Discourse in Wernicke’s aphasia

Abstract

ABSTRACT Background Language can be viewed and analysed at many levels. One of them is, “language in use” or discourse. A complex system of cognitive and linguistic processes is required for the performance of discourse; any deficits at this system level can impair the use of language. Studies have shown impaired performance of discourse in individuals with Wernicke’s aphasia (WA). In this condition the participant can talk fluently and excessively but lacks insight about the topic. The pattern of linguistic disruption seen in WA could be explored through the analysis of discourse grammar. Aims The present study aims to investigate the narrative discourse abilities of individuals with WA in comparison with Neurotypical adults (NTA) using qualitative and quantitative methods. Method & Procedure Five participants with WA (age 40–60 years) following cerebrovascular accident diagnosed by a Neurologist. Following this, WAB was administered on these participants. Five neurotypical Kannada bilinguals (age 40–60 years) were considered as controls. The narrative discourse sample on the topic “journey to a place” was video recorded and transcribed using IPA. Qualitative and quantitative discourse analysis approaches were used to assess the linguistic functions using discourse analysis scale and T-unit analysis respectively. Results The results revealed a significant difference between WA and NTA. In qualitative analysis, WA showed a significantly lower mean values for narrative proposition total and narrative non-proposition total (p < 0.05). Within-group comparison of narrative proposition total and narrative non-proposition total of discourse using Wilcoxon’s Signed Rank test revealed a significant difference for WA group. Findings were not significant for NTA group. For the quantitative analysis, the parameter Number of T-Units (NTU) showed significantly lower mean value for NTA group compared to WA group (p < 0.05). Both the groups obtained similar mean values for the parameters Number of Clauses (NC) and Number of Words Per Clauses (NWPC), p > 0.05. Summary and conclusion: This study facilitates the understanding about the discourse deficits in individuals with WA. During clinical presentation, most of the patients with fluent aphasia, Alzheimer’s Dementia and Schizophrenia exhibits similar linguistic deficits and are misdiagnosed when not complemented with a medical report. In such cases, discourse analysis would help to tap the incongruency at qualitative and quantitative linguistic performance of discourse. Hence, there is a need to approach each patient differently during the clinical evaluations and interventions.