Language is the home of the human mind. Through language, people create meaning, recall memories, and connect with the world around them. But what happens when that home begins to crumble from within—when the brain can no longer find the words? This is where the story of aphasia begins, and among its many forms, two stand out in sharp contrast: Primary Progressive Aphasia (PPA) and stroke-induced aphasia.

 

A recent narrative study by a collaborative team of linguists and neurologists from the Faculty of Medicine at Universitas Sumatera Utara and Universitas Indonesia—Fasihah Irfani Fitri, Aldy Safruddin Rambe, Elmeida Effendy, Alfansuri Kadri, Pukovisa Prawiroharjo, Inke Nadia Diniyanti Lubis, Khairul Putra Surbakti, Mustafa Mahmud Amin, Muhammad Rusda, and Gustianingsih—reveals that behind complex medical terminology lie linguistic issues deeply intertwined with daily communication. The structure of language, word choice, and everyday speech habits all shape how individuals lose their ability to use language.

 

Primary Progressive Aphasia differs from most other neurological disorders. It does not appear suddenly like a stroke but develops slowly, subtly, and often unnoticed. Someone with PPA may speak fluently today, forget a word tomorrow, and lose the ability to form full sentences within a year. Memory remains intact, reasoning is preserved, yet language slowly fades. Stroke-induced aphasia, on the other hand, occurs abruptly. When blood flow to specific brain regions is cut off, speech ability can vanish in a single day. However, because the brain does not undergo progressive degeneration, therapy can often help restore some of this lost ability.

 

“This is why research like this matters,” explains Fasihah. “Almost all aphasia diagnostic tools used in Indonesia are developed abroad—in English, with very different grammatical structures and morphological systems. Meanwhile, Indonesian has unique linguistic features that influence how aphasia appears. The sentence structure is simple, phonetic, and highly dependent on flexible affixes.”

 

For example, stroke patients in English-speaking countries often lose nouns or prepositions. In Indonesian, however, they may struggle more with affixes such as me- or ber-. In PPA, patients may still speak fluently but lose understanding of affixes or distinctions between active and passive verbs. These patterns show that diagnosis in Indonesia cannot simply replicate Western methods; it must adopt a local linguistic lens.

 

“In multilingual countries like Indonesia, the challenge becomes even more complex,” adds Aldi. “Many patients use two or three languages daily—Batak at home, Indonesian at school, and English at work. When aphasia strikes, which language disappears first? Which language is easiest to recover? These are not only medical questions, but also social and cultural ones.”

The study emphasizes that the linguistic profile of Indonesian speakers must be integrated into diagnosis and therapy. Too often, patients are misunderstood as “uncooperative” or “difficult to communicate with,” when in fact their linguistic system is unraveling. This leads experts to propose a new approach that combines neurolinguistics, sociolinguistics, and local culture—treating language not only as a tool for communication but as a mirror of identity.

 

Clinically, the study offers fresh insights for language therapy. For stroke patients, melodic intonation therapy—which retrains speech through rhythm and melody—shows strong potential due to the rhythmic and melodic nature of Indonesian prosody. For PPA patients, therapy must be more personalized and context-based, such as training with vocabulary frequently used in family conversations or daily routines.

 

Interestingly, initial findings show that bilingual Indonesian patients sometimes retain their regional language longer than Indonesian itself. This may be because local languages are acquired earlier and carry emotional depth, whereas Indonesian is often learned formally. This supports the idea that emotional memory plays a vital role in language retention.

 

Research like this offers new life to Indonesian linguistic and communication studies. It positions Indonesia not only as a subject of global research but also as a unique natural laboratory. With hundreds of languages and dialects, every case of aphasia is a different story—and only with a localized understanding can proper care be given.

 

In their conclusion, the researchers write that understanding aphasia means understanding the deep relationship between the brain and language. When someone loses the ability to speak, they lose not just words but part of how they understand the world. This is why aphasia research belongs not only to neurologists, but also to linguists, psychologists, and language educators.

 

“We urge Indonesia to begin developing diagnostic tools and therapies based on local languages—ones that account for Indonesian phonology and morphology,” Fasihah concludes. “With such tools, patients will no longer be tested using unfamiliar instruments. The hope is for future language therapy to become more inclusive, effective, and humane—not merely restoring speech, but restoring the ability to feel connected to the world.”

 

Ultimately, the story of aphasia is not only about the loss of language but also about the human struggle to preserve identity. In therapy rooms, between unfinished sentences, there lies an extraordinary effort: someone trying to rediscover their voice, and researchers striving to give them a new map back home—to the language they once had.