Disorders of the semantic level are manifested in the difficulties of selecting and pronouncing words and verbal paraphasia. They are combined with phonological disorders represented by literal paraphasia.

Motor dysprosody is manifested in stammering difficult expressive speech, which is characterized by a distortion of the rhythmic-melodic structure and a decrease in the activity of speech production.

Articulation disorders are less pronounced for single phonemes, but are often observed in sequences of articulatory movements when pronouncing words. In almost all cases of moderate Broca's aphasia, motor agrammatism is present.

Disturbances in the motor aspect of speech production are accompanied by difficulties in understanding speech, which are usually not as severe as in Wernicke's aphasia, and disorders of reading and especially writing.

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These multilevel disorders in most cases are based on rather extensive lesions affecting several neighboring speech zones in the cortical and subcortical structures of the left hemisphere of the brain that dominates speech. In patients with moderate Broca's aphasia, conventional conversational speech becomes possible, but there are significant difficulties in finding words, which are manifested in a decrease in speech production, which is impoverished, simplified and possibly inhibited due to the absence of anosognosia, or a preserved insight into speech disorders.

Word-finding difficulties in Wernicke's aphasia differ from the similar symptom in Broca's aphasia in that it is difficult for the patient to find a word that corresponds to the desired meaning, but speech production in these patients is significantly increased due to an excessive number of incorrect words, or verbal paraphasia, which is less restrained by insight, since patients with Wernicke's aphasia often have severe anosognosia of the speech disorder.

In Wernicke's aphasia, the articulation of individual phonemes and their sequences is usually preserved.

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In patients with Broca's aphasia, sentences consist mainly of high-frequency words, usually no more than two or three, and often only one word. The relative preservation of high-frequency words and sentences is especially evident in automatic speech. A patient with a significant decrease in speech output usually has only mild difficulty saying the sequence of days of the week (Monday, Tuesday.), months (January, February.) and especially simple numbers (one, two.) or in repeating the correct words when performing a popular song or reciting a familiar prayer.
Anomia is commonly seen in patients with Broca's aphasia and other types of anterior aphasia, but is even more common in patients with posterior aphasia, especially transcortical sensory aphasia. Clues based on the phonemic properties of stored vocabulary words are usually less helpful in naming objects in anterior aphasia than in posterior aphasia. Patients with Broca's aphasia often require a cue consisting of the first two or three syllables of a three- or four-syllable word. In posterior aphasia, the prompting of one or two phonemes often leads to correct naming.
In general, as shown in the following sections, phonological disturbances in Broca's aphasia may be secondary to primary disturbances in the sequence of articulatory patterns that are drawn from a stored vocabulary and further translated into more general or detailed descriptions at the level of speech movements. These impairments can be non-linguistic and permanent, causing standard literal paraphasia, phoneme omission, perseveration, and errors in transition to the appropriate phonemes at the phonological level.


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Suggestion for the first letters of the nameusually helps the patient name the object, so it is possible that retrieval of a word from a dictionary in a lexical module can be facilitated by a list of words based on their phonological properties.