Évaluation de l’endophasie dans l’aphasie avec anomie secondaire à une lésion neurologique acquise

Vollständiger Abstract

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Background. Aphasia is a language disorder caused by brain damage, affecting the ability to speak, understand, read, or write. Anomia, defined as a difficulty in lexical access, is one of its most frequent manifestations. Several studies have investigated inner speech (or endophasia), defined as language production without articulation or vocalization, to determine whether difficulties observed in overt speech are also present in the internal modality. Many patients report being able to generate the correct phonological form of the target word internally, despite failures in overt production, highlighting the potential value of assessing and training endophasia in aphasia. Although recent studies have demonstrated the effectiveness of such training in French-speaking patients, few works have systematically evaluated endophasia in this context. Objective. This study aimed to compare internalized and externalized language production in patients with anomic aphasia, in order to examine the relationship between their overt lexical production and inner speech abilities. Verbal working memory abilities were analyzed in relation to performance on the inner speech tasks. The goal was to better understand the mechanisms underlying anomia and to inform more precise therapeutic interventions. Method. Fifteen participants with anomic aphasia were assessed using standard clinical tests, behavioural tasks targeting inner speech, and a subjective questionnaire collecting their experience of endophasia. Performances were analyzed both intra- and inter-individually to identify profiles of impairment in internalized and externalized modalities. Results. The findings confirm that, in some patients, inner speech can be preserved despite impaired overt speech production, suggesting that only motor programming is deficient. However, other patients show a different profile, with a specific impairment of inner speech that may be related to difficulties in maintaining internal phonological forms. Furthermore, performance in inner speech appears to be correlated with verbal working memory abilities, suggesting the involvement of shared processes during internal phonological judgment tasks. Conclusion. These results underscore the importance of including endophasia assessment in aphasiological evaluations. Further studies with larger samples and standardized experimental tools are needed to refine these observations and facilitate their translation into clinical practice.