Pure Apraxia of Speech After Resection Based in the Posterior Middle Frontal Gyrus
| Autor: | Garret Kurteff, John P. Andrews, Robert G. Briggs, Michael E. Sughrue, Edward F. Chang, James Battiste, Andrew K. Conner |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Speech production medicine.medical_specialty Premotor cortex Apraxias Clinical Sciences Language deficit Audiology Astrocytoma behavioral disciplines and activities Apraxia 050105 experimental psychology Lateralization of brain function Neurosurgical Procedures 03 medical and health sciences Dysarthria 0302 clinical medicine Postoperative Complications Apraxia of speech Aphasia Medicine Middle frontal gyrus Humans AOS 0501 psychology and cognitive sciences Neurology & Neurosurgery business.industry Brain Neoplasms 05 social sciences Superior longitudinal fasciculus Rehabilitation Motor Cortex Neurosciences Middle Aged medicine.disease Brain Disorders medicine.anatomical_structure Surgery Female A05 Neurology (clinical) medicine.symptom Area 55b business 030217 neurology & neurosurgery |
| Zdroj: | Neurosurgery, vol 87, iss 3 |
| Popis: | Background and importance Apraxia of speech is a disorder of articulatory coordination and planning in speech sound production. Its diagnosis is based on deficits in articulation, prosody, and fluency. It is often described concurrent with aphasia or dysarthria, while pure apraxia of speech is a rare entity. Clinical presentation A right-handed man underwent focal surgical resection of a recurrent grade III astrocytoma in the left hemisphere dorsal premotor cortex located in the posterior middle frontal gyrus. After the procedure, he experienced significant long-term speech production difficulties. A battery of standard and custom language and articulatory assessments were administered, revealing intact comprehension and naming abilities, and preserved strength in orofacial articulators, but considerable deficits in articulatory coordination, fluency, and prosody-consistent with diagnosis of pure apraxia of speech. Tractography and resection volumes compared with publicly available imaging data from the Human Connectome Project suggest possible overlap with area 55b, an under-recognized language area in the dorsal premotor cortex and has white matter connectivity with the superior longitudinal fasciculus. Conclusion The case reported here details a rare clinical entity, pure apraxia of speech resulting from resection of posterior middle frontal gyrus. While not a classical language area, emerging literature supports the role of this area in the production of fluent speech, and has implications for surgical planning and the general neurobiology of language. |
| Databáze: | OpenAIRE |
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