Dr Raghuveer Choudhary Asstt. Prof. Department of PhysiologyDr S.N.Medical CollegeJodhpur
Physiology of Language and speech
Language is one of the fundamental bases of human intelligence and a key part of human culture.
To understand the spoken & printed words & to express ideas in speech & writing is called Language.
Physiology of Language
Language: refers to vocabulary & syntax independent of mode of production or comprehension
Speech: actual production or writting
Vocalization: production of sound without linguistic content
Types of speech
1. Spoken speech:
understanding spoken words & expressing ideas in speech
2. Written speech:
understanding written words and expressing ideas in writing
Categorical Hemisphere Representational Hemisphere
Functions alloted to left hemishere in right handed person
Right hand control Spoken language Written language Mathematical skills Scientific skills Reasoning
Functions alloted to right hemishere in right handed person
Left hand control Music awareness Art awareness 3 dimensional
awareness Imagination insight
Cerebral Dominance
Categorical hemisphere- analytic processes Representational hemisphere- visuospatial
relations 90% left hemisphere is categorical 70% of left handed have left hemisphere
dominance
Language areas of brainBroca’s area: anterior speech areaLocation- 3rd frontal gyrusDetailed and co-ordinated pattern of vocalization
Important Areas for Language
The primary brain areas concerned with language
are arrayed along and near the sylvian fissure (lateral cerebral sulcus) of the categorical hemisphere.
A region at the posterior end of the superior temporal gyrus called Wernicke’s area is concerned with comprehension of auditory and visual information.
It projects via the arcuate fasciculus to Broca’s area (area 44) in the frontal lobe.
Anatomy of language areas
Important Areas for Language
Exners Area
Dejerine area
Wernicks area
Broca’s area processes the information received from Wernicke’s area into a detailed and coordinated pattern for vocalization
and then projects the pattern via a speech articulation area in the insula to the motor cortex, which initiates the appropriate movements of the lips, tongue, and larynx to produce speech.
The angular gyrus behind Wernicke’s area appears to process information from words that are read in such a way that they can be converted into the auditory forms of the words in Wernicke’s area.
Location of language areas
Brain Areas Concerned with Language
Wernick’s Area(22) Broca’a Area(44,45) Motor writing area(Exners Area)(6) Motor Cortex Angular Gyrus(Dejerine Area)(39)
Broca’s and Wernicke’s: Summary
Lesion (injury) studies: Show that a brain area is necessary for a given task Without Broca’s area, you can’t produce speech Without Wernicke’s area, you can’t understand speech
If you lose these areas, you lose languageWhen you use language, you use those areas
Types of speech
1. Spoken speech:
understanding spoken words & expressing ideas in speech
2. Written speech:
understanding written words and expressing ideas in writing
Mechanism of speech
Primary auditory cortex/primary visual area
Auditory/visual association areas
Dejerine’s area
Wernicke’s area
Arcuate fasciculus
Broca’s area
Exner’s area
Motor area
Vocalization/Writing
The probable sequence of events when a subject names a visual object(horizontal section of hum-an brain)
It is interesting that in individuals who learn a second language in adulthood,
fMRI reveals that the portion of Broca’s area concerned with it is adjacent to but separate from the area concerned with the native language.
However, in children who learn two languages early in life, there is only a single area involved with both.
Speech/Language Disorders
Aphasias: Abnormalities of language functions not due to defects of vision, hearing or motor system
Classification:
1. Fluent aphasia
2. Non-fluent aphasia
3. Anomic aphasia
Aphasias
Aphasias are abnormalities of language functions that are not due to defects of vision or hearing or to motor paralysis. They are caused by lesions in the categorical hemisphere.
The most common cause is embolism or thrombosis of a cerebral blood vessel.
Fluent(sensory), nonfluent (motor), and anomic aphasias.
In nonfluent aphasia (EXPRESSIVEAPHASIA,MOTOR APHASIA)
the lesion is in Broca’s area
Speech is slow, and words are hard to come by.
Patients with severe damage to this area are limited to two or three words with which to express the whole range of meaning and emotion.
The words retained are those which were being spoken at the time of the injury or vascular accident that caused the aphasia.
Paul Broca and “Tan”
In 1861, Broca examined a patient nicknamed “Tan,” after the syllable he said most often.
The area of damage in Tan’s case is now known as “Broca’s area.”
Broca’s area: crucial for speech production
Tan’s brain: lesion (injury) in left frontal cortex
Paul Broca (1861): patient "Tan”• Severe deficit in speech production: could only say
“tan”• Good language comprehension
Nonfluent aphasia (Motor aphasia):
Slow & effortful
No grammar
Telegraphic speech
Incorrect writing/agraphia
Good comprehension
Nonfluent aphasia (Motor aphasia): Broca’s area contains memories of the sequences
of muscular movements that are needed to articulate words
Often become frustrated by their inability to speak correctly; however, comprehension is not perfect
Difficulty in comprehending meaning from word order (“The horse kicks the cow” vs. “The cow kicks the horse”)
Nonfluent aphasia (Motor aphasia): 3 major speech deficits with Broca’s aphasia:
Agrammatism – difficulty in comprehending or properly employing grammatical devices, such as verb endings and word order
Anomia – difficulty in finding (remembering) the appropriate word to describe an object, action, or attribute
Difficulty with articulation – mispronounce words, often realizing it afterwards, and trying to correct it
Fluent Aphasia ( RECEPTIVE APHASIA, SENSORY APHASIA)
Lesion in the wernicke’s area
Speech itself is normal and sometimes the patients talk excessively.
However, what they say is full of jargon and neologisms that make little sense.
The patient also fails to comprehend the meaning of spoken or written words.
SENSORY APHASIA
Difficulty in understanding the meaning of speech
Motor speech is intact,so patient talk fluently Anomia-inability to find an appropriate word to
express a thought Neologism-creating new words or meaning for
established words Impairment in reading and writing
Speech comprehension
Must not just recognize words, we must understand their meaningWernicke’s area contains neural circuits that accomplish this task
Wernicke’s aphasia – a form of aphasia characterized by poor speech comprehension and fluent but meaningless speech
Comprehension tested by directing movement toward objects asked about by experimenter is also poor (e.g. “Point to the ink bottle” – patient cannot point to ink bottle)However, patients seem unaware of their deficit, unlike with Broca’s aphasia
They do not recognize that their speech is faulty, nor that they do not comprehend other speech
Wernicke suggested that this area is a location where memories of the sequences of sounds that constitute words are stored
Broca’s and Wernicke’s Aphasia
Damage to Wernicke’s area. Speech is fluent, but
meaningless. Comprehension is very
poor. Sound substitutions are
common. Repetition is poor.
Damage to Broca’s area. Speech is not fluent. Comprehension is
affected, but good. Repetition is very poor.
conduction aphasia Lesion in the auditory cortex (areas 40, 41 &42)patients can speak relatively well and have good auditory comprehension but cannot put parts of words together or conjure up words. This is called conduction aphasia because it was thought to be due to lesions of the arcuate fasciculus connecting Wernicke’s and Broca’s areas.
Conduction Aphasia
Damage to arcuate fasciculus.
Speech production is good.
Comprehension is good.
Sound substitutions are common.
Repetition is poor.
Anomic aphasia:
Injury to angular gyrus
Difficulty in understanding written language and pictures
Global aphasia:
Injury to both broca’s & wernicke’s area
Anomic Aphasia When there is a lesion damaging the angular gyrus.
There is trouble understanding written language or pictures, because visual information is not processed and transmitted to Wernicke’s area.
Type of Aphasia andSite of Lesion
Characteristic NamingErrors
Nonfluent (Broca’s area)
Fluent (Wernicke’s area)
Fluent (areas 40, 41 and 42; conduction aphasia)
Anomic (angular gyrus)
“Tssair”
“Stool” or “choss” (neologism)invented word
“Flair . . . no, swair . . . tair”
“I know what it is . . . I have a lot of them”
Aphasias. Characteristic responses ofpatients with lesions in various areas when
shown a picture of a chair
AREA LESION FAETURES
auditory association areas
word deafness
visual association areas
word blindness called dyslexia
Wernicke's AphasiaGlobal Aphasia
unable to interpret the thought Sensory Aphasia
Broca's Area Causes Motor Aphasia
GLOBAL APHASIA (CENTRAL APHASIA)
This means the combination of the expressive problems of Broca's aphasia and the loss of comprehension of Wernicke's.
The patient can neither speak nor understand language.
It is due to widespread damage to speech areas and is the commonest aphasia after a severe left hemisphere infarct.
Writing and reading are also affected.
Global Aphasia
Damage to Broca’s area, Wernicke’s area and the arcuate fasciculus.
Abilities to speak, comprehend and repeat are impaired.
ANOMIC
NON FLUENT
GLOBAL
APHASIA
FLUENT
BROCA'S AREA• WERNICK’S AREA
CONDUCTION APHASIA
ANGULAR GYRUS
WIDESPREAD DAMAGE TO SPEECH AREAS
EXPRESSIVE RECEPTIVE
Language
Broca’s area: Involves articulation of speech. In damage, comprehension of speech in unimpaired.
Wernicke’s area: Involves language comprehension. In damage, language comprehension is destroyed, but speech is
rapid without any meaning. Angular gyrus:
Center of integration of auditory, visual, and somatesthetic information.
Damage produces aphasias. Arcuate fasciculus:
To speak intelligibly, words originating in Wernicke’s area must be sent to Broca’s area. Broca’s area sends fibers to the motor cortex which directly controls the
musculature of speech.
Dyslexia: Impaired ability to readPhonemic deficitArtists, musicians, mathematicians
Dysarthria:Imperfect vocalizationDefect in motor areas & their connections
Dyslexia which is a broad term applied to impaired ability
to read, due to an inherited abnormality.
Causes of Dyslexia:
1. Reduced ability to recall speech sounds, so there is trouble translating them mentally into sound units (phonemes).
2. There is a defect in the magnocellular portion of the visual system that slows processing and also leads to phonemic deficit.
3. There is decreased blood flow in angular gyrus in categorical hemisphere in both cases.
Brain Activation During Reading
Reader with dyslexia shows less activation of Wernicke’s area and the angular gyrus and more activation of Broca’s area.
DYSARTHRIA
Slurred speech. Language is intactParalysis, slowing or incoordination of muscles of articulation or local discomfort causes various different patterns of dysarthria.
DISORDERED ARTICULATION
Examples • 'gravelly' speech of upper motor neurone
lesions of lower cranial nerves, • jerky, ataxic speech of cerebellar lesions
(Scanning Speech), • the monotone of Parkinson's disease
(Slurred), • speech in myasthenia that fatigues and dies
away. Many aphasic patients are also somewhat dysarthric.
nasal tract
(hard) palate
oral tract
velum (soft palate)
velic port
tongue
tongue tip
pharynx
glottis(vocal folds and
space between vocal cords)
vocal folds (larynx)= vocal cords
alveolar ridge
lips
teeth
The Speech Production Apparatus (from Olive, p. 23)
Acoustic Phonetics: Anatomy
Acoustic Phonetics: Anatomy
Types of phonation (from Daniloff, p. 194)
quietbreathing
forcedinhalation
normalphonation whisper
Recognition of face
Right inferior temporal lobe Prosopagnosia Autonomic changes
An important part of the visual input goes to the inferior temporal lobe, where representations of objects, particularly faces, are stored.
In humans, storage and recognition of faces is more strongly represented in the right inferior temporal lobe in right-handed individuals, though the left lobe is also active.
Lesions in this area cause prosopagnosia, the inability to recognize faces.
They can recognize people by their voices, and many of them show autonomic responses when they see familiar as opposed to unfamiliar faces.
However, they cannot identify the familiar faces they see.
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