At age 67, American movie star Bruce Willis announced recently that he was diagnosed with aphasia, a neurological condition affecting language. Bruce Willis is not the first celebrity to go public about their neurological disorders. Other famous celebrities with neurological disorders include Michael J Fox with Parkinson Disease, Selma Blair with Multiple Sclerosis, and Tony Bennett with Alzheimer’s Disease. Let’s dive in and learn about aphasia.
Definition of Aphasia
Aphasia is a condition of abnormal language expression, repetition, and comprehension rather than a diagnosis of a disease. The language center of the brain is located in your dominant hemisphere which for most people is the left hemisphere. Aphasia results from neurological diseases that damage the area of the brain responsible for language. Aphasia does not include developmental disorder of language, stuttering or slurred speech, or thought disorders and psychosis.
Types of Aphasia
There are many types of aphasia that can be identified with a careful neurological exam and testing.
- Broca’s aphasia (expressive aphasia) – You may have difficulty using words or sentences. Broca area is located in the dominant inferior frontal lobe and is responsible for spontaneous speech production.
- Wernicke’s aphasia (receptive aphasia) – You may have difficulty understanding others. Wernicke area is located in the dominant superior temporal gyrus and is responsible for speech comprehension.
- Global aphasia – You may have both difficulty using and understanding words.
What Causes Aphasia
The sign and symptom of aphasia is a result from damage to the language center of the brain. It can develop rapidly or gradually with time depending on the neurological disease causing the aphasia.
- Stroke
- Brain Bleed
- Traumatic Head Injury
- Brain Tumors
- Alzheimer’s Dementia and other dementias
- Seizures
How Is Aphasia Diagnosed
The diagnosis starts with a thorough history and neurological examination with mental status examination testing done by your neurologist. The history is usually provided by family members if you are unable to provide the information.
Your neurologist will likely order neuroimaging such as a CT scan or MRI to locate and identify the cause of your aphasia. In certain instances, your neurologist may order a PET or SPECT scan to detect hypometabolism and decreased blood flow in a person with dementia.
You may undergo a brain wave test called an electroencephalogram ( EEG) to exclude seizure activity as the cause of your aphasia.
Comprehensive neuropsychological testing done by a psychologist will be helpful to assess your language skills and better guide your treatment. You may be tested on:
- Naming common objects
- Engaging in conversation
- Understanding and using words
- Answering questions about something your read or heard
- Repeating words and sentences
- Reading and writing
- Following instructions
Treatments for Aphasia
Recovery from aphasia varies and depends on many factors including age, cause of aphasia, extent of brain injury, and timing to intervention. The main goal of treatment is functional recovery so you can go on with your daily activities. The recovery process may be very slow. Because of his aphasia, Bruce Willis is stepping away from acting but hopefully with good therapy he may return to the acting again.
- Speech and Language Rehabilitation
- Medication is considered experimental and being studied – So far dopaminergic, cholinergic, and stimulant drugs have not shown any benefits. SSRI drugs may improve mood and behavior problems. Memantine (Namenda) and piracetam show some benefit in a small study.
- Brain Stimulation Devices – Transcranial magnetic stimulation and transcranial direct current stimulation are being studied.
- Psychological support from family and friends