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Magill’s Medical Guide, 8th Edition

Wernicke’s aphasia

by Valentina Chiarelli, Ph.D.

Disease/Disorder

Also known as: Sensory aphasia or fluent aphasia

Anatomy or system affected: Brain

Specialties and related fields: Neurology, neuropsychology, neuroscience, neurosurgery, psychology, speech pathology

Definition: An acquired language disorder that mostly causes difficulties in comprehension of oral language.

Key terms:

Broadmann’s areas: areas of the brain that are differentiated based on the cellular structure of the cerebral cortex

paragrammatism: confused or incomplete use of grammatical structures, as in case of substitution of function words and grammatical morphemes (the man are singing instead of the man is singing)

paraphasias: a type of partial aphasia that is characterized by a person who uses words incorrectly

phonological/phonemic error: a phoneme substitution/omission of the target word (boat or oat instead of goat); this type of error is also called phonological paraphasia

semantic error: the use of a word that resembles in meaning the target word (cat instead of dog); this type of error is also called semantic paraphasia

Causes and Symptoms

Wernicke’s aphasia is generally caused by a focal brain damage due to strokes, head trauma, brain tumors, or brain infections. People suffering from Wernicke’s aphasia showed a lesion in the middle-posterior tract of the first left temporal circonvolution, the so called Wernicke’s area or Broadmann’s area 22, and in the adjacent corticosubcortical areas.

The classical definition of aphasic syndromes consists of various categorization systems. Some authors categorize according to the type of language errors. Others take into consideration language production and related impairments in spontaneous speech. However, in past decades a classification has been suggested on the basis of specific clusters of aphasic disorders. In particular, aphasia syndromes are differentiated in two groups: fluent and nonfluent. Wernicke’s aphasia, as well as anomic aphasia, transcortical sensory aphasia and conduction aphasia, are considered fluent aphasias, while Broca’s aphasia, global aphasia and transcortical motor aphasia are forms of the nonfluent type. Fluent types are characterized by fluent speech, no articulation disorders, but difficulties in auditory comprehension and/or repetition and the presence of paraphasias. Nonfluent types are characterized by difficulties in articulation and spoken language with relatively preserved auditory comprehension.

Here are the main symptoms of Wernicke’s aphasia: Auditory comprehension is impaired, generally both at the level of sentences and discourse and at the level of single words. Repetition is also compromised as well as naming that is affected by semantic and phonological omissions and substitutions due to word finding retrieval problems. Spontaneous speech is well articulated and connected and produced effortlessly, but phonemic errors as well as semantically and nonsemantically related substitutions are frequent.

Treatment and Therapy

People who became aphasic after a stroke or a traumatic brain injury generally undergo a variable degree of recuperation in the period following injury referred to as “spontaneous recovery.” This effect is maximal in the first 6 months, even if there is evidence that improvement can be observed up to 2 years post onset. While all studies indicate that the initial severity, defined with global impairment measures, is the strongest predictor of recovery, the type of aphasic syndrome (e.g., Broca’s aphasia, Wernicke’s aphasia) is not a good independent predictor. Many other factors influence spontaneous recovery like etiology, handedness, age, multilingualism, and hemispheric asymmetries as well as social support and mood. The presence of spontaneous recovery suggests that neuroplasticity could be allowing the damaged brain to regain previously lost functionality. Despite the importance of spontaneous recovery, treating language deficits is essential. When planning and setting the therapeutic goals for aphasia therapy, it is important to use diagnostic tools that provide an overview of an aphasic person’s abilities and disabilities in both the language and associated cognitive domains, in order to guarantee an impairment-specific training. Generally, in the case of Wernicke’s aphasia, it is important to first treat auditory comprehension deficits through different tasks, like matching photos or pictures with words and sentences. Concerning pharmacological treatments, in the subacute to chronic phase, drugs may provide useful adjuvant therapy, but only in the presence of specific language and speech therapies.

Perspective and Prospects

Even if a diagnostic label like “Wernicke’s aphasia” can be useful to communicate information among different clinicians, recently the limits of the classic approach have been emphasized. Only roughly defined linguistic parameters and tasks are employed. An enormous variability is seen in the relative severity of each of the constituting symptoms in each syndrome. Many observed cases would not unambiguously fit one classic aphasia type. As a result, what is considered in one hospital as an instance of one type of aphasia may be occasionally classified otherwise in another hospital. The new approach to the study of language disorders has been influenced by theoretical linguistics and by cognitive neuropsychology. Each clinical condition should be described in terms of damage to representation and processes involved in a given task. The content and the format of concerned representations should be specified. Thus, the description of aphasic disorders would overcome the traditional classification of Wernicke’s aphasia, global aphasia and so on, in order to take into consideration the different levels of grammar: the phonological, the morpho-syntactic and the lexico-semantic level. Moreover, for each of these levels, a distinction between production impairments and comprehension deficits is necessary. Only this description and analysis of deficits helps clinical neuropsychologists or speech therapists to construct specific rehabilitation protocols for each patient. Then, impairment-specific training will aim primarily at relearning degraded linguistic knowledge, reactivating impaired linguistic modalities such as oral and written comprehension, and learning explicit compensatory linguistic strategies.

See also

Aphasia and dysphasia

For Further Information:

1 

Berthier, M.L. “Poststroke Aphasia: Epidemiology, Pathophysiology and Treatment.” Drugs Ageing 22, no. 2 (2005): 163-182.

2 

Denes, G., and L. Pizzamiglio. Handbook of Neuropsychology. London: Erlbaum, 1999.

3 

Hillis, A.E. The Handbook of Adult Language Disorders: Integrating Cognitive Neuropsychology, Neurology and Rehabilitation. New York: Psychology Press, 2002.

4 

Whitworth, A., J. Webster, and D. Howard. A Cognitive Neuropsychological Approach to Assessment and Intervention in Aphasia: A Clinician’s Guide. New York: Psychology Press, 2005.

Citation Types

Type
Format
MLA 9th
Chiarelli, Valentina. "Wernicke’s Aphasia." Magill’s Medical Guide, 8th Edition, edited by Bryan C. Auday, et al., Salem Press, 2018. Salem Online, online.salempress.com/articleDetails.do?articleName=MMG2018_1422.
APA 7th
Chiarelli, V. (2018). Wernicke’s aphasia. In B. C. Auday, M. A. Buratovich, G. F. Marrocco & P. Moglia (Eds.), Magill’s Medical Guide, 8th Edition. Salem Press. online.salempress.com.
CMOS 17th
Chiarelli, Valentina. "Wernicke’s Aphasia." Edited by Bryan C. Auday, Michael A. Buratovich, Geraldine F. Marrocco & Paul Moglia. Magill’s Medical Guide, 8th Edition. Hackensack: Salem Press, 2018. Accessed December 14, 2025. online.salempress.com.