Tomić Gordana, Stojanović Milena, Pavlović Aleksandra, Stanković Predrag, Zidverc-Trajković Jasna, Pavlović Dragan, Marković-Jovanović Zagorka, Covicković-Sternić Nadezda
Institute of Neurology, Clinical Center of Serbia, Dr Subotica 6, 11 000 Belgrade, Serbia.
J Neurol Sci. 2009 Aug 15;283(1-2):163-9. doi: 10.1016/j.jns.2009.02.361. Epub 2009 Mar 18.
Subcortical white matter (WM) plays an important role in speech production and language processing. Most frequently, cerebral WM lesions are secondary to small vessel disease in patients with vascular risk factors. We report the case of a 53-year-old man with history of hypertension and ischemic subcortical lesions, who presented with speech difficulties and mild cognitive impairment.
Language and cognitive assessment included Boston Diagnostic Aphasia Examination, Boston Naming Test, Rey Auditory-Verbal Learning Test, Rey-Osterrieth Complex Figure Test, Trail Making Test A and B, Wisconsin Card Sorting Test, Scale for Evaluation of Perceptive Characteristics of Voice and Speech, and Multidimensional Evaluation of Speech and Voice.
Brain MRI showed ischemic WM lesions and lacunar infarcts in the brainstem and right cerebellum. Cognitive testing revealed mild cognitive impairment, predominantly affecting attention and executive functions. Speech and language analysis demonstrated dysarthria, dysphonia with hypophonia, and imprecise articulation, as well as short rushes of speech, palilalia and mild subcortical dysphasia.
Neurolinguistic and acoustic analysis in patients with ischemic WM lesions can provide additional information in the understanding of language and speech disturbances, and can assist in patient management.
皮质下白质（WM）在言语产生和语言处理中起重要作用。在有血管危险因素的患者中，脑白质病变最常见继发于小血管疾病。我们报告一例53岁男性，有高血压病史和缺血性皮质下病变，表现为言语困难和轻度认知障碍。
语言和认知评估包括波士顿诊断性失语检查、波士顿命名测试、雷伊听觉词语学习测试、雷伊 - 奥斯特里赫复杂图形测试、连线测验A和B、威斯康星卡片分类测试、语音和言语感知特征评估量表以及言语和语音多维评估。
脑部MRI显示脑干和右小脑有缺血性白质病变和腔隙性梗死。认知测试显示轻度认知障碍，主要影响注意力和执行功能。言语和语言分析显示构音障碍、发声困难伴发声减弱、发音不精确，以及语速急促、复述症和轻度皮质下失语。
缺血性白质病变患者的神经语言学和声学分析可为理解语言和言语障碍提供额外信息，并有助于患者管理。
