Speech and language disorders secondary to diffuse subcortical vascular lesions: Neurolinguistic and acoustic analysis. A case report.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Tomić
Gordana
G
Institute of Neurology, Clinical Center of Serbia, Dr Subotica 6, 11 000 Belgrade, Serbia. gocanps@yahoo.com
Stojanović
Milena
M
Pavlović
Aleksandra
A
Stanković
Predrag
P
Zidverc-Trajković
Jasna
J
Pavlović
Dragan
D
Marković-Jovanović
Zagorka
Z
Covicković-Sternić
Nadezda
N
D020520:Brain Infarction / Q000150:complications* / Q000473:pathology; D001933:Brain Stem / Q000473:pathology; D002531:Cerebellum / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000473:pathology; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007806:Language Disorders / Q000209:etiology* / Q000473:pathology; D007807:Language Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D013018:Sound Spectrography; D013060:Speech; D013061:Speech Acoustics; D013064:Speech Disorders / Q000209:etiology* / Q000473:pathology; D013068:Speech Production Measurement