Therefore, patients can repeat complicated phrases, however they lack comprehension and propositional speech. Transcortical sensory aphasia is a disorder in which there is a discrepancy between phonological processing, which remains intact, and lexical-semantic processing, which is impaired. Fluency is determined by direct qualitative observation of the patient’s speech to determine the length of spoken phrases, and is usually characterized by a normal or rapid rate normal phrase length, rhythm, melody, and articulatory agility and normal or paragrammatic speech. Transcortical sensory aphasia is characterized as a fluent aphasia. However, since the arcuate fasciculus, Wernicke's area, and Broca's area are secluded from the rest of the brain in TSA, patients still have intact repetition (as information from the arcuate fasciculus is relayed to Broca’s area), but cannot attach meaning to words, either spoken or heard. In TSA Wernicke’s and Broca’s areas are spared, meaning that lesions do not occur in these regions of the brain. One function of the arcuate fasciculus is the connection between Wernicke’s and Broca’s area. Transcortical sensory aphasia is caused by lesions in the inferior left temporal lobe of the brain located near Wernicke's area, and is usually due to minor hemorrhage or contusion in the temporal lobe, or infarcts of the left posterior cerebral artery (PCA). Affected brain areas Damage to the inferior left temporal lobe, which is shown in green, is associated with TSA Furthermore, TMA is caused by lesions in cortical motor areas of the brain as well as lesions in the anterior portion of the basal ganglia, and can be seen in patients with expressive aphasia. Patients with TMA have impaired writing skills, difficulty speaking and difficulty maintaining a clear thought process. TSA should not be confused with transcortical motor aphasia (TMA), which is characterized by nonfluent speech output, with good comprehension and repetition. Clinical research on TSA is limited because it occurs so infrequently in patients with aphasia that it is very difficult to perform systematic studies. Speech therapy methods for patients with any subtype of aphasia are based on the principles of learning and neuroplasticity. Patients diagnosed with TSA have shown partial recovery of speech and comprehension after beginning speech therapy. Therefore, clinicians rely on language assessments and observations to determine if a patient presents with the characteristics of TSA. Transcortical sensory aphasia cannot be diagnosed through brain imaging techniques such as functional magnetic resonance imaging (fMRI), as the results are often difficult to interpret. However, transcortical sensory aphasia differs from receptive aphasia in that patients still have intact repetition and exhibit echolalia, or the compulsive repetition of words. In all of these ways, TSA is very similar to a more commonly known language disorder, receptive aphasia. The person may repeat questions rather than answer them ("echolalia"). TSA is a fluent aphasia similar to Wernicke's aphasia (receptive aphasia), with the exception of a strong ability to repeat words and phrases. Transcortical sensory aphasia ( TSA) is a kind of aphasia that involves damage to specific areas of the temporal lobe of the brain, resulting in symptoms such as poor auditory comprehension, relatively intact repetition, and fluent speech with semantic paraphasias present.
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