Conduction aphasia: Difference between revisions

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[[Dysphasia, Conduction]]; [[Associative Aphasia]]; [[Aphasia, Associative]]; [[Associative Aphasias]]; [[Dysphasias, Conduction]]; [[Aphasias, Associative]]; [[Conduction Aphasia]]; [[Conduction Dysphasias]]; [[Associative Dysphasias]]; [[Associative Dysphasia]]; [[Conduction Dysphasia]]; [[Dysphasias, Associative]]; [[Dysphasia, Associative]]; [[Aphasias, Conduction]]; [[Conduction Aphasias]]  
[[Dysphasia, Conduction]]; [[Associative Aphasia]]; [[Aphasia, Associative]]; [[Associative Aphasias]]; [[Dysphasias, Conduction]]; [[Aphasias, Associative]]; [[Conduction Aphasia]]; [[Conduction Dysphasias]]; [[Associative Dysphasias]]; [[Associative Dysphasia]]; [[Conduction Dysphasia]]; [[Dysphasias, Associative]]; [[Dysphasia, Associative]]; [[Aphasias, Conduction]]; [[Conduction Aphasias]]  
==Overview==
==Overview==
'''Conduction aphasia''', also called '''associative aphasia''', is a relatively rare form of [[aphasia]], thought to be caused by a disruption in the fiber pathways connecting [[Wernicke's area|Wernicke's]] and [[Broca's area]]s.  The [[arcuate fasciculus]] has previously been implicated as this fiber bundle,<ref>{{GeorgiaPhysiology|8/8ch15/s8c15_14}}</ref> however more recent evidence suggests that the [[extreme capsule]] connects [[Wernicke's area|Wernicke's]] and [[Broca's area]]s<ref>Schmahmann, J. and Pandya, D. "Fiber Pathways of the Brain". Oxford University Press 2006</ref>.
'''Conduction aphasia''', also called '''associative aphasia''', is a relatively rare form of [[aphasia]], thought to be caused by a disruption in the fiber pathways connecting [[Wernicke's area|Wernicke's]] and [[Broca's area]]s.  The [[arcuate fasciculus]] is the most commonly involved pathway although evidence of other pathway involvement has also been found. [[Conduction aphasia]] is characterized by impaired repetition. Usually, [[writing]], [[comprehension]], and [[fluency]] remain intact. Neuroimaging can identify the underlying etiology. Speech therapy can improve recovery in patients suffering from [[conduction aphasia]].
 
==Historical Perspective==
==Historical Perspective==
*[[Conduction aphasia]] was first described by [[Carl Wernicke]] in the year 1874. Later on in 1885, [[Lichtheim]] described this disorder further.<ref name="pmid20161054">{{cite journal |vauthors=Hickok G |title=The functional neuroanatomy of language |journal=Physics of Life Reviews |volume=6 |issue=3 |pages=121–43 |date=September 2009 |pmid=20161054 |pmc=2747108 |doi=10.1016/j.plrev.2009.06.001 |url= |issn=}}</ref>
*[[Conduction aphasia]] was first described by [[Carl Wernicke]] in the year 1874. At first, Wernicke hypothesized that conduction aphasia was caused by damage to a pathway running through the insula and connecting [[Broca's]] area and [[auditory association area]] but later the evidence proved that [[arcuate fasciculus]] was the main pathway involved in [[conduction aphasia]]. In 1885, [[Lichtheim]] described this disorder further.<ref name="pmid20161054">{{cite journal |vauthors=Hickok G |title=The functional neuroanatomy of language |journal=Physics of Life Reviews |volume=6 |issue=3 |pages=121–43 |date=September 2009 |pmid=20161054 |pmc=2747108 |doi=10.1016/j.plrev.2009.06.001 |url= |issn=}}</ref><ref name="Benson1973">{{cite journal|last1=Benson|first1=D. Frank|title=Conduction Aphasia|journal=Archives of Neurology|volume=28|issue=5|year=1973|pages=339|issn=0003-9942|doi=10.1001/archneur.1973.00490230075011}}</ref>
*In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
*In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].


==Classification==
==Classification==
*[Disease name] may be classified according to [classification method] into [number] subtypes/groups:
*[[Conduction aphasia]] may be classified into 2 subtypes.<ref name="DronkersBaldo2009">{{cite journal|last1=Dronkers|first1=N.F.|last2=Baldo|first2=J.V.|title=Language: Aphasia|year=2009|pages=343–348|doi=10.1016/B978-008045046-9.01876-3}}</ref>
:*[group1]
 
:*[group2]
:*[[Reproduction conduction aphasia]]
:*[group3]
:*[[Repetition conduction aphasia]]
*Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].
 
==Pathophysiology==
==Pathophysiology==
*The pathogenesis of [[conduction aphasia]] involves damage to [[arcuate fasciculus]]. [[Arcuate fasciculus]] is a [[white matter]] tract connecting [[Broca's]] and [[Wernicke's]] areas, the areas responsible for [[motor]] and [[sensory]] components of [[speech]]. Thus, when [[arcuate fasciculus]] is damaged the connection between [[Broca's]] and [[Wernicke's]] areas is lost. As a consequence, the transmission of information between the 2 speech centers is halted, leading to impairment of repetition.<ref name="urlConduction Aphasia - StatPearls - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK537006/#_NBK537006_pubdet_ |title=Conduction Aphasia - StatPearls - NCBI Bookshelf |author= Acharya AB, Maani CV |authorlink= |coauthors= |date= |format= |work= |publisher=statpearls publishing |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=}}</ref>
*The pathogenesis of [[conduction aphasia]] involves damage to [[arcuate fasciculus]]. [[Arcuate fasciculus]] is a [[white matter]] tract connecting [[Broca's]] and [[Wernicke's]] areas, the areas responsible for [[motor]] and [[sensory]] components of [[speech]]. Thus, when [[arcuate fasciculus]] is damaged the connection between [[Broca's]] and [[Wernicke's]] areas is lost. As a consequence, the transmission of information between the 2 speech centers is halted, leading to impairment of repetition.<ref name="urlConduction Aphasia - StatPearls - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK537006/#_NBK537006_pubdet_ |title=Conduction Aphasia - StatPearls - NCBI Bookshelf |author= Acharya AB, Maani CV |authorlink= |coauthors= |date= |format= |work= |publisher=statpearls publishing |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=}}</ref> Recent studies have indicated that conduction aphasia can result from brain damage to areas other than arcuate fasciculus, though the underlying mechanism involves disruption of connections between language centers. <ref name="pmid4696016">{{cite journal |vauthors=Benson DF, Sheremata WA, Bouchard R, Segarra JM, Price D, Geschwind N |title=Conduction aphasia. A clinicopathological study |journal=Archives of Neurology |volume=28 |issue=5 |pages=339–46 |date=May 1973 |pmid=4696016 |doi=10.1001/archneur.1973.00490230075011 |url= |issn=}}</ref>


==Causes==
==Causes==
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==Epidemiology and Demographics==
==Epidemiology and Demographics==
* The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
* [[Prevalenece]] of [[aphasia]] in United States is approximately 1 million.<ref name="urlAphasia: Incidence & Prevalence">{{cite web |url=https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934663&section=Incidence_and_Prevalence |title=Aphasia: Incidence & Prevalence |author= |authorlink= |coauthors= |date= |format= |work= |publisher= |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=}}</ref>
* In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
* The annual [[incidence]] of [[aphasia]] in [[United States]] is estimated to be [[180,000]] cases. <ref name="urlAphasia: Incidence & Prevalence">{{cite web |url=https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934663&section=Incidence_and_Prevalence |title=Aphasia: Incidence & Prevalence |author= |authorlink= |coauthors= |date= |format= |work= |publisher= |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=}}</ref> Separate epidemiological data for [[conduction aphasia]] is not availabe.
===Age===
*Patients of all age groups may develop [disease name].
*[Disease name] is more commonly observed among patients aged [age range] years old.
*[Disease name] is more commonly observed among [elderly patients/young patients/children].
   
   
===Age===
*[[Aphasia]] after [[stroke]] is more commonly observed among elderly patients. <ref name="pmid26916396">{{cite journal |vauthors=Ellis C, Urban S |title=Age and aphasia: a review of presence, type, recovery and clinical outcomes |journal=Topics in Stroke Rehabilitation |volume=23 |issue=6 |pages=430–439 |date=December 2016 |pmid=26916396 |doi=10.1080/10749357.2016.1150412 |url= |issn=}}</ref>
===Gender===
===Gender===
*[Disease name] affects men and women equally.
*[[Conduction aphasia]] affects men and women equally.
   
   
*[Gender 1] are more commonly affected with [disease name] than [gender 2].
* The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
   
   
===Race===
===Race===
*There is no racial predilection for [disease name].
*There is no racial predilection for [[conduction aphasia]].
*[Disease name] usually affects individuals of the [race 1] race.
*[Race 2] individuals are less likely to develop [disease name].


==Risk Factors==
==Risk Factors==
*Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
*Common risk factors in the development of [[conduction aphasia]] are [[stroke]], [[CNS infections]], [[tumor]]. <ref name="urlConduction Aphasia - StatPearls - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK537006/#_NBK537006_pubdet_ |title=Conduction Aphasia - StatPearls - NCBI Bookshelf |author= Acharya AB, Maani CV |authorlink= |coauthors= |date= |format= |work= |publisher=statpearls publishing |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=}}</ref>


== Natural History, Complications and Prognosis==
== Natural History, Complications and Prognosis==
*The majority of patients with [disease name] remain asymptomatic for [duration/years].
*Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
*If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
*Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
*Prognosis depends upon the underlying etiology. If the [[conduction aphasia]] occurs as a result of [[stroke]], then there is a probability of making a good recovery but persistent speech deficits may still remain. <ref name="urlConduction Aphasia - StatPearls - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK537006/#_NBK537006_pubdet_ |title=Conduction Aphasia - StatPearls - NCBI Bookshelf |author= Acharya AB, Maani CV |authorlink= |coauthors= |date= |format= |work= |publisher=statpearls publishing |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=}}</ref>
*Prognosis depends upon the underlying etiology. If the [[conduction aphasia]] occurs as a result of [[stroke]], then there is a probability of making a good recovery but persistent speech deficits may still remain. <ref name="urlConduction Aphasia - StatPearls - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK537006/#_NBK537006_pubdet_ |title=Conduction Aphasia - StatPearls - NCBI Bookshelf |author= Acharya AB, Maani CV |authorlink= |coauthors= |date= |format= |work= |publisher=statpearls publishing |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=}}</ref>


== Diagnosis ==
== Diagnosis ==
===Diagnostic Criteria===
===Diagnostic Criteria===
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
There is no established diagnostic criteria for the diagnosis of [[conduction aphasia]].
:*[criterion 1]
 
:*[criterion 2]
:*[criterion 3]
:*[criterion 4]
=== History and Symptoms ===
=== History and Symptoms ===
*Symptoms of [[conduction aphasia]] may include the following:<ref name="urlConduction Aphasia - StatPearls - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK537006/#_NBK537006_pubdet_ |title=Conduction Aphasia - StatPearls - NCBI Bookshelf |author= Acharya AB, Maani CV |authorlink= |coauthors= |date= |format= |work= |publisher=statpearls publishing |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=}}</ref><ref name="SwanbergNasreddine2007">{{cite journal|last1=Swanberg|first1=Margaret M.|last2=Nasreddine|first2=Ziad S.|last3=Mendez|first3=Mario F.|last4=Cummings|first4=Jeffrey L.|title=Speech and Language|year=2007|pages=79–98|doi=10.1016/B978-141603618-0.10006-2}}</ref>
*Symptoms of [[conduction aphasia]] may include the following:<ref name="urlConduction Aphasia - StatPearls - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK537006/#_NBK537006_pubdet_ |title=Conduction Aphasia - StatPearls - NCBI Bookshelf |author= Acharya AB, Maani CV |authorlink= |coauthors= |date= |format= |work= |publisher=statpearls publishing |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=}}</ref><ref name="SwanbergNasreddine2007">{{cite journal|last1=Swanberg|first1=Margaret M.|last2=Nasreddine|first2=Ziad S.|last3=Mendez|first3=Mario F.|last4=Cummings|first4=Jeffrey L.|title=Speech and Language|year=2007|pages=79–98|doi=10.1016/B978-141603618-0.10006-2}}</ref>


:*[[impaired repitition]]
:*[[impaired repetition]]
:*[[paraphasic errors]]
:*[[paraphasic errors]] e.g fireball → firewall
:*"[[conduit d’approache]]" (Often the responses are close to the target words, and the patient does repeated effort to correct the errors)
:*"[[conduit d’approache]]" (Often the responses are close to the target words, and the patient does repeated effort to correct the errors)
:*abnormal [[confrontational naming]]
:*abnormal [[confrontational naming]]
:* Disturbed loud voice reading
:* Difficulty reading in loud voice
:*[[Speech]] fluency, [[reading]], [[writing]] and [[comprehension]] may remain intact.
:*[[Speech]] fluency, [[reading]], [[writing]] and [[comprehension]] may remain intact.
In some cases, symptoms of [[conduction aphasia]] may only last for few hours or few days.


=== Physical Examination ===
=== Physical Examination ===
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===Other Diagnostic Studies===
===Other Diagnostic Studies===
There are no other diagnostic studies associated with [disease name].
Other diagnostic tests for [[conduction aphasia]] include [[Western Aphasia Battery-Revised]] and [[Boston Diagnostic Aphasia Examination]]. These tests assess attributes like comprehension, articulation, writing, problem-solving, and other features that can be affected by aphasia. <ref name="Roth2011">{{cite journal|last1=Roth|first1=Carole|title=Boston Diagnostic Aphasia Examination|year=2011|pages=428–430|doi=10.1007/978-0-387-79948-3_868}}</ref> <ref name="urlWAB-R Western Aphasia Battery-Revised">{{cite web |url=https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Speech-%26-Language/Western-Aphasia-Battery-Revised/p/100000194.html |title=WAB-R Western Aphasia Battery-Revised |author= |authorlink= |coauthors= |date= |format= |work= |publisher= |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=}}</ref>
 
OR
 
[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].


== Treatment ==
== Treatment ==
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=== Surgery ===
=== Surgery ===
* There is no surgical treatment directed for improvement of aphasia. However, surgery can be performed to eradicate certain causes leading to aphasia like tumors or infections. <ref name="urlConduction Aphasia - StatPearls - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK537006/#_NBK537006_pubdet_ |title=Conduction Aphasia - StatPearls - NCBI Bookshelf |author= Acharya AB, Maani CV |authorlink= |coauthors= |date= |format= |work= |publisher=statpearls publishing |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=}}</ref>
* There is no surgical treatment directed for improvement of [[aphasia]]. However, surgery can be performed to eradicate certain causes leading to aphasia like tumors or infections. <ref name="urlConduction Aphasia - StatPearls - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK537006/#_NBK537006_pubdet_ |title=Conduction Aphasia - StatPearls - NCBI Bookshelf |author= Acharya AB, Maani CV |authorlink= |coauthors= |date= |format= |work= |publisher=statpearls publishing |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=}}</ref>


=== Prevention ===
=== Prevention ===
*There are no primary preventive measures available for [disease name].
*There are no primary preventive measures available for [[conduction aphasia]].
*Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
 
*Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
==Presentation==
Patients with conduction aphasia show the following characteristics:
 
* speech is fluent
* comprehension remains good
* oral reading is poor
* Major Impairment in repetition
* many phonemic paraphasias (phone substitution errors)
* [[Transposition (mathematics)|transpositions]] of sounds within a word ("television" &rarr; "velitision") are common.


To understand the symptoms, recall that [[Broca's area]] is associated roughly with expression, [[Wernicke's area]] with comprehension.


With both areas intact but the neural connections between them broken, there is the curious condition where the patient can understand what is being said but cannot repeat it (or repeats it incorrectly). This patient will also end up saying something inappropriate or wrong, realize his/her mistake, but continue making further mistakes while trying to correct it.
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 03:47, 21 November 2020

Conduction aphasia
Broca's area and Wernicke's area
MeSH D018886

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Muneeb, MBBS[2] Synonyms and keywords: Dysphasia, Conduction; Associative Aphasia; Aphasia, Associative; Associative Aphasias; Dysphasias, Conduction; Aphasias, Associative; Conduction Aphasia; Conduction Dysphasias; Associative Dysphasias; Associative Dysphasia; Conduction Dysphasia; Dysphasias, Associative; Dysphasia, Associative; Aphasias, Conduction; Conduction Aphasias

Overview

Conduction aphasia, also called associative aphasia, is a relatively rare form of aphasia, thought to be caused by a disruption in the fiber pathways connecting Wernicke's and Broca's areas. The arcuate fasciculus is the most commonly involved pathway although evidence of other pathway involvement has also been found. Conduction aphasia is characterized by impaired repetition. Usually, writing, comprehension, and fluency remain intact. Neuroimaging can identify the underlying etiology. Speech therapy can improve recovery in patients suffering from conduction aphasia.

Historical Perspective

Classification

Pathophysiology

Causes

The most common cause of conduction aphasia is damage to arcuate fasciculus lying deep to left supra marginal gyrus. Other common causes of conduction aphasia include damage to other brain areas including leftsuperior temporal gyrus, left primary auditory cortices, insula and left inferior parietal lobe. Damage can be caused by multiple insults including stroke, tumors, infections. [6][7][4]

Differentiating conduction aphasia from other Diseases

  • Conduction aphasia must be differentiated from other diseases that cause speech/language problems such as:[4]

Epidemiology and Demographics

Age

Gender


Race

Risk Factors

Natural History, Complications and Prognosis

  • Prognosis depends upon the underlying etiology. If the conduction aphasia occurs as a result of stroke, then there is a probability of making a good recovery but persistent speech deficits may still remain. [4]

Diagnosis

Diagnostic Criteria

There is no established diagnostic criteria for the diagnosis of conduction aphasia.

History and Symptoms

In some cases, symptoms of conduction aphasia may only last for few hours or few days.

Physical Examination

  • Physical examination is usually normal but may be remarkable for different findings depending upon the part of brain damaged. These may include:[10]

Laboratory Findings

Electrocardiogram

There are no ECG findings associated with conduction aphasia.

X-ray

There are no x-ray findings associated with conduction aphasia.

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with conduction aphasia.

CT scan

Brain CT scan may be helpful in the diagnosis of underlying etiology of conduction aphasia. As conduction aphasia is caused by damage in dominant hemisphere so ct scan can show stroke, tumor, infection or other pathologies of dominant hemisphere. [4]

MRI

Brain MRI may also be helpful in the diagnosis of the underlying etiology of conduction aphasia, as it can identify the pathologies of dominant hemisphere including stroke, infection, tumor etc. [4]

Other Imaging Findings

There are no other imaging findings associated with conduction aphasia.

Other Diagnostic Studies

Other diagnostic tests for conduction aphasia include Western Aphasia Battery-Revised and Boston Diagnostic Aphasia Examination. These tests assess attributes like comprehension, articulation, writing, problem-solving, and other features that can be affected by aphasia. [11] [12]

Treatment

Medical Therapy

Surgery

  • There is no surgical treatment directed for improvement of aphasia. However, surgery can be performed to eradicate certain causes leading to aphasia like tumors or infections. [4]

Prevention


References

  1. Hickok G (September 2009). "The functional neuroanatomy of language". Physics of Life Reviews. 6 (3): 121–43. doi:10.1016/j.plrev.2009.06.001. PMC 2747108. PMID 20161054.
  2. Benson, D. Frank (1973). "Conduction Aphasia". Archives of Neurology. 28 (5): 339. doi:10.1001/archneur.1973.00490230075011. ISSN 0003-9942.
  3. Dronkers, N.F.; Baldo, J.V. (2009). "Language: Aphasia": 343–348. doi:10.1016/B978-008045046-9.01876-3.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 Acharya AB, Maani CV. "Conduction Aphasia - StatPearls - NCBI Bookshelf". statpearls publishing.
  5. Benson DF, Sheremata WA, Bouchard R, Segarra JM, Price D, Geschwind N (May 1973). "Conduction aphasia. A clinicopathological study". Archives of Neurology. 28 (5): 339–46. doi:10.1001/archneur.1973.00490230075011. PMID 4696016.
  6. Jiménez de la Peña MM, Gómez Vicente L, García Cobos R, Martínez de Vega V (2018). "Neuroradiologic correlation with aphasias. Cortico-subcortical map of language". Radiologia. 60 (3): 250–261. doi:10.1016/j.rx.2017.12.008. PMID 29439808.
  7. Damasio H, Damasio AR (June 1980). "The anatomical basis of conduction aphasia". Brain : a Journal of Neurology. 103 (2): 337–50. doi:10.1093/brain/103.2.337. PMID 7397481.
  8. 8.0 8.1 "Aphasia: Incidence & Prevalence".
  9. Ellis C, Urban S (December 2016). "Age and aphasia: a review of presence, type, recovery and clinical outcomes". Topics in Stroke Rehabilitation. 23 (6): 430–439. doi:10.1080/10749357.2016.1150412. PMID 26916396.
  10. 10.0 10.1 Swanberg, Margaret M.; Nasreddine, Ziad S.; Mendez, Mario F.; Cummings, Jeffrey L. (2007). "Speech and Language": 79–98. doi:10.1016/B978-141603618-0.10006-2.
  11. Roth, Carole (2011). "Boston Diagnostic Aphasia Examination": 428–430. doi:10.1007/978-0-387-79948-3_868.
  12. "WAB-R Western Aphasia Battery-Revised".

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