A technician examines a brain scan. / El Correo

What is aphasia, the condition affecting Bruce Willis?

The actor says goodbye to the film industry at 67 after being diagnosed with this rare disorder

RAFAEL SANZ DEL RÍO

From Die Hard (1988) to Glass (2019), the face of Walter Bruce Willis has been linked to cinema and success. He has reaped a fantastic career over three decades and says goodbye after discovering that he suffers from a rare pathology that affects his cognitive abilities: aphasia.

The American Speech-Language-Hearing Association (ASHA) defines aphasia as a disorder resulting from an injury to the parts of the brain responsible for language, and which can cause problems in related skills: expression, comprehension, reading and writing.

Bruce Willis

This condition is common in middle-aged adults and especially in older people, and also appears in 30-40 per cent of stroke survivors, affecting around two million people worldwide according to Spanish clinic Neuron. Aphasia can manifest itself in two main ways:

Wemicke's aphasia

Also known as receptive aphasia, this is a lesion in the area of the brain with the same name. The patient can speak with ease and rhythm, but often the sentences are confusing and meaningless. The patients do not realise that their communication is disordered, which affects their reading and writing.

Broca's (expressive) aphasia

This second variant affects semantics. The sufferer understands the meaning of words and is aware of his own communicative intention, but has problems in finding the term he wants to express.

His speech lacks a normal rhythm because of the effort involved, and the use of swear words in speech is common, but the message to the sender always makes sense. This type also impairs writing skills, and the patients also can have great difficulty in repeating a normal sentence.

Other types of aphasia

Alexia (difficulty in understanding written words), anomia (poor ability to remember names or concepts) or global aphasia (variant that affects both brain areas but retains the use of swear words as it is connected to the emotional side of the organ).

Diagnosis and treatment

The detection of this branch of the condition is often confusing, since there are nervous conditions, such as dysarthria, with similar symptoms but affecting the nervous and muscular system rather than brain activity. Tests focus on fluency of speech, difficulty in starting a conversation and the ability to repeat sentences. But the patient’s comprehension is also monitored - tests requiring them to write and read aloud are performed. Usually this type of examination is performed by a speech therapist or a neuropsychologist, who will also request CT scans and MRI scans to check on the brain’s activity.

For the treatment of this condition, it is vital to know the origin of the lesion. For example, if cancer causes brain swelling, drugs such as corticosteroids can reduce it and thereby restore language skills.

ASHA advocates that the most appropriate approach is a combination of formal and informal tasks, in coordination with different health sectors (since in cases such as strokes, the involvement of different fields is necessary). There are many cases where patients do not recover their primary language skills and are forced to communicate through electronic devices, and some even with notebooks.