title: Clinical-anatomical correlation in a selective phonemic speech production impairment.
abstract: 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).
authors.affiliation: Dementia Research Group, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. a.larner@thewaltoncentre.nhs.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Larner
authors.forename: G
authors.initials: G
authors.lastname: Robinson
authors.forename: L D
authors.initials: LD
authors.lastname: Kartsounis
authors.forename: J S
authors.initials: JS
authors.lastname: Rakshi
authors.forename: M M K
authors.initials: MM
authors.lastname: Muqit
authors.forename: R J S
authors.initials: RJ
authors.lastname: Wise
authors.forename: L
authors.initials: L
authors.lastname: Cipolotti
authors.forename: M N
authors.initials: MN
authors.lastname: Rossor
mesh_terms: D001039:Aphasia, Broca / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*; D002114:Calcinosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D004569:Electroencephalography; D005260:Female; D005625:Frontal Lobe / Q000473:pathology* / Q000503:physiopathology*; D006391:Hemangioma / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D009483:Neuropsychological Tests; D013060:Speech; D014057:Tomography, X-Ray Computed