Journal Article

Word-finding difficulty: a clinical analysis of the progressive aphasias

Jonathan D. Rohrer, William D. Knight, Jane E. Warren, Nick C. Fox, Martin N. Rossor and Jason D. Warren

in Brain

Published on behalf of The Guarantors of Brain

Volume 131, issue 1, pages 8-38
Published in print January 2008 | ISSN: 0006-8950
Published online October 2007 | e-ISSN: 1460-2156 | DOI: http://dx.doi.org/10.1093/brain/awm251
Word-finding difficulty: a clinical analysis of the progressive aphasias

Show Summary Details

Preview

The patient with word-finding difficulty presents a common and challenging clinical problem. The complaint of ‘word-finding difficulty’ covers a wide range of clinical phenomena and may signify any of a number of distinct pathophysiological processes. Although it occurs in a variety of clinical contexts, word-finding difficulty generally presents a diagnostic conundrum when it occurs as a leading or apparently isolated symptom, most often as the harbinger of degenerative disease: the progressive aphasias. Recent advances in the neurobiology of the focal, language-based dementias have transformed our understanding of these processes and the ways in which they breakdown in different diseases, but translation of this knowledge to the bedside is far from straightforward. Speech and language disturbances in the dementias present unique diagnostic and conceptual problems that are not fully captured by classical models derived from the study of vascular and other acute focal brain lesions. This has led to a reformulation of our understanding of how language is organized in the brain. In this review we seek to provide the clinical neurologist with a practical and theoretical bridge between the patient presenting with word-finding difficulty in the clinic and the evidence of the brain sciences. We delineate key illustrative speech and language syndromes in the degenerative dementias, compare these syndromes with the syndromes of acute brain damage, and indicate how the clinical syndromes relate to emerging neurolinguistic, neuroanatomical and neurobiological insights. We propose a conceptual framework for the analysis of word-finding difficulty, in order both better to define the patient's complaint and its differential diagnosis for the clinician and to identify unresolved issues as a stimulus to future work.

Keywords: aphasia; progressive aphasia; anomia; dementia; speech and language

Journal Article.  21320 words.  Illustrated.

Subjects: Neurology ; Neuroscience

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.