Larner A J, Robinson G, Kartsounis L D, Rakshi J S, Muqit M M K, Wise R J S, Cipolotti L, Rossor M N
Dementia Research Group, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
J Neurol Sci. 2004 Apr 15;219(1-2):23-9. doi: 10.1016/j.jns.2003.12.001.
Although phonemic paraphasias are common in aphasic disorders, including Broca's aphasia, conduction aphasia and transcortical motor aphasia, selective phonemic speech production impairment, or phonemic disintegration, is unusual. A patient with a selective phonemic speech production disorder underwent clinical, neuropsychological and structural neuroradiological assessment over a period of 6 years. The disorder was characterised by phonemic paraphasias (phonemic disintegration) with preserved comprehension and naming. Imaging showed a focal lesion in the white matter of the left precentral gyrus and, to a lesser extent, the posterior part of the left middle frontal gyrus, with overlying cortical atrophy. Biopsy of the lesion, after several years of observation, showed a calcified haemangioma. Clinical-anatomical correlation in this case suggests the importance of primary motor cortex of the inferior precentral (pre-Rolandic) gyrus and subjacent white matter in phoneme production, with sparing of the posterior inferior frontal gyrus (Broca's area).
尽管音素性错语在失语症中很常见，包括布罗卡失语症、传导性失语症和经皮质运动性失语症，但选择性音素言语产生障碍或音素解体并不常见。一名患有选择性音素言语产生障碍的患者在6年时间里接受了临床、神经心理学和结构性神经放射学评估。该障碍的特征是存在音素性错语（音素解体），同时理解和命名能力保留。影像学检查显示左侧中央前回白质有一个局灶性病变，在较小程度上，左侧额中回后部也有病变，并伴有皮质萎缩。经过数年观察后对病变进行活检，结果显示为钙化性血管瘤。该病例中的临床-解剖学相关性表明，中央前回下部（中央前回前区）的初级运动皮层及相邻白质在音素产生中具有重要作用，而后下额叶回（布罗卡区）未受影响。
