Word-Finding Difficulty: Aphasia or Normal?

What is Aphasia?

Aphasia is a neurological symptom that affects a person’s ability to communicate or understand verbal information. Doctors refer to these as “expressive” or “receptive” language abilities. Depending on which areas of the brain are affected, a person can have an expressive aphasia, a receptive aphasia, or both.

The most common causes of aphasia are stroke, traumatic brain injury, neurodegenerative conditions, brain tumors, and epilepsy. When any of these conditions involve the areas of the brain that are primarily responsible for expressive or receptive language, aphasia and its characteristic communication symptoms become evident.  

What is Normal vs. Aphasia

Everyone can experience word-finding difficulty or that “tip-of-the-tongue” sensation. This is normal and becomes more prominent with age. It can worsen when people feel anxious, excited, depressed or even sleep deprived. Those situations are not classified as aphasia. The distinction is important since people often misinterpret their word-finding difficulty—thinking it is caused by a physical or mental disease—when in fact it can be quite normal. 

Neuropsychological assessments can offer clarity on what is normal aging, anxiety, depression or other “reversible” causes of language changes and what is, in fact, aphasia.  

Treatment for Aphasia

Treatment for aphasia depends on the underlying neurological cause.

Some conditions, such as stroke or a traumatic brain injury, result in sudden changes. In these instances, the aphasia may be quite pronounced and may improve to varying degrees over time with therapy from a speech and language pathologist.

A more gradual onset of aphasia may be due to a class of neurodegenerative conditions known as primary progressive aphasias (PPAs), which mostly fall under the category of frontotemporal dementias. These conditions are—as their name implies—progressive and develop gradually.

While there are no known medications to stop their progression, there are some medications that may slow the rate of progression. 

Speech and language pathologists can play a vital role in the lives of patients with PPA by helping them make the most of their communication abilities, teaching ways to compensate, or exploring how to use technology to communicate thoughts. The condition may also impact swallowing and an assessment can be completed to reduce risk of choking.

Lifestyle Modifications and Aphasia

Lifestyle modifications have also been associated with slower rates of disease progression. Those who stay physically, socially, and mentally active progress at slower rates than those who are more sedentary.

The impact of these lifestyle factors cannot be overstated. In addition to slowing progression rates, they further reduce the risk of depression, anxiety, other emotional distress, and the excessive caregiver burden that may occur with a progressive aphasia.

Epilepsy and Aphasia

The impact of epilepsy-induced aphasia can be managed with medication and lifestyle changes that help control seizures. With sustained control of the seizure activity, patients can achieve varying degrees of improvement in expressive or receptive language. This depends on the degree of aphasia present prior to treatment.

Brain Tumors and Aphasia

Patients can also have aphasia directly due to tumor growth around the language areas of the brain. They can also have an indirect impact on language due to brain edema (swelling) or structural shifting because of tumor growth. Treatment for the cerebral edema may result in improved language function if the aphasia is edema-related. Neurosurgery to remove the tumor may also result in improved language function to varying degrees.

Advanced Technology Maps Brain Function

Lancaster General Health offers advanced technology to help diagnose and treat neurological disorders and minimize the risk or impact of aphasia.

Functional magnetic resonance imaging (fMRI) shows which areas of the brain activate during specific tasks. Utilizing this technology, neurosurgeons, neuropsychologists and neuroradiologists work together to achieve the best outcomes based on a patient’s individual brain activity. 

This technology can help minimize the impact of surgery on important brain functions and preserve quality of life. As it relates to aphasia, fMRI can provide valuable information to help preserve language areas of the brain during a biopsy or while having a tumor removed, reducing the risk of aphasia (or worsening aphasia) after surgery.

If you or your family are noticing changes in your ability to communicate, reach out to your health-care provider about your concerns. Together, you can determine the most appropriate course of action for you.