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Pure Apraxia of Speech After Resection Based in the Posterior Middle Frontal Gyrus
- Source :
- Neurosurgery, vol 87, iss 3
- Publication Year :
- 2020
- Publisher :
- eScholarship, University of California, 2020.
-
Abstract
- 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.
- Subjects :
- 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
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Neurosurgery, vol 87, iss 3
- Accession number :
- edsair.doi.dedup.....a9ddbac136de01a761f3c55d83034902