Transcortical motor aphasia
What is transcortical motor aphasia?
Transcortical motor aphasia (TMA or TMoA) is a type of aphasia that is similar to Broca’s aphasia. It is a non-fluent aphasia, usually caused by a stroke or traumatic brain injury (TBI) that causes injury near Broca’s area. Broca’s area is the area of the brain responsible for making language.
TMA is less common than Broca’s aphasia. People who have it usually have trouble with spoken language. Compared to Broca’s aphasia, people with TMA will usually have an easier time understanding spoken language.
Symptoms
What are the symptoms of transcortical motor aphasia?
People with TMA usually have halting speech with a lot of starts and stops. They usually are still good at repeating words and phrases, and tend to be better at repetition than speaking on their own.
As an example, a person with TMA may have no trouble repeating the sentence, “I went to the store today and bought oranges.” However, they may have trouble answering if someone asks, “Where did you go today?”
Other symptoms of TMA include:
- Having trouble finding words or feeling words are “on the tip of my tongue”
- Difficulty with sentence structure and “functor” words (articles, prepositions)
- Tending to use content words like nouns and verbs
- Slow and halting speech without intonation or rhythm
- Having a hard time starting to speak
- Difficulty with writing (often their writing will be similar to their spoken language)
A person with TMA may have no trouble understanding other people’s speech, or they only have a little bit of trouble with it.
Transcortical motor aphasia can be more or less severe. For example, a person with mild TMA might have trouble finding words and creating complex sentences, but not show other symptoms. A person with more severe TMA might be unable to speak.
Causes
What causes transcortical motor aphasia?
Transcortical motor aphasia is caused by a brain injury near Broca’s area. This is often due to a stroke or other accidents that impact the brain.
Which part of the brain is affected?
TMA affects the area near Broca’s area the brain. Broca’s area is the part of the brain responsible for producing language.
Diagnosis
How is transcortical motor aphasia diagnosed?
A medical professional such as a doctor or neurologist will diagnose what caused the aphasia (i.e. stroke or TBI) through a series of tests and exams. This may include brain scans, such as CT or MRI scans, as well as physical exams and speaking or comprehension tests.
A speech-language pathologist will conduct language tests to diagnose aphasia, and diagnose the type of aphasia. SLPs are specially trained professionals who have an in-depth understanding of language and the parts of the brain associated with each aspect of speaking, reading, understanding, and writing.
Treatment
How is transcortical motor aphasia treated?
Transcortical motor aphasia is best treated through speech therapy. An SLP will work with you to help you regain your ability to speak, or find new ways to communicate.
You may also have physical and occupational therapy to improve other aspects of your health alongside speech therapy.
A medical provider may also prescribe medications to help with other conditions that could treat the symptoms of stroke.
Additionally, doctors and speech-language pathologists will work with your caregivers and loved ones to help them in your treatment. For example, they will teach the people you interact with several methods to help you, such as:
- Giving you extra time to respond
- Cueing you by giving you hints to words (“it starts with a ‘p’ sound”)
- Using text to help you retrain your brain
Recovery and prevention
Can transcortical motor aphasia improve?
Depending on how severe the brain injury was, TMA can improve over time and with the right speech therapy. Many patients with TMA may experience more severe aphasia symptoms immediately after brain injury or stroke, but will start regaining language slowly over time.
Practicing in speech therapy and at home can help improve TMA over time.
Can transcortical motor aphasia be prevented?
There isn’t any way to prevent TMA completely. However, you can reduce your risk by following medical guidelines to reduce the risk of stroke and wearing a helmet or protective gear when doing any activity that can hurt your head.
It’s also important to know the signs of a stroke and call emergency services immediately for treatment. This can reduce the amount of damage done to the brain during a stroke.
Living with transcortical motor aphasia
What is it like to live with transcortical motor aphasia?
Living with transcortical motor aphasia usually means a person has a hard time speaking on their own. With speech therapy and other treatments, they can often regain some ability to speak and communicate.
It’s important to note that most people with TMA do not have any trouble understanding what other people are saying. They also don’t have intellectual defects.
A speech-language pathologist may recommend a person with TMA use augmentative and alternative communication (AAC) to help them communicate. This can include high-tech devices like Lingraphica’s AAC device, or low-tech tools like communication boards.
AAC devices can be helpful to “cue” speech for people with TMA by using pre-recorded words, phrases, or sentences that a person with TMA can follow along or repeat.
What emotional or psychological effects can occur?
People with transcortical motor aphasia have a hard time speaking, which can be frustrating. They may stop talking altogether out of frustration or embarrassment. This can lead them to withdraw from their daily lives, which can also lead to anxiety or depression.
It’s important for people with TMA to find safe places to practice their speech outside of speech therapy.
