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Clinical Trial
. 2015 Jun;46(6):1561-6.
doi: 10.1161/STROKEAHA.115.009211. Epub 2015 Apr 23.

Patterns of poststroke brain damage that predict speech production errors in apraxia of speech and aphasia dissociate

Alexandra Basilakos  1 , Chris Rorden  1 , Leonardo Bonilha  1 , Dana Moser  1 , Julius Fridriksson  2
Affiliations
Clinical Trial

Patterns of poststroke brain damage that predict speech production errors in apraxia of speech and aphasia dissociate

Alexandra Basilakos et al. Stroke. 2015 Jun.

Abstract

Background and purpose: Acquired apraxia of speech (AOS) is a motor speech disorder caused by brain damage. AOS often co-occurs with aphasia, a language disorder in which patients may also demonstrate speech production errors. The overlap of speech production deficits in both disorders has raised questions on whether AOS emerges from a unique pattern of brain damage or as a subelement of the aphasic syndrome. The purpose of this study was to determine whether speech production errors in AOS and aphasia are associated with distinctive patterns of brain injury.

Methods: Forty-three patients with history of a single left-hemisphere stroke underwent comprehensive speech and language testing. The AOS Rating Scale was used to rate speech errors specific to AOS versus speech errors that can also be associated with both AOS and aphasia. Localized brain damage was identified using structural magnetic resonance imaging, and voxel-based lesion-impairment mapping was used to evaluate the relationship between speech errors specific to AOS, those that can occur in AOS or aphasia, and brain damage.

Results: The pattern of brain damage associated with AOS was most strongly associated with damage to cortical motor regions, with additional involvement of somatosensory areas. Speech production deficits that could be attributed to AOS or aphasia were associated with damage to the temporal lobe and the inferior precentral frontal regions.

Conclusions: AOS likely occurs in conjunction with aphasia because of the proximity of the brain areas supporting speech and language, but the neurobiological substrate for each disorder differs.

Keywords: aphasia; apraxia, articulatory; neuroimaging; stroke.

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Figures

Figure 1
Figure 1
Lesion overlap maps for all patients. Area of greatest overlap (in red) indicates locations where at least 16 patients have damage.
Figure 2
Figure 2
Patterns of damage related to AOS (blue) and aphasia (red), and shared by both disorders (yellow). Colored regions survived a p < 0.05 threshold controlling for both multiple comparisons and the variability described by the other deficit.
See this image and copyright information in PMC

References

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