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PSYB65 - Lec 10 (near verbatim).docx

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Ted Petit

Lec 10: PSYB65 Last week talked about how brain is lateralized, how the right hemi doesn’t do the same thing as the left; right = primarily used in language; talked about how that developed both during evolution and you as an individual; what the right hemi did = more spatial -left hemi, at least in right handed ppl is involved in speech (left hemi is involved in speech in ALL ppl but if you’re left handed, you also have involvement of the right hemi) Today: How speech functions in the left hemisphere, how speech is organized in left hemisphere *what problem you have depends on where the stroke/tumor is and how big it is; if really big  Most language comes in in terms of what you hear, temporal lobe towards the back (receptive area for audition); Wernicke’s area = for receiving and understanding and integrating language; motor output is in frontal cortex (primary motor strip); area where language gets out = Broca’s area = mouth motor cortex  Language is organized in terms of coming thru the ear being decoded and then recoded and then moved to Broca’s area to get it out, in terms of speaking language; association cortex just in front of the primary motor strip  Whenever we hear something, there’s a part of the brain in the temporal lobe, closely associated with the part of the brain that is associational cortex which is very close to the primary receptive area for audition and it decodes and then helps us recode and understand; output of speech is a motor function (it’s more than simply moving mouth and tongue, you have to plan all of that also = part of associational cortex (higher order cortex which is involved in the output, which is in the motor cortex just in front of your primary motor strip = Broca’s area)  What happens when these diff areas get damaged? o Leads to aphasias o Aphasia really means that the person has NO language BUT we never really use it in that way; it should actually be called DYSPHASIA (but we don’t usually use this); we usually say a person has a mild aphasia, severe aphasia and diff types of aphasia o alexia = deficit in reading o agraphia = problem in writing o aphasia = having some sort of large language problems  3 major types of aphasias: o 1) Receptive aphasias: aphasias that deal with receiving and understanding language; decoding o 2) Integrative aphasias: problems in comprehension and formation of language o 3) Expressive aphasias: problems in expressing language, getting language out -in hospital setting, can do complicated tests but then at the beginning ask them to do simple things so you get an idea of what they can and can’t do -can they obey a command? (touch nose, point to ceiling)  check if they understand what you’re saying (comprehend you; assuming that they have no motor problem) -can they name objects? -more specifically, can ask them to read, write or speak (repeating). -can determine what a person can and can’t do, therefore can determine type of aphasia Receptive Aphasia (1):  1) Pure word deafness o Involves problems in relating incoming sounds into representations which allow the understanding of discourse  person can hear the sounds but they can’t distinguish language, don’t hear it as language, can’t understand it as language (ex: say you’re in a Chinese restaurant, others are speaking in Chinese; you can hear them, but you can’t decipher it)  sounds like gibberish o Patient quote: Voice comes, but no words; I can hear, sounds come, but words don’t separate. There’s no trouble at all with sound. I can hear sounds, but I can’t understand it. o The comprehension portion of the brain isn’t functioning o These patients have normal ability to read, write and speak; all normal language functions are intact, they just can’t break the noise down into something that makes sense as language o Can’t understand what anybody is saying to you o May or may not know that they have a problem o What happens when they hear themselves speak? Depending on the damage, they can’t understand their own speech. Sometimes, they’ll hear themselves and think that they’re speaking gibberish, start to panic (think they’ve had a stroke or something); BUT their speech is perfectly fine, someone else hearing them will think that their speech is perfectly normal, they themselves CAN’T understand what they say o Can recognize ppl’s voices (b/c tonal info is in right hemi) b/c has nothing to do with language o Associated with damage just outside the primary receptive area/immediately adjacent to it; generally, the concept of being able to hear something but not understand is due to damage in this area Integrative Aphasias (6):  Integrative Aphasias: problems in selecting and arranging meaningful units and their eventual conversion into comprehensible, coherent speech; this is about truly being able to comprehend what speech/language means, not only being able to hear it, but when you hear it, does it make any sense to you and can you put it together?  1) Wernicke’s Aphasia: worst type o aka: jargon aphasia; person speaks gibberish o speak unintelligible statements (primary) o if really big tumor/stroke, get classic Wernicke’s aphasia; if small, will get mild Wernicke’s aphasia; severity is related to size and location of damage to the brain o often, will talk for long periods of time without making any sense BUT rhythm of language is intact (sounds like correct language), they pause  has tonal qualitities; assumption = because tonal quality of language is in the right hemi (deals with music/tonal abilities) o really extreme cases, may not make up recognizable words (not real words) o usually can’t name an object very well o in milder cases, usually fairly close at naming objects (usually normal ppl tend to do that too) but this is especially characteristic of mild cases of Wernicke’s aphasia o sometimes use jargon o generally not able to come up with the word o these ppl have lost an awareness of what language is, so it doesn’t even bother them; generally not depressed o are able to use objects and utensils correctly o respond poorly to commands b/c don’t understand what you’re saying o can’t repeat things b/c can’t decipher that language and get it back together again o it’s easier for them if it’s a mild stroke = can say things that are very well rehearsed but you have to get them to understand TO REPEAT; possibility that some of these overlearned things are in the right hemi (learn b4 we were 6; things that we repeat constantly maybe stored elsewhere in the brain) o IQ usually down b/c can’t understand what to do o Can sing just fine except that they sing with jargon; have tonal qualities of song and if it’s a simple song that they’ve been singing for ever, then they’ll get part of the little song right but they add in jargon o Little evidence that they can read and comprehend written language; even if they can’t understand written language, they can read aloud fairly well o Write gibberish/jargon that they would speak (writing is just as bad) These other integrative aphasias are not as devastating, but whenever ppl have them, it is mildly irritating.  2) Nominal aphasia o aka anomia; can’t come up with a name; problems with names o show object, can’t name it o do the same things that normal ppl do when we can’t come up with a name right away; we search around and we eventually come up with it; these patients search around also but sometimes, they may still not be able to c
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