Basilakos Alexandra, Rorden Chris, Bonilha Leonardo, Moser Dana, Fridriksson Julius
From the Aphasia Lab, Department of Communication Sciences and Disorders (A.B., J.F.), Department of Psychology (C.R.), University of South Carolina, Columbia; Department of Neurosciences, Medical University of South Carolina, Charleston (L.B.); and Department of Communication Sciences & Disorders, University of New Hampshire, Durham (D.M.).
Stroke. 2015 Jun;46(6):1561-6. doi: 10.1161/STROKEAHA.115.009211. Epub 2015 Apr 23.
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.
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.
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.
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.
获得性言语失用症（AOS）是一种由脑损伤引起的运动性言语障碍。AOS常与失语症同时出现，失语症是一种语言障碍，患者在其中也可能表现出言语产生错误。两种障碍中言语产生缺陷的重叠引发了关于AOS是源于独特的脑损伤模式还是作为失语综合征的一个子元素出现的问题。本研究的目的是确定AOS和失语症中的言语产生错误是否与独特的脑损伤模式相关。
43名单侧左半球中风病史的患者接受了全面的言语和语言测试。使用AOS评定量表对特定于AOS的言语错误与也可能与AOS和失语症都相关的言语错误进行评分。使用结构磁共振成像确定局部脑损伤，并使用基于体素的病变损害映射来评估特定于AOS的言语错误、那些可能发生在AOS或失语症中的言语错误与脑损伤之间的关系。
与AOS相关的脑损伤模式与皮质运动区域的损伤最密切相关，体感区域也有额外受累。可归因于AOS或失语症的言语产生缺陷与颞叶和中央前回下部区域的损伤相关。
由于支持言语和语言的脑区相邻，AOS可能与失语症同时发生，但每种障碍的神经生物学基础不同。
