Preface

Aphasia is an acquired central disorder of language that impairs a person's ability to understand and/or produce spoken language, often associated with impairment in reading (alexia) and writing (agraphia). Aphasia may supplementarily affect a person's ability to use musical notation, mathematical operations, and so on. Consequently, the aphasic person may present with difficulties generating and using symbol systems. Aphasia is different from a peripheral (sensory-motor) disorder of language that may mimic aphasia (such as weakness of the muscles of articulation). At the same time, it is an acquired phenomenon that appears after language has already been learned.

The most common etiology of aphasia is a stroke (80% of aphasia cases are vascular aphasias), with a prevalence of 25%–30% in acute ischemic stroke. Stroke is the third most frequent cause of death and the first cause of disability across the globe. Aphasia is considered an important marker of stroke severity, associated with a high risk of mortality, poor functional prognosis, and augmented risk of vascular dementia.

This book reviews different aspects of aphasias. It is divided into two sections including seven chapters that cover the main aspects of aphasias.

Section 1 focuses on the diagnosis of aphasias and contains four chapters.

Chapter 1, "Contributions of Linguistics to the Study of Aphasias: Focus on Discursive Approaches" by Novaes-Pinto and de Lima, discusses how aphasia disturbs not only linguistic formal levels (phonetical-phonological, syntactic, lexical-semantic) but also pragmatic and discursive aspects of language that are constitutive of meaning processes involved in the social use of language. The authors show that qualitative longitudinal research (mainly case studies) is a privileged locus to seek evidence of how linguistic levels are impacted in several forms of aphasia.

Chapter 2, "A Comprehensive Overview of Broca's Aphasia after Ischemic Stroke" by Jianu et al., discusses language and neurologic examination, diagnosis, and therapy of the patient with vascular Broca's aphasia, which is non-fluent aphasia comprising the widest range of symptoms (articulatory disturbances, paraphasias, agrammatism, evocation disorders, and discrete comprehension disorders of spoken and written language). It is considered the third most common form of acute vascular aphasia, after global and Wernicke's aphasia. Vascular Broca's aphasia is produced by infarcts or severe hypoperfusion of the superior division of the left middle cerebral artery. The reversal of hypoperfusion, following recanalization (spontaneous or secondary to thrombolysis or thrombectomy), is associated with

regression of aphasia. Speech therapy is needed as soon as permitted by clinical condition. Unfortunately, pharmacotherapy remains to be evaluated. Other studies examined the potential interest of new treatments, such as transcranial magnetic stimulation.

approach, and systematic evaluations enables therapists to measure the effectiveness and efficacy of communication groups in terms of functional communication,

Professor of Neurology, M.D., Ph.D., Dr.Habil., PhD Coordinator,

Head of the Centre for Cognitive Research in Neuropsychiatric Pathology

Chairman of the Neurosciences Department "Iuliu Hațieganu" University of

President of the European Federation of Neurorehabilitation Societies

"Victor Babeș" University of Medicine and Pharmacy,

"Victor Babeș" University of Medicine and Pharmacy,

Professor of Neurology, M.D., Ph.D., MBA, PhD Coordinator,

Corresponding Member of the Romanian Academy

Head of the First Deptartment of Neurology, Timișoara Clinical Emergency County Hospital,

**Dragoș Cătălin Jianu**

Timișoara, Romania

Timișoara, Romania

Timișoara, Romania

**Dafin Fior Mureșanu**

Medicine and Pharmacy, Cluj-Napoca, Romania

Senior Consultant Neurologist,

(NeuroPsy-Cog),

Senior Consultant Neurologist, Department of Neurology,

social inclusion, and quality of life.

Chapter 3, "Imaging of Vascular Aphasia" by Duron et al., reviews the state of the art of morphological and functional imaging of vascular aphasias. Magnetic resonance imaging (MRI) is the modality of choice for the etiological diagnosis of aphasia, assessment of its severity, and prediction of recovery. Diffusion-weighted imaging is used to detect, localize, and quantify the extension of the irreversibly injured brain tissue called the ischemic core. Perfusion weighted imaging (from MRI or computed tomography) is useful to assess the extension of hypoperfused but salvageable tissue called penumbra. Functional imaging (positron emission tomography, functional MRI) may help predict recovery and is useful for the understanding of language networks and individual variability.

Chapter 4, "Primary Progressive Aphasia (PPA)" by Channabasvegowda and Nagaraj, focuses on primary progressive aphasia (PPA), which is a type of dementia characterized by a loss in one or more language functions in people younger than 65 years. It is a progressive impairment of language, with the preservation of other mental processes and daily life tasks for at least two years.

Section 2 discusses outcomes and treatment of aphasias and contains three chapters.

Chapter 5, "Spontaneous Recovery and Intervention in Aphasia" by Yamaji and Maeshima, discusses the spontaneous recovery of aphasia, which occurs immediately after the onset of the disease and lasts for several months or more. The speed and degree of improvement in aphasia varies depending on the time since onset, the severity of aphasia, and each language modality. Speech and language therapy should not only promote the improvement of aphasia but also take a comprehensive approach to improving the quality of life of aphasics.

Chapter 6, "Treatment Approaches for Word Retrieval Deficits in Persons with Aphasia: Recent Advances" by Deepak et al. discusses word retrieval deficits in aphasic patients and the need for speech-language pathologists to treat this aspect of the condition. Word retrieval is an intricate process that entails various levels of processing.

Finally, Chapter 7, "The Importance of Aphasia Communication Groups" by Charalambous and Kambanaros, talks about the importance of communication buddies, who can be family members, friends, health professionals, and speech and language therapy students who serve as communication facilitators for each group member. The use of the communication buddy system, total communication approach, and systematic evaluations enables therapists to measure the effectiveness and efficacy of communication groups in terms of functional communication, social inclusion, and quality of life.

> **Dragoș Cătălin Jianu** Professor of Neurology, M.D., Ph.D., Dr.Habil., PhD Coordinator, Senior Consultant Neurologist, Department of Neurology, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania

Head of the Centre for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania

> Head of the First Deptartment of Neurology, Timișoara Clinical Emergency County Hospital, Timișoara, Romania

#### **Dafin Fior Mureșanu**

Professor of Neurology, M.D., Ph.D., MBA, PhD Coordinator, Senior Consultant Neurologist, Chairman of the Neurosciences Department "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania

President of the European Federation of Neurorehabilitation Societies Corresponding Member of the Romanian Academy

Section 1
