What is the primary deficit in Wernicke's aphasia?

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Question: What is the primary deficit in Wernicke's aphasia?

Option analysis:
- Speech perception: In Wernicke's aphasia, patients typically have intact basic speech perception and auditory discrimination, but they struggle with understanding meaning and producing meaningful language. The core problem is not the sensory perception of speech sounds but the interpretation of spoken language. Therefore this option is not the best characterization of the primary deficit.
- Speech comprehension: This is the hallmark feature of Wernicke's aphasia. Individuals have fluent speech output, yet their comprehension of spoken language is severely impaired, leading to misunderstandings and nonsensical or paraphasic speech. This aligns with the standard clinical description of Wernicke's aphasia as a receptive language disorder. Hence this option accurately identifies the primary deficit.
- Speech production: While some language production aspects may be affected due to disorganized or fluent but meaningless speech, the defining impairment in Wernicke's aphasia is not the production itself but the failure to comprehend language. Other aphasia types (like Broca's) more prominently feature production deficits. Therefore this option does not capture the primary deficit.

To connect these points: Wernicke's area is involved in processing and understanding language. When damaged, the brain's ability to derive meaningful meaning from words and sentences deteriorates, even though the individual may speak fluently. Misunderstandings, jargon, and nonsensical content are common because the linguistic form is produced without accurate semantic integration.

Summary of why the other options are less appropriate: 'Speech perception' would imply a sensory-level hearing issue, which is not the core problem in Wernicke's aphasia. 'Speech production' would emphasize the act of speaking itself, which is relatively preserved or only superficially affected in this condition. The strongest, most clinically supported description is the profound deficit in 'speech comprehension.'

PSC 135 001 SQ 2025 Lecture 26: (Disorders of) Language I: Syntax/Semantics; Aphasias

What is the primary deficit in Wernicke's aphasia?

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