Broca’s aphasia
What is Broca’s aphasia?
Broca’s aphasia (or Broca’s expressive aphasia) is a type of aphasia in which the person knows what they want to say but can’t produce the words or sentence they mean. It is the most common type of non-fluent aphasia.
It’s also known as non-fluent aphasia or expressive aphasia. People with Broca’s aphasia are often aware of their communication difficulties.
Symptoms
What are the symptoms of Broca’s aphasia?
The main symptoms of Broca’s aphasia are:
- Having a hard time speaking, or speaking in a labored or halting way
- Having a limited vocabulary
- Difficulty with small words (prepositions, articles, conjunctions) that they may leave out when speaking
- Disjointed or scrambled sentences
- Substituting words (like “pen” for “pencil” or “week” for “month”)
- Mixing up opposite words (like yes and no, or he and she)
- Writing may mirror speech
Causes
What causes Broca’s aphasia?
Broca’s aphasia is caused by damage to Broca’s area in the brain. This is most often due to a stroke (ischemic or hemorrhagic stroke) or traumatic brain injury, although people can also develop Broca’s aphasia due to brain tumors, brain infections, or conditions like Alzheimer’s or Primary Progressive Aphasia.
Which part of the brain is affected?
Broca’s area is on the left side of the brain in the frontal lobe (near the temple). The area is named for French scientist Paul Broca. It is responsible for producing language.
Diagnosis
How is Broca’s aphasia diagnosed?
A medical provider will diagnose what caused the Broca’s aphasia with exams, such as neurological and physical evaluations. The provider will also review your health history. They may request imaging test of your brain, such as an MRI, CT scan, or PET scan, to look for damage to the brain.
A speech-language pathologist (SLP) will often do a language test to diagnose aphasia. This test will usually consist of asking you to:
- Repeat phrases
- Follow commands
- Name objects (“chair”, “pencil”, “bed”)
- Read or write
Treatment
How is Broca’s aphasia treated?
Treatment for Broca’s aphasia is tailored to your symptoms. The most common treatment is speech therapy with an SLP. The SLP will work to help you find ways to communicate, such as:
- Word finding strategies
- Communication boards
- Augmentative and alternattive communication (AAC) devices
- Musical therapy
Your healthcare team may also recommend medications or physical and occupational therapy based on your physical diagnosis.
Many patients with Broca’s aphasia also rely on their friends, family, and other care partners to help them re-learn communication and manage their quality of life.
Recovery and prevention
Can Broca’s aphasia improve?
There is no cure for Broca’s aphasia, but with speech therapy and home practice, Broca’s aphasia can often improve. However, this depends on the extent of damage done to the language processing area.
Many patients experience a period of rapid aphasia improvement within the first year after a stroke or brain injury.
Can Broca’s aphasia be prevented?
There is no way to prevent Broca’s aphasia. However, you can reduce your risk of a stroke or traumatic brain injury, which can reduce your risk of developing Broca’s aphasia.
To prevent brain damage from a stroke or TBI, follow your medical provider’s advice on living a stroke-prevention lifestyle and always wear protective gear on your head when engaging in any activity that could harm your brain (like wearing a helmet when riding a bike or motorcycle, for example).
Living with Broca’s aphasia
What is it like to live with Broca’s aphasia?
For someone with Broca’s aphasia, they often feel they have the words “on the tip of my tongue”. People with Broca’s aphasia usually have trouble speaking easily and will have frequent starts and stops.
Another symptom of Broca’s aphasia is that when a person speaks a sentence, it will have an incorrect word order or grammar (syntax). You may leave words out, replace words, or repeat words when speaking.
In Broca’s aphasia, the person will usually have more trouble with speaking than they will with reading, listening, or writing. Generally, a person with Broca’s aphasia will be able to understand what someone says but will have a hard time responding. They will often have an easier time with simpler sentences.
Someone with Broca’s aphasia can also have less obvious issues with communication. This might include having yes/no confusion, or saying yes when they mean no. They may also have a hard time using the right pronouns (so they might say “he” when referring to a woman, for example).
Patients with Broca’s aphasia will often rely on speech therapy with an SLP to regain their communication skills or learn new ways to communicate. It’s also important for loved ones to be part of ongoing therapy for the best outcomes.
What emotional or psychological effects can occur?
Because they have difficulty speaking, but can still understand, people with Broca’s aphasia often report feeling frustrated. They may also experience isolation, especially if they are left out of conversations or social situations.
Broca’s aphasia can make it difficult to speak, which can make people tired. They may also develop depression or withdraw from social situations.
It’s important for people with Broca’s aphasia to have strong support from friends and family. Often, practicing speech can help improve their ability to communicate over time.
A medical provider may also prescribe mental health treatments such as medications or therapy to help a person with Broca’s aphasia.
