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Pure apraxia of speech due to infarct in premotor cortex
Affiliations- Penn Memory Center, Department of Neurology, Hospital of University of Pennsylvania, Philadelphia
- Department of Speech Therapy, Temple University Hospital, 3401N. Broad St., Philadelphia
- Department of Physical Medicine and Rehabilitation, Temple University Hospital, 3401N. Broad St., Philadelphia
- Department of Physical Medicine and Rehabilitation, Metropolitan Hospital Center, 1901 First Avenue, New York
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Abstract
Apraxia of speech (AOS) is now recognized as an articulation disorder distinct from dysarthria and aphasia. Various lesions have been associated with AOS in studies that are limited in precise localization due to variability in size and type of pathology. We present a case of pure AOS in setting of an acute stroke to localize more precisely than ever before the brain area responsible for AOS, dorsal premotor cortex (dPMC). The dPMC is in unique position to plan and coordinate speech production by virtue of its connection with nearby motor cortex harboring corticobulbar tract, supplementary motor area, inferior frontal operculum, and temporo-parietal area via the dorsal stream of dual-stream model of speech processing. The role of dPMC is further supported as part of dorsal stream in the dual-stream model of speech processing as well as controller in the hierarchical state feedback control model.
Abstract
Apraxia of speech (AOS) is now recognized as an articulation disorder distinct from dysarthria and aphasia. Various lesions have been associated with AOS in studies that are limited in precise localization due to variability in size and type of pathology. We present a case of pure AOS in setting of an acute stroke to localize more precisely than ever before the brain area responsible for AOS, dorsal premotor cortex (dPMC). The dPMC is in unique position to plan and coordinate speech production by virtue of its connection with nearby motor cortex harboring corticobulbar tract, supplementary motor area, inferior frontal operculum, and temporo-parietal area via the dorsal stream of dual-stream model of speech processing. The role of dPMC is further supported as part of dorsal stream in the dual-stream model of speech processing as well as controller in the hierarchical state feedback control model.
Keywords
Apraxia of speech, Stroke, Insula, Premotor cortex, Dorsal stream
About this articleTitle
Pure apraxia of speech due to infarct in premotor cortex
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
519-524
Page views
488
Article views/downloads
900
DOI
10.1016/j.pjnns.2017.08.006
Bibliographic record
Neurol Neurochir Pol 2017;51(6):519-524.
Keywords
Apraxia of speech
Stroke
Insula
Premotor cortex
Dorsal stream
Authors
Riddhi Patira
Lauren Ciniglia
Timothy Calvert
Eric L. Altschuler
