A case of pure apraxia of speech after left hemisphere stroke: behavioral findings and neural correlates.
A case of pure apraxia of speech after left hemisphere stroke: behavioral findings and neural correlates.
复制标题
左半球卒中后单纯言语失用症1例：行为学表现和神经相关性。
DOI：
10.3389/fneur.2023.1187399
复制
发表时间：
2023
影响因子：
3.4
通讯作者：
中科院分区：
文献类型：
--
作者：
言语失用症（AOS）是一种运动性言语障碍，会损害产生言语所需的复杂发音动作的协调性。AOS通常与非流畅性失语症（一种语言障碍）同时发生，这使得确定导致AOS的特定大脑结构具有挑战性。无失语症的单纯AOS病例很罕见，但为了解支持发音规划的神经关联提供了最佳视角。本研究的目的是探究一例单纯AOS病例中言语失用错误的模式及其潜在的神经关联。
一名67岁的右利手男性因缺血性中风导致额岛叶病变而出现严重的AOS。在发病后的1个月、3个月和12个月对该参与者的言语和语言进行了评估。在发病后12个月获取了高分辨率结构磁共振成像（包括弥散加权成像）。
在首次评估时，该参与者在综合性失语症测试中出现了一些小错误，表现出在书写、听觉理解和重复方面有轻度缺陷。到第二次评估时，他不再有失语症。在运动性言语评估中，他的AOS严重程度最初被评为5分（满分7分），到第二次评估时改善到4分，这可能是由于当时他的言语治疗师对他进行了放慢语速的训练。结构磁共振成像数据显示额岛叶病变累及岛叶的中央前回上部以及额下回和额中回的部分区域以及中央前回。从弥散磁共振成像得出的纤维束成像显示额叶斜束和弓状束沿着到岛叶的白质投射部分受损。
这个无失语症的单纯严重AOS病例为了解这种运动性言语障碍的行为和神经机制提供了一个独特的视角。目前的研究结果支持先前的观察结果，即AOS和失语症是可分离的，并证实了岛叶的中央前回和布洛卡区44以及下方的白质在支持复杂发音动作的协调方面的作用。此外，还讨论了包括中央前回、布洛卡区和55b区在内的其他区域在成功产生言语方面的潜在作用。
Apraxia of speech (AOS) is a motor speech disorder impairing the coordination of complex articulatory movements needed to produce speech. AOS typically co-occurs with a non-fluent aphasia, or language disorder, making it challenging to determine the specific brain structures that cause AOS. Cases of pure AOS without aphasia are rare but offer the best window into the neural correlates that support articulatory planning. The goal of the current study was to explore patterns of apraxic speech errors and their underlying neural correlates in a case of pure AOS. A 67-year-old right-handed man presented with severe AOS resulting from a fronto-insular lesion caused by an ischemic stroke. The participant’s speech and language were evaluated at 1-, 3- and 12-months post-onset. High resolution structural MRI, including diffusion weighted imaging, was acquired at 12 months post-onset. At the first assessment, the participant made minor errors on the Comprehensive Aphasia Test, demonstrating mild deficits in writing, auditory comprehension, and repetition. By the second assessment, he no longer had aphasia. On the Motor Speech Evaluation, the severity of his AOS was initially rated as 5 (out of 7) and improved to a score of 4 by the second visit, likely due to training by his SLP at the time to slow his speech. Structural MRI data showed a fronto-insular lesion encompassing the superior precentral gyrus of the insula and portions of the inferior and middle frontal gyri and precentral gyrus. Tractography derived from diffusion MRI showed partial damage to the frontal aslant tract and arcuate fasciculus along the white matter projections to the insula. This pure case of severe AOS without aphasia affords a unique window into the behavioral and neural mechanisms of this motor speech disorder. The current findings support previous observations that AOS and aphasia are dissociable and confirm a role for the precentral gyrus of the insula and BA44, as well as underlying white matter in supporting the coordination of complex articulatory movements. Additionally, other regions including the precentral gyrus, Broca’s area, and Area 55b are discussed regarding their potential role in successful speech production.
登录
查看更多内容
影响因子：
3.5
作者：
Garyfallidis E;Brett M;Amirbekian B;Rokem A;van der Walt S;Descoteaux M;Nimmo-Smith I;Dipy Contributors
通讯作者：
Dipy Contributors
人脑网络组图谱：基于连接架构的新大脑图谱
DOI：
10.1093/cercor/bhw157
发表时间：
2016-08
期刊：
Cerebral cortex (New York, N.Y. : 1991)
影响因子：
--
作者：
Fan L;Li H;Zhuo J;Zhang Y;Wang J;Chen L;Yang Z;Chu C;Xie S;Laird AR;Fox PT;Eickhoff SB;Yu C;Jiang T
通讯作者：
Jiang T
影响因子：
2
作者：
Cho-Reyes S;Thompson CK
通讯作者：
Thompson CK
影响因子：
3.6
作者：
Baldo, Juliana V.;Wilkins, David P.;Dronkers, Nina F.
通讯作者：
Dronkers, Nina F.
影响因子：
2.9
作者：
Ivanova MV;Zhong A;Turken A;Baldo JV;Dronkers NF
通讯作者：
Dronkers NF