Editing Receptive aphasia (section)

==Signs and symptoms==
The following are common symptoms seen in patients with Wernicke's aphasia:
* ''Impaired comprehension'': deficits in understanding (receptive) written and spoken language.<ref name="Brookshire" /> This is because Wernicke's area is responsible for assigning meaning to the language that is heard, so if it is damaged, the brain cannot comprehend the information that is being received.
* ''Poor word retrieval'': ability to retrieve target words is impaired.<ref name="Brookshire" /> This is also referred to as '''''anomia''''', and it is often classified into the following subsets:
** ''Word-selection anomia'': this type of anomia describes patients who know the function of a certain object, and can single out the target object from a larger group of objects, but they do not have the ability to name the object. For example when shown different clothes items and asked to select the one meant to keep their head warm, they will correctly select the hat, but will not be able to state the name of the object.<ref name=":4">{{Cite book |last=Devinsky |first=Orrin |title=Neurology of cognitive and behavioral disorders |last2=D'Esposito |first2=Mark |date=2004 |publisher=Oxford University Press |isbn=978-0-19-513764-4 |series=Contemporary neurology series |location=Oxford}}</ref> In some patients this type of anomia is specific to certain categories like colors or animals.
** ''Semantic anomia'': unlike patients with word-selection anomia, patients exhibiting semantic anomia also lose the ability to correctly distinguish the function or use of a given object, along with not being able to provide the name of it. Therefore, even provided with both the name and function of an object, these patients still would not be able to correctly select it out of a group.<ref name=":4" />
** ''Disconnection anomia or modality-specific anomia'': this subset of anomia affects patients' ability to name or distinguish objects if they are presented through a certain sensory modality, and is caused by a disconnect between the given sensory cortex and the language centers of the brain. For example, a patient may be able to distinguish an apple from a banana when presented with their given smells, but not when they are presented the objects through only touch.<ref name=":4" />
** ''Phonemic substitution anomia'': describes patients that exhibit paraphasia when trying to name objects. This can result in patients either selecting incorrect phonemes, such as saying 'bad' when shown an image of a 'bat', or they may simply try to use non-real words, or neologisms.<ref>{{Cite journal |last=Benson |first=D. Frank |date=August 1991 |title=What's in a Name? |url=https://linkinghub.elsevier.com/retrieve/pii/S0025619612612063 |journal=Mayo Clinic Proceedings |language=en |volume=66 |issue=8 |pages=865–867 |doi=10.1016/S0025-6196(12)61206-3}}</ref>
* ''[[Neologism#Other uses|Neologisms]]'': Neologism is a Greek-derived word meaning "new word". The term is used in this sense to mean invented non-words that have no relation to the target word.<ref name="Brookshire" />
** E.g. "dorflur" for "shoe"
* ''Production of jargon'': speech that lacks content, consists of typical intonation, and is structurally intact.<ref name="Jargon">{{cite web |title=ASHA Glossary |url=https://www.asha.org/Glossary/Jargon/ |website=American Speech-Language-Hearing Association}}</ref> Jargon can consist of a string of neologisms, as well as a combination of real words that do not make sense together in context. The jargon may include [[word salad]]s.
* ''Fluent speech'': individuals with Wernicke's aphasia do not have difficulty with producing connected speech that flows.<ref name="NAA1">{{cite web|title=Wernicke's (Receptive) Aphasia|url=https://www.aphasia.org/aphasia-resources/wernickes-aphasia/|website=National Aphasia Association}}</ref> Although the connection of the words may be appropriate, the words they are using may not belong together or make sense (Jargon).<ref>{{cite web|title=Types of Aphasia|url=http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/CommunicationChallenges/Types-of-Aphasia_UCM_310096_Article.jsp|website=American Stroke Association}}</ref> Some patients with Wernicke's Aphasia experience [[Logorrhea (psychology)|logorrhea]], which is also known as over fluency. These patients use an excessive amount of words when speaking or writing.<ref>{{Citation |last=Chadwick |first=Ruth |title=Preface |date=2012 |url=http://dx.doi.org/10.1016/b978-0-12-373932-2.09005-0 |work=Encyclopedia of Applied Ethics |pages=xxv |access-date=2023-11-26 |publisher=Elsevier}}</ref>
* ''Awareness'': Individuals with Wernicke's aphasia are often not aware of their incorrect productions, which would further explain why they do not correct themselves when they produce jargon, paraphasias, or neologisms.<ref>{{cite web|title=Aphasia Definitions|url=https://www.aphasia.org/aphasia-definitions/|website=National Aphasia Association}}</ref> Additionally, patients may become irritated or frustrated because others cannot understand what they are saying, but they believe their speech is completely comprehensible.<ref name=":1">{{Cite web |last=Acharya |first=Aninda |last2=Wroten |first2=Michael |date=2023 |title=Wernicke Aphasia |url=https://www.ncbi.nlm.nih.gov/books/NBK441951/ |website=National Library of Medicine}}</ref>
* ''Paraphasias'':<ref name="Brookshire" /><ref name="Damasio" />
** ''Phonemic'' (literal) ''paraphasia'': Errors in selecting phonemes. Involves the substitution, addition, omission, or rearrangement of sounds so that an error can be defined as sounding like the target word. Often, half of the word is still intact which allows for easy comparison to the appropriate, original word (E.g. "bap" for "map"). The more phonemic paraphasias in a word, the harder it is to understand, to the extent at which may become unidentifiable. Often, these unidentifiable words are known as neologisms.
** ''Semantic'' (verbal) ''paraphasia'': Failure to select the proper words with which to convey their ideas. The word used is always a real word, however it may not always be directly or closely related to the word the patient is trying to convey. Can result in saying a word that is related to the target word in meaning or category (E.g. "jet" for "airplane" or "knife" for "fork"). Other times, semantic paraphasias can result in empty speech, or the use of overly generic words such as "thing" or "stuff" to stand in for the word they cannot come up with. This leads to speech that contains real words but lacks any substantial meaning.
* ''Circumlocution'': talking around the target word.<ref name="Brookshire" />
** E.g. "uhhh it's white... it's flat... you write on it..." (when referencing paper)
* ''Pressured speech'': Wernicke's patient's inclination to run on their speech. Often described as an overabundance of speech. Common in Wernicke's patients due to the ease at which they produce speech, circumlocution, and lack of self-monitoring.
** E.g. a clinician asks, "what do you do at a supermarket?" And the individual responds with "Well, the supermarket is a place. It is a place with a lot of food. My favorite food is Italian food. At a supermarket, I buy different kinds of food. There are carts and baskets. Supermarkets have lots of customers, and workers..."
* ''Lack of hemiparesis'': typically, no motor deficits are seen with a localized lesion in Wernicke's area.<ref name="Murdoch" />
* ''Reduced retention span'': reduced ability to retain information for extended periods of time.<ref name="Brookshire" />
* ''Impairments in reading and writing'': impairments can be seen in both reading and writing with differing severity levels.<ref name="NAA1" />
{| class="wikitable"
|+Wernicke's Aphasia Symptom Checklist
!Symptom
!Patients with Wernicke's Aphasia
|-
|Comprehension of spoken material
|Impaired (can range from mild to severe)
|-
|Segmental phonology
|Impaired (phonemic paraphasia, neologisms, jargon)
|-
|Word selection
|Impaired (semantic paraphasia, empty speech)
|-
|Word semantics
|Normal
|-
|Fluency (production of speech)
|Normal or overly fluent (logorrhea)
|-
|Production of writing
|Normal
|-
|Use of function words
|Normal
|-
|Grammaticality
|Normal or mildly impaired (paragrammatism)
|-
|Repetition of what others say
|Impaired
|-
|Controversial proficiency
|Normal
|-
|Concern about impairment
|Little to none
|-
|Concern about errors in language
|Little to none
|-
|Short-term retention and recall of verbal materials
|Impaired
|}
'''Distinction from other types of aphasia/other conditions'''<ref name="Brookshire" />
* ''Expressive aphasia'' (non-fluent Broca's aphasia): this is generally considered the second main categorization of aphasia, where individuals have great difficulty forming complete sentences with generally only basic content words (leaving out words like "is" and "the"). Unlike Wernicke's aphasia, which causes patients to speak fluently, but producing a jumbled mix of nonsensical words, people with Broca's aphasia speak slowly, and typically in small sentences, yet they are much more able to convey the intended meaning of the sentence. Additionally, while people with Wernicke's aphasia typically are unaware of their confusing language and may get frustrated with the listener for not understanding them, people with Broca's aphasia are completely aware of their language difficulties and can sometimes become frustrated with themselves. <ref name=":5">{{Cite web |title=What Is Wernicke's Aphasia? |url=https://www.webmd.com/brain/what-is-wernickes-aphasia |access-date=2023-12-28 |website=WebMD |language=en}}</ref>
* ''Global aphasia'': individuals have extreme difficulties with both expressive (producing language) and receptive (understanding language).
* ''[[Anomic aphasia]]'': the biggest hallmark is one's poor word-finding abilities; one's speech is fluent and appropriate, but full of circumlocutions (evident in both writing and speech).
* ''Conduction aphasia'': individuals can comprehend what is being said and are fluent in spontaneous speech, but they cannot repeat what is being said to them.
* ''Transcortical sensory aphasia'': individuals have impaired auditory comprehension with intact repetition and fluent speech.<ref>{{Cite journal |last=Goldstein |first=Kurt |date=1948 |title=Language and language disturbances |url=http://dx.doi.org/10.1002/1097-4679(194904)5:2<185::aid-jclp2270050218>3.0.co;2-l |journal=Journal of Clinical Psychology |volume=5 |issue=2 |pages=185–185 |doi=10.1002/1097-4679(194904)5:2<185::aid-jclp2270050218>3.0.co;2-l |issn=0021-9762}}</ref>
* ''Progressive confluent aphasia'': A form of frontotemporal dementia characterized by motor speech impairment, agrammatism, laborious speech, and apraxia of speech. It is understood that comprehension of speech and semantic memory are relatively preserved. Symptoms progress over time unlike many other aphasias where symptoms appear immediately after stroke.<ref>{{Cite journal |last=Ogar |first=Jennifer M. |last2=Dronkers |first2=Nina F. |last3=Brambati |first3=Simona M. |last4=Miller |first4=Bruce L. |last5=Gorno-Tempini |first5=Maria Luisa |date=2007 |title=Progressive Nonfluent Aphasia and Its Characteristic Motor Speech Deficits |url=http://dx.doi.org/10.1097/wad.0b013e31815d19fe |journal=Alzheimer Disease & Associated Disorders |volume=21 |issue=4 |pages=S23–S30 |doi=10.1097/wad.0b013e31815d19fe |issn=0893-0341}}</ref>
* [[Wernicke-Korsakoff Syndrome]]: A well described syndrome of neurological and cognitive problems that comprises both [[Wernicke encephalopathy|Wernicke's Encephalopathy]] (WE) and [[Korsakoff Syndrome]] (KS). It is often characterized by impairment in memory formation and is caused by long term thiamine deficiency.<ref>{{Cite journal |last=Isenberg-Grzeda |first=Elie |last2=Kutner |first2=Haley E. |last3=Nicolson |first3=Stephen E. |date=2012 |title=Wernicke-Korsakoff-Syndrome: Under-Recognized and Under-Treated |url=http://dx.doi.org/10.1016/j.psym.2012.04.008 |journal=Psychosomatics |volume=53 |issue=6 |pages=507–516 |doi=10.1016/j.psym.2012.04.008 |issn=0033-3182}}</ref>