Thalamische Aphasien
Ätiologie und Erscheinungsformen von Sprachverarbeitungsstörungen nach Thalamusläsionen
Abstract
Primär nach linksseitigen thalamischen Läsionen manifestieren sich zwei sprachpathologische Syndrome, die charakterisiert sind durch eine entweder verminderte oder aber flüssige Spontansprachenproduktion, Wortabrufstörungen infolge mangelhafter semantischer Selektion, Perseverationen, Paraphasien, relativ intakte schriftsprachliche, syntaktische und repetitive Fähigkeiten, moderate auditive und visuelle Sprachverständnisstörungen sowie fakultative sprechmotorische Beeinträchtigungen wie Hypophonie und/oder Dysprosodie. Diese als «thalamische Aphasien» bezeichneten Syndrome zeigen einen im Vergleich zu kortikalen Aphasien distinkten Pathomechanismus, da vor allem kognitive Basisprozesse (wie Aufmerksamkeit, Gedächtnis, Exekutivfunktionen, Antrieb etc.) beeinträchtigt sind, die sekundär zu ineffizienten Sprachverarbeitungsprozessen führen. Zudem führen thalamische Läsionen oft zu Amnesien, Orientierungsstörungen und Anosognosie, die auf sprachlicher Ebene u. a. thematische Instabilität, Fragmentation und Konfabulationen zur Folge haben.
After left-hemispheric thalamic lesions primarily two pathological language syndromes occur. These are characterized by several symptoms, such as a reduced spontaneous speech production or spared fluency, anomia which is caused by impaired semantic selection, perseverations, paraphasias, relatively unimpaired abilities in reading and writing and in syntactical and repetition skills, moderately impaired auditory and visual comprehension and optional speech disturbances like hypophonia and/or dysprosodia. These syndromes, known as «thalamic aphasias», show a distinct pathomechanism in comparison with cortical aphasias, because they mainly effect basic cognitive processes (attention, memory, executive functions, internal drive etc.), which secondary cause a deteriorated language processing. Additionally, thalamic lesions often cause amnesias, disorientation and anosognosia, which lead to thematic instability, fragmentation and confabulations.
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