Fluent Nonfluent Aphasias

Fluent Nonfluent Aphasias

Which are the nonfluent aphasias and which are the fluent aphasias?

Nonfluent Aphasias

Anterior aphasias are Nonfluent Aphasias which includes

• Broca’s,
• global,
• mixed transcortical
• transcortical motor

Fluent aphasias

The posterior aphasias are fluent aphasias which includes

• Wernicke’s,
• transcortical sensory,
• and usually thalamic 

The Aphasias

	Fluency	Repetition	Naming/Word Finding	Comprehension	Reading	Writing	Paraphasic Errors	Lesion Location
Transcortical motor	NF	Gd		Gd			Semantic	Supplementary motor
Mixed transcortical	NF	Gd		↓				Watershed distribution
Aphemia	NF			Nl		Nl		Lower motor strip, SMA
Anterior subcortical (basal ganglia)	Dysarthria, decreased fluency	Mild ↓		Mild ↓				Basal ganglia—putamen and caudate
Global	NF	↓	↓	↓	↓	↓		Broca’s and Wernicke’s
Broca’s	NF	↓	Poor	Relatively nl	↓	↓	Semantic and phonemic	Frontal operculum/Brodmann 44 and 45
Conduction	F	↓	Anomia	Nl			Phonemic	Arcuate fasciculus
Wernicke’s	F	↓	↓	↓		↓	Semantic and phonemic	Posterior temporal/Brodmann 22, 37, 39, or 40
Transcortical sensory	F	Gd		↓			Semantic	Temporoparietal
Anomic	F	Gd	↓	Nl				Temporal–parietal–occipital Association
Thalamic	F	Gd—fairly	Severe	↓	↓	↓		Ant, VA, DL, VL, Ant DM nuclei
Alexia w/o agraphia	F	Gd	Gd	Nl	↓	Nl		Left occipital plus posterior corpus callosum
Alexia w/agraphia	F	Gd	Gd	Nl	↓	↓		Angular gyrus

NF , Nonfluent; F , fluent; Gd , good; Nl , normal; SMA , supplementary motor area; Ant , Anterior nucleus; VA , Ventral anterior nucleus; DL , Lateral dorsal nucleus; VL , Lateral ventral nucleus; Ant DM , Anterior part of the medial dorsal nucleus.