title: Damage to the Left Precentral Gyrus Is Associated With Apraxia of Speech in Acute Stroke.
abstract: OBJECTIVE
  Apraxia of speech (AOS) is a motor speech disorder, which is clinically characterized by the combination of phonemic segmental changes and articulatory distortions. AOS has been believed to arise from impairment in motor speech planning/programming and differentiated from both aphasia and dysarthria. The brain regions associated with AOS are still a matter of debate. The aim of this study was to address this issue in a large number of consecutive acute ischemic stroke patients.
  
  
  METHODS
  We retrospectively studied 136 patients with isolated nonlacunar infarcts in the left middle cerebral artery territory (70.5±12.9 years old, 79 males). In accordance with speech and language assessments, the patients were classified into the following groups: pure form of AOS (pure AOS), AOS with aphasia (AOS-aphasia), and without AOS (non-AOS). Voxel-based lesion-symptom mapping analysis was performed on T2-weighted images or fluid-attenuated inversion recovery images. Using the Liebermeister method, group-wise comparisons were made between the all AOS (pure AOS plus AOS-aphasia) and non-AOS, pure AOS and non-AOS, AOS-aphasia and non-AOS, and pure AOS and AOS-aphasia groups.
  
  
  RESULTS
  Of the 136 patients, 22 patients were diagnosed with AOS (7 patients with pure AOS and 15 patients with AOS-aphasia). The voxel-based lesion-symptom mapping analysis demonstrated that the brain regions associated with AOS were centered on the left precentral gyrus.
  
  
  CONCLUSIONS
  Damage to the left precentral gyrus is associated with AOS in acute to subacute stroke patients, suggesting a role of this brain region in motor speech production.
authors.affiliation: From the Departments of Stroke Neurology (R.I., Y.Y., E.F.) and Rehabilitation Medicine (Y.K.), Kohnan Hospital, Sendai, Japan; and Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan (R.I., Y.N., M.M., E.M.). ritabash@kohnan-sendai.or.jp nishiou@med.tohoku.ac.jp.
authors.forename: Ryo
authors.initials: R
authors.lastname: Itabashi
authors.affiliation: From the Departments of Stroke Neurology (R.I., Y.Y., E.F.) and Rehabilitation Medicine (Y.K.), Kohnan Hospital, Sendai, Japan; and Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan (R.I., Y.N., M.M., E.M.). ritabash@kohnan-sendai.or.jp nishiou@med.tohoku.ac.jp.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nishio
authors.affiliation: From the Departments of Stroke Neurology (R.I., Y.Y., E.F.) and Rehabilitation Medicine (Y.K.), Kohnan Hospital, Sendai, Japan; and Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan (R.I., Y.N., M.M., E.M.).
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kataoka
authors.affiliation: From the Departments of Stroke Neurology (R.I., Y.Y., E.F.) and Rehabilitation Medicine (Y.K.), Kohnan Hospital, Sendai, Japan; and Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan (R.I., Y.N., M.M., E.M.).
authors.forename: Yukako
authors.initials: Y
authors.lastname: Yazawa
authors.affiliation: From the Departments of Stroke Neurology (R.I., Y.Y., E.F.) and Rehabilitation Medicine (Y.K.), Kohnan Hospital, Sendai, Japan; and Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan (R.I., Y.N., M.M., E.M.).
authors.forename: Eisuke
authors.initials: E
authors.lastname: Furui
authors.affiliation: From the Departments of Stroke Neurology (R.I., Y.Y., E.F.) and Rehabilitation Medicine (Y.K.), Kohnan Hospital, Sendai, Japan; and Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan (R.I., Y.N., M.M., E.M.).
authors.forename: Minoru
authors.initials: M
authors.lastname: Matsuda
authors.affiliation: From the Departments of Stroke Neurology (R.I., Y.Y., E.F.) and Rehabilitation Medicine (Y.K.), Kohnan Hospital, Sendai, Japan; and Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan (R.I., Y.N., M.M., E.M.).
authors.forename: Etsuro
authors.initials: E
authors.lastname: Mori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001072:Apraxias / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications* / Q000175:diagnosis*
keywords: aphasia; apraxia, articulatory; speech; stroke