Conduction aphasia example cases and therapy

If you’re interested in learning about aphasia or suspect that someone you know may have conduction aphasia, you’ve come to the right place. This blog post talks about conduction aphasia example scenarios on how it manifests to patients and information on therapy used to treat this disorder.

What is Conduction aphasia?

Conduction aphasia is a language disorder that causes difficulty with repeating words or phrases but usually has good comprehension and spontaneous speech. The disorder is characterized by phonological paraphasias (substituting or deleting phonemes), impairments in naming, reading, and writing, and ideomotor apraxia. There are two main types of conduction aphasia: the efferent-reproduction type, involving phonemic organization and representation of words and correlated with parietal and insular damage, and the afferent-repetition type, involving short-term memory defects and associated with lesions of the temporal lobe.

Causes

The cause of conduction aphasia has been attributed to a disconnection between the superior temporal gyrus and the inferior frontal gyrus, but other explanations, including verbal memory defects and segmental ideomotor apraxia, have also been proposed. The recovery in conduction aphasia is generally good and sometimes complete. Although most patients diagnosed with conduction aphasia have some anomia and reading difficulties, the disorder is not typically a pure repetition disorder, and features of the condition relate more to a cortical deficit than a pure disconnection mechanism.

Role of arcuate fasciculus

Conduction aphasia is traditionally explained as a disconnection syndrome between Wernicke’s and Broca’s areas due to a lesion affecting the arcuate fasciculus (AF). However, most cases of AF lesions are not limited to the AF boundaries, and cortical lesions alone without a subcortical extension may also produce conduction aphasia. Therefore, the specific role of the AF in conduction aphasia is difficult to ascertain. To better understand conduction aphasia, it is essential to further understand the neurophysiology of vocal repetition in both animals and humans.

Characteristics of Conduction Aphasia

People with conduction aphasia have difficulty repeating words or phrases but can still read, write, and speak fluently. They understand what others say, but they cannot repeat it verbally. They may be able to write down what is said to them, although longer and more complex sentences can be challenging. Self-correction is common in people with conduction aphasia, as they are aware of their errors and try to correct them. While rare, some people with conduction aphasia may also have difficulty finding the right words to express themselves (anomic aphasia). Here are examples of how conduction aphasia manifests:

Can Read but Cant Repeat Verbally

Imagine that a person with conduction aphasia is having a conversation with a friend. Their friend asks them what they had for breakfast that morning, and the person with conduction aphasia replies, “I had…I had…uhh…I had…I had oatmeal!” They were able to retrieve the word “oatmeal” from their memory but had difficulty repeating it initially.

Can Understand but Cant Repeat Verbally

Later in the conversation, their friend tells them a funny joke and asks them to repeat it to someone else. The person with conduction aphasia tries to repeat the joke but struggles to get the words out correctly. They say, “There was a…there was a man who walked into a bar…no, no, there was a man who…a man who…went into a bar…wait, wait, let me try that again.” They continue to attempt self-correction until they are finally able to say the joke correctly.

Here is another Youtube video example of how conduction aphasia manifests:

Can Write but Cant Repeat Verbally

Imagine that a person with conduction aphasia is attending a meeting at work. Their boss is giving a presentation with a lot of technical jargon and complex sentences. While the person with conduction aphasia can understand the presentation’s overall gist, they struggle to repeat or verbally summarize the information. However, they are able to take notes and write down key points as their boss speaks.

Later, when the meeting is over, the person with conduction aphasia reviews their notes and can better understand the information presented. They may even use their notes to summarize the presentation for others or write a report on the topic.

Diagnosis

Doctors use standardized tests like the BDAE and WAB to diagnose and classify different types of aphasia, including conduction aphasia. These tests may involve tasks such as naming pictures, reading words, and repeating words and non-words. Neuro-imaging, like MRIs or CT scans, can also identify the underlying cause of the aphasia, such as a stroke or tumor.

Treatment

The primary treatment for conduction aphasia is speech therapy, specifically sentence repetition therapy. This therapy utilizes neuroplasticity, which is the brain’s capability to reorganize itself by forming new neural connections and pathways throughout a person’s lifetime. By practicing repeating sentences, patients can rewire their brains and recover some function, allowing healthy parts of the brain to control the other parts previously controlled by injured ones.

Here are some examples of how sentence repetition therapy is typically done for individuals with conduction aphasia:

1. The speech therapist reads a sentence out loud to the patient.
2. The patient then repeats the sentence back to the therapist.
3. If the patient is successful in repeating the sentence, the therapist moves on to a new sentence. If the patient struggles, the therapist may break the sentence down into smaller segments for easier repetition.
4. The therapist provides feedback to the patient on their accuracy and encourages them to practice the sentence throughout the week.
5. The following week, the therapist repeats the process with a new set of sentences.

Over time, the sentences may become longer and more complex as the patient improves their ability to repeat phrases. In addition to sentence repetition therapy, speech therapists may also use other techniques, such as semantic feature analysis, which involves identifying key attributes of words, to help individuals with conduction aphasia improve their language skills.