Subclassification of anarthrie/apraxia of speech and the mechanisms of its symptoms Yuki Takakura 1,2 , Mika Otsuki 3 1Department of Rehabilitation, Sapporo Shuyukai Hospital 2Graduate School of Health Sciences, Hokkaido University 3Faculty of Health Sciences, Hokkaido University Keyword: 失構音 , 発語失行 , DIVAモデル , 構音の歪み , 音の連結不良 , anarthrie , apraxia of speech , DIVA model , distortion of articulation , disconnected speech sounds pp.258-274
Published Date 2016/12/15
DOI https://doi.org/10.11477/mf.6001200100
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 We investigated the neuropsychological and neuroanatomical features of 10 right-handed patients with pure anarthrie/apraxia of speech (2 of them with concomitant mild aphasia), 2 patients with dysarthria without anarthrie, and 16 age-matched normal control adults. Based on the auditory psychological assessment and quantitative measurements of speech rate and reaction time, anarthrie could be classified into four subtypes:type I with prominent distortion of articulation, type II with prominent disconnection of speech sounds, type III with equally prominent distortions of articulation and disconnected speech sounds, and type IV, which has never been reported hitherto as a subclassification of anarthrie/apraxia of speech, with no signs of disconnected speech sounds, abnormal speech rate, or delayed reaction time. The neuroanatomical features of these anarthrie patients varied across types. The lesions of the patients with type I were located in the left precentral gyrus, type II in both the left precentral gyrus and premotor cortex, type III in the white matter of the left periventricular region, type IV in the left basal ganglia. From the perspective of the DIVA (Direction in sensory space Into Velocities of the Articulators) model, we infer that the impairment in type I patients accords with the impairment of Articulator Velocity and Position Maps, the impairment in type II patients accords with that of the Speech Sound Maps, the impairment in type III patients could be presumed to be a complication of that in types I and II, while the type IV patients could have impairment of the feedback control system.

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