Mixed transcortical aphasia
What is mixed transcortical aphasia?
Mixed transcortical aphasia is a language disorder where the person tends to repeat words or phrases. It can also be called isolation aphasia and is considered a more severe form of aphasia. A person with mixed transcortical aphasia will have a very difficult time speaking on their own. The symptoms are similar to global aphasia, except that the person has an easier time repeating words or phrases.
Symptoms
What are the symptoms of mixed transcortical aphasia?
A person with mixed transcortical aphasia will usually have these symptoms:
- Very impaired spoken language
- Slow and halting (non-fluent) speech
- No rhythm or prosody when speaking
- Often able to repeat what someone else says
- Difficult time starting to speak or creating spontaneous language
- Difficulty reading
- Difficulty writing (and writing will look like how they speak)
Unlike with other types of aphasia, a person with mixed transcortical aphasia will often be able to repeat what someone else says very well, even if they have trouble starting to speak on their own or understanding what someone else says. They may even be able to repeat a three- or four-word sentence.
It’s important to know that a person with mixed transcortical aphasia hasn’t lost their intelligence; they’ve just lost their ability to speak or understand language as well as they could before.
Causes
What causes mixed transcortical aphasia?
Mixed transcortical aphasia is caused by damage to the language center areas of the brain. These centers include Broca’s area (which is responsible for language production) and Wernicke’s area (which is responsible for understanding language).
This type of damage is usually caused by an injury to the brain, such as after a stroke or traumatic brain injury (TBI).
Which part of the brain is affected?
Mixed transcortical aphasia is caused by damage near Broca’s area and Wernicke’s area, known as the language centers of the brain. In this case, the damage isolates these parts of the brain from the rest of the brain, rather than affecting them directly.
Diagnosis
How is mixed transcortical aphasia diagnosed?
A speech-language pathologist (SLP) will diagnose mixed transcortical aphasia based on a patient’s symptoms, usually after a stroke or TBI.
To diagnose mixed transcortical aphasia, the SLP will do a series a tests, such as:
- Asking the patient to speak or name objects
- Asking the patient to read
- Asking if they understand what is being said
- Scanning the brain through an MRI or CAT scan
Treatment
How is mixed transcortical aphasia treated?
The most common way to treat mixed transcortical aphasia is through speech therapy. This type of therapy is provided by a speech-language pathologist who will create a treatment plan based on the patient’s symptoms.
SLPs work with patients, their caregivers, and their families to help the patient re-learn how to speak or find new ways to communicate.
Some common therapies include:
- Communication boards – the patient can learn to point to images or phrases on a board to show what they mean to say if they can’t speak
- Augmentative and alternative communication ( AAC) devices – usually an electronic tablet that the patient can use to say pre-recorded words or phrases
- Drawing therapy – where the patient tries drawing what they mean to say, because drawing can bypass the language centers
- Music therapy – using music can help a person bypass the language centers of the brain and retrain the brain to understand and communicate
A medical provider may prescribe medicine to help with other aspects of the brain injury. Physical or occupational therapy may be part of the treatment plan, alongside speech therapy.
Recovery and prevention
Can mixed transcortical aphasia improve?
A patient with mixed transcortical aphasia may be able to speak and understand language again with the right therapy over time. Recovery depends on how much damage the brain has sustained and how much the patient is able to practice their speaking and understanding skills.
Studies have shown that patients who have support from friends, family, and caregivers often have better outcomes from speech therapy. This is because practicing the skills a patient learns in therapy is the best way to re-learn language or use the skills they still have to communicate.
There is no cure for mixed transcortical aphasia, but many patients can improve with speech therapy and other medical interventions.
Can mixed transcortical aphasia be prevented?
There is no way to prevent mixed transcortical aphasia. However, you can reduce your risk of developing it by:
- Living a lifestyle that helps reduce your risk of having a stroke
- Seeking treatment for stroke symptoms as quickly as possible
- Protecting your head during activities that could cause brain damage (e.g. wearing a helmet when you ride a bicycle or motorcycle)
Living with mixed transcortical aphasia
What is it like to live with mixed transcortical aphasia?
A person living with mixed transcortical aphasia will have a hard time communicating their needs and feelings in everyday life. This can make them feel very frustrated. They may also withdraw from social situations because they have such a hard time communicating.
It’s important for someone with mixed transcortical aphasia to get the speech therapy they need and to have support from a health care team, friends, family members, and caregivers.
What emotional or psychological effects can occur?
The most common feeling people with mixed transcortical aphasia report is frustration. They can feel left out of conversations when they have trouble saying what they mean or understanding what is said.
Many patients report feeling depressed or anxious.
