関: acquired aphasia、aphasia、dysphasia、global aphasia、progressive aphasia、semantic aphasia

WordNet

an impairment of language (especially speech production) that is usually due to brain damage
inability to use or understand language (spoken or written) because of a brain lesion

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失語症

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/04/22 23:02:58」(JST)

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For the progressive metal band, see Alogia (band).

In psychology, alogia (Greek α-, “without”, and λόγος, “speech”^[1]), or poverty of speech,^[2] is a general lack of additional, unprompted content seen in normal speech. As a symptom, it is commonly seen in patients suffering from schizophrenia, and is considered as a negative symptom. It can complicate psychotherapy severely because of the considerable difficulty in holding a fluent conversation.

Alogia is often considered a form of aphasia, which is a general impairment in linguistic ability. It often occurs with mental retardation and dementia as a result of damage to the left hemisphere of the brain. People can revert to alogia as a way of reverse psychology, or avoiding questions.

Characteristics

Alogia is characterized by a lack of speech, often caused by a disruption in the thought process. Usually, an injury to the left hemisphere of the brain will cause alogia to appear in an individual.^[1] In conversation, alogic patients will reply very sparsely and their answers to questions will lack spontaneous content; sometimes, they will even fail to answer at all.^[3] Their responses will be brief, generally only appearing as a response to a question or prompt.^[4]

Apart from the lack of content in a reply, the manner in which the person delivers the reply is affected as well. Patients affected by alogia will often slur their responses, and not pronounce the consonants as clearly as usual. The few words spoken usually trail off into a whisper, or are just ended by the second syllable. Studies have shown a correlation between alogic ratings in individuals and the amount and duration of pauses in their speech when responding to a series of questions posed by the researcher.^[1]^[5]

The disability to speak stems from a deeper mental disability that causes alogic patients to have difficulty grasping the right words mentally, as well as formulating their thoughts. A study investigating alogics and their results on the category fluency task showed that schizophrenics suffering from alogia display a more disorganized semantic memory than controls. While both groups produced the same number of words, the words produced by schizophrenics were much more disorderly and the results of cluster analysis revealed bizarre coherence in the alogia group.^[4]

Example

Alogia	Normal speech
Q: Do you have any children? A: Yes. Q: How many? A: Two. Q: How old are they? A: Six and sixteen. Q: Are they boys or girls? A: One of each. Q: Who is the sixteen-year-old? A: The boy. Q: What is his name? A: Edmond. Q: And the girl's? A: Alice.	Q: Do you have any children? A: Yes, a boy and a girl. Q: How old are they? A: Edmond is sixteen and Alice is six.

Causes

Alogia can be brought on by frontostriatal dysfunction which causes degrading of the semantic store, the center located in the temporal lobe that processes meaning in language. A subgroup of chronic schizophrenic patients in a word generation experiment generated fewer words than the unaffected subjects and had limited lexicons, evidence of the weakening of the semantic store. Another study found that when given the task of naming items in a category, schizophrenic patients displayed a great struggle but improved significantly when experimenters employed a second stimulus to guide behavior unconsciously. This conclusion was similar to results produced from patients with Huntington's and Parkinson's disease, ailments which also involve frontostriatal dysfunction.^[6]

Treatment

Medical studies conclude that certain adjunctive drugs effectively palliate the negative symptoms of schizophrenia, mainly alogia. In one study, Maprotiline produced the greatest reduction in alogia symptoms with a 50% decrease in severity.^[7] Of the negative symptoms of schizophrenia, alogia had the second best responsiveness to the drugs, surpassed only by attention deficiency. D-amphetamine is another drug that has been tested on people with schizophrenia and found success in alleviating negative symptoms. This treatment, however, has not been developed greatly as it seems to have adverse effects on other aspects of schizophrenia such as increasing the severity of positive symptoms.^[8]

Relation to schizophrenia

Although alogia is found as a symptom in a variety of health disorders, it is most commonly found as a negative symptom of schizophrenia.

The negative symptoms of schizophrenia have previously been considered to be related to a psychiatric form of the Dysexecutive Syndrome (also known as frontal lobe syndrome). Studies show that the symptoms of schizophrenia do indeed correlate with frontal lobe syndrome.^[9]

Previous studies and analyses conclude that there are three factors that include both the positive and negative symptoms of schizophrenia. These three factors are: alogia, attentional impairment, and inappropriate affect. Studies suggest that an inappropriate affect is strongly associated with bizarre behavior and positive formal thought disorder, attentional impairment correlates significantly with psychotic, disorganization, and negative symptom factors. However, alogia is seen to contain both positive and negative symptoms, with the poverty of content of speech as the disorganization factor, and poverty of speech, latency, and blocking as the negative symptom factor. These results suggest that three dimensions are needed to categorize schizophrenia's negative and positive symptoms.^[10]

References

^ ^a ^b ^c "MedTerms medical dictionary, Alogia definition". Archived from the original on 22 October 2006. Retrieved 2006-09-30.
^ American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: DSM-IV-TR®. American Psychiatric Pub. p. 301. ISBN 978-0-89042-025-6. Retrieved 29 April 2012.
^ "Alogia- Definition".
^ ^a ^b Alpert, M., Kotsaftis, A. & Pouget, E.R. (1997). Speech fluency and schizophrenic negative signs. Schizophrenia Bulletin, 23, 171-177.
^ Alpert, M. Clark, A. & Pouget, E.R. (1994). The syntactic role of pauses in the speech of schizophrenic patients with alogia. Journal of Abnormal Psychology, 103, 750-757
^ Chen, R.Y., Chen, E.Y., Chan, C.K., Lam, L.C. & Lieh-Mak, E. (2000). Verbal fluency in schizophrenia: reduction in semantic store. Australian and New Zealand Journal of Psychiatry, 34, 43-48.
^ Shafti, S.S., Rey, S., Abad, A. (2005). "Drug – Specific Responsiveness of Negative Symptoms.". International Journal of Psychosocial Rehabilitation. pp. 10 (1), 43–51.
^ Desai, N., Gangadhar, B.N., Pradhan, N. & Channabasavanna, S.M. (1984). Treatment of negative schizophrenia with d-amphetamine. The American Journal of Psychiatry, 141, 723-724.
^ Barch, D.M. & Berenbaum, H. (1996). Language production and thought disorder in schizophrenia. Journal of Abnormal Psychology, 105, 81-88.
^ Miller, D., Arndt, S. & Andreasen, N. (2004). Alogia, attentional impairment, and inappropriate affect: Their status in the dimensions of schizophrenia. Comprehensive psychiatry, 34, 221-226.

UpToDate Contents

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English Journal

Efficacy of semantic-phonological treatment combined with tDCS for verb retrieval in a patient with aphasia.

Manenti R1, Petesi M, Brambilla M, Rosini S, Miozzo A, Padovani A, Miniussi C, Cotelli M.
Neurocase.Neurocase.2015 Feb;21(1):109-19. doi: 10.1080/13554794.2013.873062. Epub 2014 Jan 13.
Recent studies reported enhanced performance on language tasks induced by transcranial direct current stimulation (tDCS) in patients with aphasia. One chronic patient with non-fluent aphasia received 20 sessions of a verb anomia training combined with off-line bihemispheric tDCS applied to the dorso
PMID 24417248

Verbal creativity in semantic variant primary progressive aphasia.

Wu TQ1, Miller ZA, Adhimoolam B, Zackey DD, Khan BK, Ketelle R, Rankin KP, Miller BL.
Neurocase.Neurocase.2015 Feb;21(1):73-8. doi: 10.1080/13554794.2013.860179. Epub 2013 Dec 12.
Emergence of visual and musical creativity in the setting of neurologic disease has been reported in patients with semantic variant primary progressive aphasia (svPPA), also called semantic dementia (SD). It is hypothesized that loss of left anterior frontotemporal function facilitates activity of t
PMID 24329034

CSF levels of Aβ1-38/Aβ1-40/Aβ1-42 and (11)C PiB-PET studies in three clinical variants of primary progressive aphasia and Alzheimer's disease.

Ikeda M1, Tashiro Y, Takai E, Kurose S, Fugami N, Tsuda K, Arisaka Y, Kodaira S, Fujita Y, Makioka K, Mizuno Y, Shimada H, Harigaya Y, Takatama M, Amari M, Yamazaki T, Yamaguchi H, Higuchi T, Okamoto K, Tsushima Y, Ikeda Y.
Amyloid : the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis.Amyloid.2014 Dec;21(4):238-45. doi: 10.3109/13506129.2014.949231. Epub 2014 Aug 20.
Abstract Primary progressive aphasia (PPA) is a cognitive syndrome characterized by progressive and isolated language impairments due to neurodegenerative diseases. Recently, an international group of experts published a Consensus Classification of the three PPA clinical variants (naPPA, svPPA and l
PMID 25139672

Japanese Journal

統合失調症患者における長期意味記憶の衰退と精神症状の関連

住吉チカ
脳と精神の医学 = Brain science and mental disorders 18(1), 61-72, 2007-03-25
NAID 10029854286

<Originals>Information processing capacity in schizophrenics : with special regard to communication disorders

OISHI Masaaki
Acta medica Kinki University 22(2), 181-191, 1997-06-00
… It is considered that the impairment of this ability is closely related to attentional impairment and alogia among the negative symptoms of schizophrenia, and that impairment progresses as duration of the illness is prolonged. …
NAID 110000007450

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NAID 110006180933