Aphasia: The disorder that makes you lose your words - Susan Wortman-Jutt

譯者: Ann Chen 審譯者: 瑞文Eleven 林Lim

Language is an essential part of our lives that we often take for granted.

語言是我們日常生活中 重要的一部份

我們視其為理所當然

With it, we can communicate our thoughts and feelings,

藉著它，我們能傳達思想與感覺

lose ourselves in novels,

忘我地沉浸於小說中

send text messages,

傳送簡訊

and greet friends.

以及問候朋友

It's hard to imagine being unable to turn thoughts into words.

很難想像無法將思想 轉成話語的情況

But if the delicate web of language networks in your brain

但如果大腦中精密的 語言網絡系統

became disrupted by stroke, illness, or trauma,

因中風、疾病或創傷而被阻斷

you could find yourself truly at a loss for words.

你會發現你真的是張口結舌

This disorder, called aphasia, can impair all aspects of communication.

這種病症稱為「失語症」 會影響到各方面的溝通

People who have aphasia remain as intelligent as ever.

失語症的人仍保有原本的智力

They know what they want to say,

他們知道自己要說什麼

but can't always get their words to come out correctly.

但無法每次都正確地說出

They may unintentionally use substitutions called paraphasias,

他們可能無心地使用了替代字眼 稱為「言語錯亂症」

switching related words, like saying "dog" for "cat,"

即替換了相關的字眼 例如將「貓」說成「狗」

or words that sound similar, such as "house" for "horse."

或說了語音相似的字

例如將馬 (horse) 說成房子 (house)

Sometimes, their words may even be unrecognizable.

有時，別人甚至 無法聽懂他們所說的字

There are several types of aphasia grouped into two categories:

失語症有許多症型 大致分為兩種類型

fluent, or receptive, aphasia

流暢型，即接受型失語症

and non-fluent, or expressive, aphasia.

以及非流暢型，即表達型失語症

People with fluent aphasia may have normal vocal inflection

流暢型失語症的人 可能說話有正常的抑揚頓挫

but use words that lack meaning.

但使用一些無意義的詞彙

They have difficulty comprehending the speech of others

他們無法理解別人所說的話

and are frequently unable to recognize their own speech errors.

而且常無法意識到 自己使用了錯誤的字眼

People with non-fluent aphasia, on the other hand,

反之，非流暢型失語症的人

may have good comprehension

可能理解能力很好

but will experience long hesitations between words and make grammatical errors.

但說話遲滯斷續，並且語法錯誤

We all have that tip-of-the-tongue feeling from time to time

當我們說話想不出字詞時 偶而會有舌頭打結的感覺

when we can't think of a word,

but having aphasia can make it hard to name simple, everyday objects.

但失語症患者

連日常用品的名稱也無法說出

Even reading and writing can be difficult and frustrating.

甚至連閱讀與書寫 也會感到困難與挫折

So how does this language loss happen?

這種失語症狀是如何發生的呢？

The human brain has two hemispheres.

人類的大腦有兩個半球

In most people, the left hemisphere governs language.

多數人的左半球掌管語言

We know this because in 1861,

我們知道這個是因為在 1861 年

the physician Paul Broca studied a patient

保羅·布洛卡醫師研究了一位病人

who lost the ability to use all but a single word, "tan."

這病人只能說出一個字 “tan”

During a postmortem study of that patient's brain,

於屍體解剖研究病人的大腦時

Broca discovered a large lesion in the left hemisphere

布洛卡醫師發現 在其左半球有大片損傷

now known as Broca's area.

即現今所知的布洛卡區

Scientists today believe that Broca's area is responsible in part for naming objects

現在科學家認為布洛卡區 是負責事物命名

and coordinating the muscles involved in speech.

以及協調講話時所用的肌肉

Behind Broca's area is Wernicke's area near the auditory cortex.

在布洛卡區的後方 靠近聽覺皮層的是韋尼克區

That's where the brain attaches meaning to speech sounds.

這是大腦將語音和意義相連之處

Damage to Wernicke's area impairs the brain's ability to comprehend language.

韋尼克區損傷 會影響理解語言的能力

Aphasia is caused by injury to one or both of these specialized language areas.

失語症就是導因於 其中一個或兩個特殊語言區的損傷

Fortunately, there are other areas of the brain

幸好大腦尚有其他部位

which support these language centers

可支援這些語言中樞

and can assist with communication.

以及協助溝通

Even brain areas that control movement are connected to language.

甚至連大腦掌管運動的部位 也和語言區相連

FMRI studies found that when we hear action words, like "run" or "dance,"

功能性磁振造影研究發現

當我們聽到動作詞語 如「跑」或「跳舞」

parts of the brain responsible for movement light up

大腦掌管運動的部位會亮起來

as if the body was actually running or dancing.

彷彿身體真正在跑或跳舞

Our other hemisphere contributes to language, too,

大腦右半球也有助於語言

enhancing the rhythm and intonation of our speech.

它能加強說話的節律與聲調

These non-language areas sometimes assist people with aphasia

當溝通困難時，這些非語言區 有時也會協助失語症患者

when communication is difficult.

So how common is aphasia?

失語症到底有多常見呢？

Approximately 1 million people in the U.S. alone have it,

單單在美國，就約有 1 百萬的人罹患此病

with an estimated 80,000 new cases per year.

估計每年新增 8 萬名患者

About one-third of stroke survivors suffer from aphasia

約 1/3 中風倖存者為失語症所苦

making it more prevalent than Parkinson's disease

比帕金森氏症 或多發性硬化症更為普遍

or multiple sclerosis,

yet less widely known.

但此病仍鮮為人知

There is one rare form of aphasia called primary progressive aphasia, or PPA,

有種罕見的失語症 稱為「原發型進行性失語症」

又稱 PPA

which is not caused by stroke or brain injury,

它不是肇因於中風或大腦創傷

but is actually a form of dementia

事實上它是失智症的一種現象

in which language loss is the first symptom.

而失語症正是它的初始症狀

The goal in treating PPA is to maintain language function for as long as possible

治療 PPA 的目標是：

在其他失智症狀發生之前 儘可能保有患者的語言能力，愈久愈好

before other symptoms of dementia eventually occur.

However, when aphasia is acquired from a stroke or brain trauma,

然而，當失語症源於 中風或腦部外傷時

language improvement may be achieved through speech therapy.

透過語言治療可能改善語言的能力

Our brain's ability to repair itself, known as brain plasticity,

大腦自我修復的能力── 也就是「大腦可塑性」

permits areas surrounding a brain lesion

使得大腦損傷部位的周圍區域

to take over some functions during the recovery process.

於恢復過程中行使了部份的機能

Scientists have been conducting experiments using new forms of technology,

科學家一直在用新技術進行實驗

which they believe may encourage brain plasticity in people with aphasia.

他們認為這些技術 會提升失語症患者的大腦可塑性

Meanwhile, many people with aphasia remain isolated,

同時，許多失語症患者處於孤立隔絕

afraid that others won't understand them or give them extra time to speak.

生怕其他人不了解他們 或不給他們多些時間表達

By offering them the time and flexibility to communicate in whatever way they can,

藉著給予他們 時間與盡情溝通的靈活性

you can help open the door to language again,

你能協助他們再度打開語言的大門

moving beyond the limitations of aphasia.

超越失語症的局限