Afazide Üretim Problemleri
Özet
Nörobiyolojik ve bilişsel modeller çerçevesinde afazideki üretim ve işitsel anlama problemleri incelendiğinde, sözcük tekrarının motor aktivasyon, arcuat fasikül ve superior parietal temporal alan gibi beyin bölgeleriyle ilişkili olduğu ve bu yetinin afazide sıklıkla bozulduğu görülmektedir. Özellikle jargon afazisinde karşılaşılan neolojizm (hedef dışı anlamsız sözcük üretimi) ve perseverasyon süreçleri, sözcük seçimi ile fonolojik kodlama düzeyindeki ciddi bozukluklardan kaynaklanmaktadır. Dilin üretim sürecindeki en kritik aşamalardan biri olan sözcük seçimi aksadığında; harflerin yer değiştirmesiyle literal, farklı sözcük kullanımıyla verbal ve anlamsız ses dizimleriyle neolojistik parafaziler ortaya çıkmaktadır. İşitsel anlama yetisi ise sol posterior temporo-parietal korteks (cümle düzeyinde) ve alt-anterior temporal lezyonlar (sözcük düzeyinde) ile doğrudan bağlantılıdır. Afazili bireylerde işitsel girdinin işlenmesi, bağlamsal ipuçlarını içeren yukarıdan aşağıya (top-down) ve fonemleri ayırt eden aşağıdan yukarıya (bottom-up) sistemlerin veya bu sistemler arası etkileşimin inme sebebiyle hasar görmesi neticesinde sekteye uğramaktadır.
When production and auditory comprehension problems in aphasia are examined within neurobiological and cognitive models, word repetition is associated with brain regions such as motor activation, arcuate fasciculus, and superior parietal temporal area, and this ability is frequently impaired in aphasia. Neologism (production of meaningless words unrelated to the target) and perseveration processes, particularly encountered in jargon aphasia, stem from severe impairments at the level of word selection and phonological encoding. When word selection, one of the most critical stages in the language production process, is disrupted, literal paraphasias occur through the displacement of letters, verbal paraphasias through the use of different words, and neologistic paraphasias through meaningless sound sequences. Auditory comprehension is directly linked to left posterior temporo-parietal cortex (at the sentence level) and inferior-anterior temporal lesions (at the word level). Auditory input processing in individuals with aphasia is disrupted due to stroke-induced damage to top-down systems containing contextual cues, bottom-up systems distinguishing phonemes, or the interaction between these systems.
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