How do sufferers of Receptive Aphasia understand instruction?
April 15, 2008 3:52 PM   Subscribe

How do sufferers of Receptive (aka Fluent or Wernicke's) Aphasia understand instruction from experimenters?

I've heard recordings of subjects exhibiting characteristic impairments on naming and repetition tasks, but I don't understand how they comprehend the task instructions! Maybe the (intact) hivemind can help. . .
posted by nilihm to Science & Nature (8 answers total)
Okay, obviously I'm not an expert on these things, but when my mom had aphasia it was kind of like being able to understand a language but not remembering the words to speak it herself even though she knew what she was wanting to say. Suddenly the vocabulary just wasn't accessible to her when she wanted to say things.
posted by miss lynnster at 3:55 PM on April 15, 2008

miss_lynnster, nilihm is talking about receptive aphasia. It's the inverse of what your mother had. Instead of losing the ability to construct sentences, one loses the ability to understand sentences spoken to you. However, you can still speak fluently.
posted by Netzapper at 4:08 PM on April 15, 2008

Best answer: Fluent aphasia doesn't mean you can still speak and be understood, it means the part of your brain that converts sentences to sounds is still entirely intact (in the 'classical' model, Broca's area does the motor stuff, and Wernicke's area does the grammar/syntax/etc stuff - it's pretty well recognized that that separation isn't really fully there, and both areas have overlap, and other areas are involved).

Anyway, aphasias are largely problems with speech production (i.e., being able to find the right words, then organize those words, then say those words). A lot of what you hear just goes right past all that. Unless its very dramatic, a lot of language is still preserved.

In terms of comprehension, the bigger problem is cadence & tone. I vaguely remember a paper suggesting that mirror neurons around Broca's area are responsible for a large amount of auditory comprehension (i.e, you hear a sound, then decide that that sound is a word, because it sounds like how you'd produce that word).

If you're really interested in this, I can dig up the citation for a review article from a few years ago that has good explanations of a lot of the newer theories (and why the classical model is wrong).
posted by devilsbrigade at 4:56 PM on April 15, 2008 [1 favorite]

Well there you go. Guess that further solidifies my claim of not being an expert, now doesn't it? *slinks away*
posted by miss lynnster at 6:29 PM on April 15, 2008

Hm? Both Broca's & Wernicke's areas are involved in word selection. Losing your selection ability (i.e., you may know that you write with a pen, but you don't know that it's called a pen, or that what you do with it is called writing) is a pretty common one.
posted by devilsbrigade at 6:51 PM on April 15, 2008

Response by poster: devilsbrigade: Thank you for your response! I would really appreciate that reference if you find it.
posted by nilihm at 10:16 PM on April 15, 2008

Best answer: Fluent aphasias always recover somewhat. The florid Wernicke "word salad" with normal affective prosody and tone but devoid of recognizable words or grammar is an acute finding; with time patients regain the ability to understand a few things.

People with Wernicke aphasia also get very, very good at understanding nonverbal cues. I do not know what tasks you have in mind but most neuropsychological test-tasks for aphasic people can generally be mimed out to show a person what you want them to do. Mime is not interpreted with the verbal part of the brain and so the aphasia generally doesn't impair comprehension of nonverbal cues and commands.
posted by ikkyu2 at 10:20 PM on April 15, 2008

Best answer: Damasio, Antonio R. "Aphasia." The New England Journal of Medicine 326.n8 (Feb 20, 1992): 531(9).

I can't find the full text. NEJM's online archives only go back through 1993, as far as I can tell, and I didn't see anyone else who had the full text. Gale might be able to find you another source. If you can't, MeFi mail me.
posted by devilsbrigade at 12:13 AM on April 16, 2008

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