Instruct: Given a question, retrieve relevant documents that answer the question.
Query: What is the number one cause of Broca's aphasia?
Broca's (expressive) aphasia is a type of non-fluent aphasia in which an individual’s speech is halting and effortful. Misarticulations or distortions of consonants and vowels, namely phonetic dissolution, are common. Individuals with expressive aphasia may only produce single words, or words in groups of two or three. Long pauses between words are common and multi-syllabic words may be produced one syllable at a time with pauses between each syllable. The prosody of a person with Broca's aphasia is compromised by shortened length of utterances and the presence of self-repairs and disfluencies. Intonation and stress patterns are also deficient.
Examination of the brains of Broca's two historic patients with high-resolution MRI has produced several interesting findings. First, the MRI findings suggest that other areas besides Broca's area may also have contributed to the patients' reduced productive speech. This finding is significant because it has been found that, though lesions to Broca's area alone can possibly cause temporary speech disruption, they do not result in severe speech arrest. Therefore, there is a possibility that the aphasia denoted by Broca as an absence of productive speech also could have been influenced by the lesions in the other region. Another finding is that the region, which was once considered to be critical for speech by Broca, is not precisely the same region as what is now known as Broca's area. This study provides further evidence to support the claim that language and cognition are far more complicated than once thought and involve various networks of brain regions.
Agnosia is "the loss or diminution of the ability to recognize familiar objects or stimuli usually as a result of brain damage". There are several different kinds of agnosia that affect every one of our senses, but the two most common related to speech are speech agnosia and phonagnosia.
Agnosia is the inability to process sensory information. Often there is a loss of ability to recognize objects, persons, sounds, shapes, or smells while the specific sense is not defective nor is there any significant memory loss. It is usually associated with brain injury or neurological illness, particularly after damage to the occipitotemporal border, which is part of the ventral stream. Agnosia only affects a single modality, such as vision or hearing. More recently, a top-down interruption is considered to cause the disturbance of handling perceptual information.
Eloquent cortex is a name used by neurologists for areas of cortex that—if removed—will result in loss of sensory processing or linguistic ability, minor paralysis, or paralysis. The most common areas of eloquent cortex are in the left temporal and frontal lobes for speech and language, bilateral occipital lobes for vision, bilateral parietal lobes for sensation, and bilateral motor cortex for movement.
Damage to the left hemisphere of the brain has been explicitly implicated in the associative form of visual agnosia. Goldberg suggested that the associative visual form of agnosia results from damage to the ventral stream of the brain, the occipito-temporal stream, which plays a key role in object recognition as the so-called "what" region of the brain, as opposed to the "where," dorsal stream.
Studies on specific cases demonstrate how particular impaired areas of the hippocampus are associated with the severity of RA. Damage can be limited to the CA1 field of the hippocampus, causing very limited RA for about 1 to 2 years. More extensive damage limited to the hippocampus causes temporally graded amnesia for 15 to 25 years. Another study also suggests that large medial temporal lobe lesions, that extend laterally to include other regions, produce more extensive RA, covering 40 to 50 years. These findings suggest that density of RA becomes more severe and long-term as the damage extends beyond the hippocampus to surrounding structures.
The motor control for speech production in right handed people depends mostly upon areas in the left cerebral hemisphere. These areas include the bilateral supplementary motor area, the left posterior inferior frontal gyrus, the left insula, the left primary motor cortex and temporal cortex. There are also subcortical areas involved such as the basal ganglia and cerebellum. The cerebellum aids the sequencing of speech syllables into fast, smooth and rhythmically organized words and longer utterances.
Neuroplasticity is defined as the brain's ability to reorganize itself, lay new pathways, and rearrange existing ones, as a result of experience. Neuronal changes after damage to the brain such as collateral sprouting, increased activation of the homologous areas, and map extension demonstrate the brain's neuroplastic abilities. According to Thomson, "Portions of the right hemisphere, extended left brain sites, or both have been shown to be recruited to perform language functions after brain damage. All of the neuronal changes recruit areas not originally or directly responsible for large portions of linguistic processing. Principles of neuroplasticity have been proven effective in neurorehabilitation after damage to the brain. These principles include: incorporating multiple modalities into treatment to create stronger neural connections, using stimuli that evoke positive emotion, linking concepts with simultaneous and related presentations, and finding the appropriate intensity and duration of treatment for each individual patient.
Two cortical processing streams exist: a ventral one which maps sound onto meaning, and a dorsal one, that maps sound onto motor representations. The dorsal stream projects from the posterior Sylvian fissure at the temporoparietal junction, onto frontal motor areas, and is not normally involved in speech perception. 
Carl Wernicke identified a pathway between the left posterior superior temporal sulcus (a cerebral cortex region sometimes called the Wernicke's area) as a centre of the sound "images" of speech and its syllables that connected through the arcuate fasciculus with part of the inferior frontal gyrus (sometimes called the Broca's area) responsible for their articulation. This pathway is now broadly identified as the dorsal speech pathway, one of the two pathways (together with the ventral pathway) that process speech. The posterior superior temporal gyrus is specialized for the transient representation of the phonetic sequences used for vocal repetition. Part of the auditory cortex also can represent aspects of speech such as its consonantal features.
In a case reported only due to its rarity, triplegia was reported following a tonsillectomy (surgical removal of the tonsils). An eight-year-old male patient was sent to Willard Parker Hospital on August 12, 1929 and had been diagnosed with poliomyelitis. After an unrelated, and routine, tonsillectomy there was complete flaccid paralysis and loss of feeling in both the legs, right arm, and muscles in the trunk.
An incident of disinformation about coprolalia and Tourette's involved Dr. Laura Schlessinger. According to the former Tourette Syndrome Association (name changed to Tourette Association of America in 2015), she berated a caller inquiring whether a child with TS should attend a family wedding, declaring that a majority of those with the condition exhibited coprolalia and should be excluded from many social situations, provoking an avalanche of angry calls about the misinformation. Garrison Keillor, radio show host of NPR's "A Prairie Home Companion", produced a segment in 2006, titled "Broadway Tourette's", about segregating people with stereotypical TS from other passengers on a cruise ship, prompting a press release from the Tourette Syndrome Association.
The National Autistic Society said in 2008 that it was "extremely concerned" about possible harmful effects of the devices upon people with autism. Since autism causes auditory hypersensitivity, individuals with this disability can have more intense reactions to this sound, especially if they are also under 25. Since autism can also affect communication skills, some individuals may not be able to communicate their discomfort to caregivers. A supermarket in Longridge, England, removed a mosquito device in 2008 after a campaign by a 19-year-old Paul Brookfield, who has autism. Brookfield contended that the device was causing him pain due to his disability.
In all cases, illness is caused by the botulinum toxin produced by the bacterium "C. botulinum" in anaerobic conditions and not by the bacterium itself. The pattern of damage occurs because the toxin affects nerves that fire (depolarize) at a higher frequency first.
Speech production is process by which a thought in the brain is converted into an understandable auditory form. This is a multistage mechanism that involves many different areas of the brain. The first stage is planning, where the brain constructs words and sentences that turn the thought into an understandable form. This occurs primarily in the inferior frontal cortex, specifically in an area known as Broca's area. Next, the brain must plan how to physically create the sounds necessary for speech by linking the planned speech with known sounds, or phonemes. While the location of these associations is not known, it is known that the supplementary motor area plays a key role in this step. Finally, the brain must signal for the words to actually be spoken. This is carried out by the premotor cortex and the motor cortex.
In most cases, speech production is controlled by the left hemisphere. In a series of studies, Wilder Penfield, among others, probed the brains of both right-handed (generally left-hemisphere dominant) and left-handed (generally right-hemisphere dominant) patients. They discovered that, regardless of handedness, the left hemisphere was almost always the speech controlling side. However, it has been discovered that in cases of neural stress (hemorrhage, stroke, etc.) the right hemisphere has the ability to take control of speech functions.
Priming studies on Cochrane revealed that individuals with severe amnesia can display intact priming capabilities regardless of episodic memory damage. Priming involves initially exposing a subject to a word or image so that a memory of that word or image can be formed. This is meant to improve a subject's recall of that word or image when that word or image is shown at a later time. Cochrane additionally showed that priming effects can last for long periods of time; in one study, researchers presented Cochrane with a list of words, and after 12 months showed him the same words with letters missing. Cochrane was able to complete these fragmented words as successfully as a person with normal brain function who was shown the same list initially. This challenged the previous opinion that patients with anterograde amnesia are incapable of adding information to their declarative memory.
Faculty provides care for thousands suffering from mild to traumatic brain injuries. The concussion clinic at Medstar NRH focuses primarily on this form of brain injury and is regarded as one of the best in the country according to U.S. News & World Report. 75 percent of all traumatic brain injuries that occur are concussions. Traumatic brain injuries contribute to a third of all deaths in the United States with over 1.5 million brain injuries occurring each year. During their stay, patients are also educated on precautions they can take to prevent a future incidence.
Uncommon risk factors include genetic disorders such as neurofibromatosis, Li–Fraumeni syndrome, tuberous sclerosis, or Turcot syndrome. Previous radiation therapy is also a risk. For unknown reasons, GBM occurs more commonly in males.
The treatment of Tourette's focuses on identifying and helping the individual manage the most troubling or impairing symptoms. Most cases of Tourette's are mild, and do not require pharmacological treatment; instead, psychobehavioral therapy, education, and reassurance may be sufficient. Treatments, where warranted, can be divided into those that target tics and comorbid conditions, which, when present, are often a larger source of impairment than the tics themselves. Not all people with tics have comorbid conditions, but when those conditions are present, they often take treatment priority.
Neuro-oncology is the study of brain and spinal cord neoplasms, many of which are (at least eventually) very dangerous and life-threatening (astrocytoma, glioma, glioblastoma multiforme, ependymoma, pontine glioma, and brain stem tumors are among the many examples of these). Among the malignant brain cancers, gliomas of the brainstem and pons, glioblastoma multiforme, and high-grade (highly anaplastic) astrocytoma are among the worst. In these cases, untreated survival usually amounts to only a few months, and survival with current radiation and chemotherapy treatments may extend that time from around a year to a year and a half, possibly two or more, depending on the patient's condition, immune function, treatments used, and the specific type of malignant brain neoplasm. Surgery may in some cases be curative, but, as a general rule, malignant brain cancers tend to regenerate and emerge from remission easily, especially highly malignant cases. In such cases, the goal is to excise as much of the mass (tumor cells) and as much of the tumor margin as possible without endangering vital functions or other important cognitive abilities.
FI is a sign or a symptom, not a diagnosis, and represents an extensive list of causes. Usually, it is the result of a complex interplay of several coexisting factors, many of which may be simple to correct. Up to 80% of people may have more than one abnormality that is contributing. Deficits of individual functional components of the continence mechanism can be partially compensated for a certain period of time, until the compensating components themselves fail. For example, obstetric injury may precede onset by decades, but postmenopausal changes in the tissue strength reduce in turn the competence of the compensatory mechanisms. The most common factors in the development are thought to be obstetric injury and after effects of anorectal surgery, especially those involving the anal sphincters and hemorrhoidal vascular cushions. The majority of incontinent persons over the age of 18 fall into one of several groups: those with structural anorectal abnormalities (sphincter trauma, sphincter degeneration, perianal fistula, rectal prolapse), neurological disorders (multiple sclerosis, spinal cord injury, spina bifida, stroke, etc.), constipation/fecal loading (presence of a large amount of feces in the rectum with stool of any consistency), cognitive and/or behavioral dysfunction (dementia, learning disabilities), diarrhea, inflammatory bowel diseases (e.g. ulcerative colitis, Crohn's disease), irritable bowel syndrome, disability related (people who are frail, acutely unwell, or have chronic/acute disabilities), and those cases which are idiopathic (of unknown cause). Diabetes mellitus is also known to be a cause, but the mechanism of this relationship is not well understood.
One of the first indications of brain function lateralization resulted from the research of French physician Pierre Paul Broca, in 1861. His research involved the male patient nicknamed "Tan", who suffered a speech deficit (aphasia); "tan" was one of the few words he could articulate, hence his nickname. In Tan's autopsy, Broca determined he had a syphilitic lesion in the left cerebral hemisphere. This left frontal lobe brain area (Broca's area) is an important speech production region. The motor aspects of speech production deficits caused by damage to Broca's area are known as expressive aphasia. In clinical assessment of this aphasia, it is noted that the patient cannot clearly articulate the language being employed.
Shortly after Paul Broca published his findings on language deficits caused by damage to what is now referred to as Broca's area, Wernicke began pursuing his own research into the effects of brain disease on speech and language. Wernicke noticed that not all language deficits were the result of damage to Broca's area. Rather he found that damage to the left posterior, superior temporal gyrus resulted in deficits in language comprehension. This region is now referred to as Wernicke's area, and the associated syndrome is known as Wernicke’s aphasia (receptive aphasia), for his discovery.In 1897, with Theodor Ziehen (1862-1950), he founded the journal "Monatsschrift für Psychiatrie und Neurologie".
In the classical sense, expressive aphasia is the result of injury to Broca's area; it is often the case that lesions in specific brain areas cause specific, dissociable symptoms, although case studies show there is not always a one-to-one mapping between lesion location and aphasic symptoms. The correlation between damage to certain specific brain areas (usually in the left hemisphere) and the development of specific types of aphasia makes it possible to deduce (albeit very roughly) the location of a suspected brain lesion based only on the presence (and severity) of a certain type of aphasia, though this is complicated by the possibility that a patient may have damage to a number of brain areas and may exhibit symptoms of more than one type of aphasia. The examination of lesion data in order to deduce which brain areas are essential in the normal functioning of certain aspects of cognition is called the deficit-lesion method; this method is especially important in the branch of neuroscience known as aphasiology. Cognitive science - to be specific, cognitive neuropsychology - are branches of neuroscience that also make extensive use of the deficit-lesion method.
Since studies carried out in the late 1970's it has been understood that the relationship between Broca's area and Broca's aphasia is not as consistent as once thought. Lesions to Broca's area alone don't result in a Broca's aphasia, nor do Broca's aphasic patients necessarily have lesions in Broca's area. Lesions to Broca's area alone are known to produce just a transient mutism that resolves inside 3–6 weeks. This discovery suggests that Broca's area may be included in some aspect of verbalization or articulation; however, it does not address its part in sentence comprehension. Still, Broca's area frequently emerges in functional imaging studies of sentence processing. However, it also becomes activated in word-level tasks. This suggests that Broca’s area is not dedicated to sentence processing but supports a function common to both. In fact, Broca's area can show activation in such non-linguistic tasks as imagery of motion.
Broca’s aphasia, or non-fluent aphasia, is a language disorder caused by damage to Broca’s area and surrounding regions in the left frontal lobe. Those with non-fluent aphasia are able to understand language fairly well, but they struggle with language production and syntax.