Which aphasia type is characterized by nonfluent speech with relatively preserved repetition?

• A. Transcortical motor aphasia
• B. Wernicke's aphasia
• C. Global aphasia
• D. Conduction aphasia

Answer: (A)

Focusing on how speech is produced and repeated helps clarify this pattern. When speech is nonfluent—effortful, with short, telegraphic phrases—but repetition remains relatively intact, the profile fits transcortical motor aphasia. The person understands language well and can repeat phrases, but spontaneous speech initiation is impaired, so talking is slow and hesitant. This happens because the frontal speech-initiation circuits are disrupted (often anterior to the classic Broca’s area), while the pathway that supports repetition, the arcuate fasciculus, stays functional.

This differs from other aphasias: Wernicke’s aphasia involves fluent but often meaningless speech with poor comprehension; global aphasia shows major deficits in both language production and comprehension; conduction aphasia features fluent speech with impaired repetition due to disruption of the repetition pathway. The key idea is that nonfluency with preserved repetition points to a motor initiation disruption rather than a breakdown in language comprehension or the repetition network.