병리언어학, 외국어대학교, 2011 1학기
A woman in her early 50s was admitted to a hospital because of increasingly odd behavior
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Memory problems(건망증, 기억력상실)◦
Strong feelings of jealousy(질투)◦
Become disoriented at home(e.g., didn’t know where she was)◦
Hiding objects
During a doctor's examination
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치매◦
Unable to remember her husband's name, the year, or how long she had been at the hospital◦
Could read but did not seem to understand what
“NO MIND”, “OUT OF MIND”, “DEPRIVED OF MIND”, “CRAZY”
하나의 특정 병명이 아닌 여러 관련 병을 포함한 포괄적 병명 (not just one type of disease)
An “umbrella term” for a group of both pathological conditions and syndromes (or many types of
dementia)
후천성 (acquired)
노인성 (senile)
신경학적 원인으로 발생한 지적, 인지장애
정상적 일상활동 문제
건망증, 기억력 상실 (APA, 1994)
의사소통장애
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Diagnosed if two or more brain functions - such asmemory, language skills, perception, or cognitive skills including reasoning(논리적 사고) and judgment(판단력) - are significantly impaired without loss of
consciousness
병소에 따라 치매 증상이 달라짐
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피질 치매, 피질하 치매◦
다발성뇌졸증(multiple strokes)◦
감염(infections)◦
알츠하이머(Alzheimer’s disease)◦
파킨슨병(Parkinson’s disease)◦
픽 증후군(Pick’s disease)◦
헌팅턴 증후군, 무도병(Huntington’s disease)
Alzheimer’s disease accounts for over 50 % of
all dementia cases
뇌조직 (세포) 파괴(the deterioration of brain tissue)
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피질 치매(cortical dementia) The cellular changes associated with dementia primarily in cortical areas
Alzheimer’s disease
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피질하 치매(subcortical dementia) The cellular changes primarily in subcortical areas
One-third of cases of Parkinson’s disease
치매 증상
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명명능력 감퇴(name recall difficulties)◦
occasional disorientation in time
in place
in person
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기억력 감퇴(memory loss)◦
의사소통장애(severe communication difficulties)◦
성격 변화(radical personality changes or behavioral problems)◦
감정변화(emotional problems)
언어관련 증상 (Language difficulties)
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기억력 상실과 주로 관련 A significant decline in naming and word retrieval
Language form – phonology, morphology, and syntax- is generally less disordered
Conversation may lack coherence(일관성)
May be filled with repetitions, stereotypic utterances, false starts, verbal repairs, jargon, neologisms
Use of phrases such as “that one” and “you know”
(Shekim & LaPointe, 1984)
A cortical pathology that affects approximately 6%
of individuals over age sixty-five and 15% of those over age eighty (Clarke & Witte, 1991)
Primarily impaired in memory, language, or visuospatial skills (DeSanti, 1997)
Two or three times as common in women as in men
Often referred to as “senile dementia”(노인성치매, 망령 )
“Unknown cause”
Die of aspiration(흡인)/폐렴
As a result of diffuse brain atrophy, an affected individual’s brain may decrease in weight by 20%
Extensive damage to the
hippocampus(해마, “장기기억저장소”)
Symptoms include:
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Memory problems◦
Impairment in retention(기억력, 보유력) of newly learned information (Convit et al., 1995)◦
Long-term memory initially unimpaired but deteriorates as the disease progresses
In the early stages
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may experience memory impairment, lapses of judgment, and subtle changes in personality
As the disorder progresses
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memory and language problems worsen◦
begin to have difficulty performing activities of daily living, such as “balancing a checkbook” or“remembering to take medications”
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이전에 해오던 행동/일 문제 May become disoriented about places and times
may suffer delusions
may become short-tempered and hostile
During the late stages of the disease
begin to lose the ability to control motor functions such as swallowing, or lose bowel and bladder control
eventually lose the ability to recognize family members and to speak
aspiration and pneumonia(주요 사망원인)
언어관련증상
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Initial language difficulties 이름대기/찾기 문제(Word finding difficulties)
Off-topic comments
Comprehension-related difficulties
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Later language difficulties Paraphasia
Delayed responding
언어관련증상
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In more severe stages Reduced expressive and receptive vocabulary and complex sentence production
Pronoun confusion
Topic digression
Inability to return to and to shift topic
쓰기, 읽기 문제 (Mentis, Briggs-Whitetaker, & Gramigna, 1995)
언어관련증상
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In its most severe form Naming errors
The use of generic words (e.g., this, that)
Syntactic errors
Minimal comprehension
Jargon, echolalia, or mutism (DeSanti, 1997)
More severe communicational breakdown
Parkinson’s(파킨슨병) disease which affects mostly subcortical brain areas
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톱니바퀴경직성(cogwheel movement)◦
Resting tremor(안정 떨림)◦
“Bradykinesia”(움직임 느림)
Significant impact on the ability to produce speech
Difficulties in initiating or articulating speech
sounds
Dysgraphia (실서증, or disturbance in the ability to write)
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Micrographia (i.e., a tendency to write very small letters)◦
Inappropriate use of space in writing◦
A tendency to err more frequently on inflectional endings
Primarily with memory problems
Problems operating on the knowledge they
already have (e.g., spelling “world” backwards)
Impairment in retention of newly learned information (Grossman et al., 1994)
Exposed to a new verb (“wamble”, meaning “to return home”) and asked about it 10 minutes later
Learned nothing about the verb, or picked up only semantic information but not information about syntactic use
