Signs of Broca's Aphasia
Broca's aphasia is characterized by non-fluent, effortful speech with preserved comprehension, agrammatism (telegraphic speech with omission of grammatical elements), and impairments across all language modalities including speaking, comprehension, reading, and writing. 1
Core Speech Production Features
- Non-fluent, halting speech typically limited to one to three words per utterance, representing the most distinguishing feature 2
- Effortful articulation with slow, labored speech production that requires significant effort from the patient 1, 3
- Agrammatism (telegraphic speech) with omission of function words, grammatical morphemes, and simplified sentence structure—this is the characteristic feature enabling differential diagnosis 1
- Hesitations and pauses during speech attempts, reflecting the struggle to produce language 4
Language Comprehension Deficits
- Relatively preserved comprehension compared to speech production, though not entirely intact 3
- Variable comprehension patterns exist across patients—contrary to older theories, Broca's aphasia does not produce a single consistent pattern of comprehension performance 5
- Difficulty with complex grammatical structures, particularly passive voice constructions and non-canonical sentence types, though this varies significantly between individuals 5
Impairments Across All Language Modalities
- Reading deficits affecting the ability to comprehend written language 1
- Writing impairments with similar agrammatic features as seen in speech 1
- Word-finding difficulties particularly with longer words and less frequently occurring words in English 6
- Repetition difficulties though typically less severe than in other aphasia types 3
Associated Motor Speech Features
- Dysarthria may coexist due to impaired innervation of phonatory and articulatory musculature 1
- Apraxia of speech (motor planning/programming difficulties) is commonly associated, particularly in the nonfluent/agrammatic variant 4, 3
- These motor speech disorders do not fully account for all linguistic deficits observed 1
Neuroanatomical Correlation
- Left inferior frontal lobe damage (Broca's area) is the primary lesion site 3
- Damage to dorsal language pathways including the arcuate fasciculus and superior longitudinal fasciculus may be involved 4, 2
Common Error Patterns
- Semantic errors are the most common error type across all aphasia types, including Broca's 6
- "No response" errors are significantly more common in Broca's aphasia during oral expression tasks compared to other aphasia types 6
Clinical Pitfalls to Avoid
Do not assume comprehension is completely intact simply because it appears relatively preserved compared to expression—comprehensive assessment should evaluate all language domains including comprehension, speaking, reading, writing, and gesturing 4. The presence of dysarthria does not explain the full linguistic deficit pattern; true aphasia involves language processing impairments beyond motor execution 1.