacy that we inherit from previous generations. It is the single greatest meme we’ve ever created (in your face, Grumpy Cat), yet we take it for granted. Language is so central to our lives that it doesn’t even occur to most of us that it can be taken away. But it can.

Aphasia is a language disorder that affects language processing. It is common in people who have experienced a stroke; 20% to 40% of acute stroke patients develop aphasia. Because stroke is so common (it is the third leading cause of death in industrialized countries1), that amounts to 40-60 people out of every 100,000 every year3.

There are several types of aphasia, and the condition can have a variety of symptoms, potentially affecting all areas of language. It can impact a person’s ability to both speak and understand the speech of others, as well as their ability to read and write3. Lots of factors influence recovery, including age, gender, environment, as well as the type of stroke3. Unfortunately, total recovery is rare. Most patients are left with some impairment. The experience of aphasia patients illustrates the downside of our dependence on language, and it is a stark reminder of the importance of language. Studies have found that aphasia reduces the chances of a patient returning to work and social activities, and (likely because of this) also significantly reduces their quality of life3.

But it’s not all bad news. Patients usually experience some gradual spontaneous recovery from aphasia, with the greatest amount occurring within the first 3 months. This type of recovery generally plateaus around a year after the stroke1. Recovery depends on the return of normal blood flow to the parts of the brain impacted by the stroke. After that, the neural circuitry responsible for language must be rebuilt. Because the brain is plastic, neural connections can be formed and reformed throughout our lives (to a certain extent, anyway). The brain can literally heal itself, allowing us to survive adversity by giving us a nearly infinite capacity for change.

What could be more human?

Aphasia highlights the brain's ability to repair itself.
Plastic makes perfect.

Cause: Aphasia most commonly results from a stroke3. Stroke is caused by depleted blood flow to the brain from either blood loss (through a burst or leaky blood vessel) or the blockage of a blood vessel by a blood clot. With decreased blood flow comes a reduction in oxygen, which leads to brain cell death and can impact brain function2.

Consequence: Aphasia affects all aspects of language processing, including speech comprehension and expression, and reading and writing ability. Adding another layer of complexity, the severity of these symptoms also varies3.

Cure: There is no cure for aphasia. Aphasia is predominately treated with speech therapies, and the type, time started, duration, and intensity of therapy may significantly affect recovery3. Although some medications have been suggested to treat aphasia, their use is still controversial1.

References

  1. Berthier, ML. (2005). Poststroke aphasia: epidemiology, pathology and treatment. Drugs & Aging, 22: 163-182.
  1. National Stroke Association. What is a stroke? Web. 28 April 2016.
  1. Watila, MM, and SA Balarabe. (2015). Factors predicting post-stroke aphasia recovery. Journal of Neurological Sciences, 352: 12-18.

Image credit: Creative Commons, https://www.youtube.com/watch?v=HgmQe-HXP9w

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Suzi Claflin

I am a postdoctoral fellow studying chronic disease epidemiology.

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