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Slide 2 Functional neuroanatomy of language and its disorders A Concise Overview By: Shimon Neuman Slide 3 Anterior Terminology Posterior Superior Inferior Slide 4 Frontal Lobe Parietal Lobe Temporal Lobe Occipital Lobe Terminology Slide 5 Brocas Area Wernickes Area Slide 6 Planning the message Accessing the semantic properties of the words Accessing the phonologic properties of the words Accessing the sensory and motor properties of the words Grammar Preparing the phonology Motor PlanningArticulation (Rohrer et al., 2007) Slide 7 Planning the message Occurs in the prefrontal cortex. What can go wrong? Dynamic Aphasia: inability to plan a message. In its pure form no other area of language production or comprehension is impaired. (Robinson, Blair, & Cipolotti, 1998) Slide 8 Accessing the concepts Occurs in the middle and inferior temporal gyri. What can go wrong? Semantic Dementia: inability to access semantic data. (Semantic memory loss) Transcortical sensory aphasia: compromised naming and comprehension skills. (Hickok, 2009; Rohrer et al., 2007) Slide 9 Accessing the phonologic properties of the words Occurs posterior superior temporal sulcus and middle temporal gyrus. What can go wrong? Transcortical sensory aphasia: Naming and auditory comprehension is compromised (Gow, 2012) Slide 10 Accessing the sensory and motor properties of the words Occurs in the inferior parietal region including the supramarginal gyrus. What can go wrong? Wernicke's aphasia: Difficulty understanding and producing meaningful language (Gow, 2012; Rohrer et el,. 2007) Slide 11 Transferring to the Frontal Lobe The arcuate fasciculus (red and green in MRI image top and schematic bottom) connects the temporal lobe to the frontal lobe. (Rilling & Glasser, 2008) What can go wrong? Anomic Aphasia: Difficulty retrieving words. In its pure form no other aspect of language is compromised. (Fridriksson, Kjartansson, Morgan, Hjaltason, & Magnusdottir, 2010) Slide 12 Accessing the correct grammar Occurs in the inferior posterior frontal gyrus (Brocas area.) What can go wrong? Non fluent aphasia: Inability to produce fluent speech. (Broca, 1861) Slide 13 Preparing and organizing the phonology Occurs in the inferior posterior frontal gyrus (Brocas area.) What can go wrong? Non fluent aphasia: Inability to produce fluent speech. (Broca, 1861) Slide 14 Motor planning Occurs in: Brocas area Left insula Subcortical Regions What can go wrong? Non fluent aphasia: Inability to produce fluent speech. (Ogar, Slama, Dronkers, Amici, & Gorno-Tempini, 2005; Beal, 2005) Slide 15 Executing the articulation Involves the motor neuron tract. What can go wrong? Ataxic dysarthria Hyperkinetic dysarthria Hypokinetic dysarthria Spastic dysarthria Flaccid dysarthria (McCaffrey, 1999) Slide 16 Ataxic dysarthria Effects the cerebellar Symptoms: Responsible for: Fine Movement Coordination Muscle Tone (McCaffrey, 1999; "Mixed Dysarthria," n.d.) Articulation: Irregular articulatory breakdowns. Irregular speech alternating motion rate (AMR). Distorted vowels Prosody: Excess and equal stress Excess loudness variations Slide 17 Hyperkinetic dysarthria Effects the Extrapyramidal tract, specifically the basal ganglia Symptoms: Responsible for: involuntary reflexes and movement (McCaffrey, 1999; "Mixed Dysarthria," n.d.) Respiration: Audible inspiration Sudden forced inspiration Phonation: Harsh voice Voice tremor Shortness of breath Articulation: Distorted vowels Irregular articulatory breakdowns Slow/irregular AMRs Resonance: Intermittent hypernasality Prosody: Inappropriate silences Excessive loudness variations variable patterns of stress and rate Slide 18 Hypokinetic dysarthria Effects the Substantia nigra Symptoms: Responsible for: Control of voluntary Movement Respiration: Decreased vital capacity Shallow breathing Uncoordinated chest/diaphragm Phonation: Harsh & breathy voice Periods of dysphonia Articulation: Distorted & incorrect production of phonemes Incorrect consonant blending Palilalia Replacing stops with fricatives Resonance: Minimal hypernasality Prosody: Monopitch Monoloudness Reduced stress Inappropriate silences Variable rate (McCaffrey, 1999; "Mixed Dysarthria," n.d.) Slide 19 Spastic dysarthria Effects the pyramidal tract Symptoms: Responsible for: Transmission of voluntary Movement Phonation: Breathy voice Strained-strangled vocal quality Low pitch Harshness Pitch breaks Articulation: Imprecise consonants Slow rate Short phrases Distorted vowels Resonance: Hypernasality Prosody: Reduced, excess, & equal stress Monoloudness Monopitch (McCaffrey, 1999; "Mixed Dysarthria," n.d.) Slide 20 Phonation: Breathy & harsh voice Audible inspiration Short phrases Articulation: Imprecise consonants Flaccid dysarthria Effects motor units of cranial or spinal nerves Symptoms: Responsible for: Transmission of voluntary Movement Resonance: Hypernasality Prosody: Monoloudness Monopitch (McCaffrey, 1999; "Mixed Dysarthria," n.d.) Slide 21 References Beal, J. A. (2005, November 30). Frontal (Coronal) section of the brain [Photograph]. Retrieved from http://upload.wikimedia.org/wikipedia/commons/5/59/Human_b rain_frontal_%28coronal%29_section_description_2.JPG http://upload.wikimedia.org/wikipedia/commons/5/59/Human_b rain_frontal_%28coronal%29_section_description_2.JPG Broca, P. P. (1861). Loss of speech, chronic softening and partial destruction of the anterior left lobe of the brain. Bulletin de la Socit Anthropologique, 2, 235-238. Fridriksson, J., Kjartansson, O., Morgan, P. S., Hjaltason, H., & Magnusdottir, S. (2010). Impaired speech repetition and left parietal lobe damage. The Journal of Neuroscience, 30(33), 11057-11061. Gow, D. W., Jr. (2012). The cortical organization of lexical knowledge: A dual lexicon model of spoken language processing. Brain Language, 121(3), 273-288. http://dx.doi.org/doi:10.1016/j.bandl.2012.03.005 Slide 22 References Hickok, G. (2009). The functional neuroanatomy of language. Physics of Life Reviews, 6(3), 121-143. http://dx.doi.org/10.1016/j.plrev.2009.06.001 http://dx.doi.org/10.1016/j.plrev.2009.06.001 McCaffrey, P. (1999). Dysarthria at a glance [Fact sheet]. Retrieved June 10, 2013, from http://www.csuchico.edu/~pmccaffrey//CMSD642StudyGuide.p df http://www.csuchico.edu/~pmccaffrey//CMSD642StudyGuide.p df Mixed dysarthria. (n.d.). Retrieved June 10, 2013, from http://mixeddysarthria.wix.com/mixeddysarthria#! http://mixeddysarthria.wix.com/mixeddysarthria# Ogar, J., Slama, H., Dronkers, N., Amici, S., & Gorno-Tempini, M. L. (2005). Apraxia of speech: An overview. Neurocase, 11, 427-432. http://dx.doi.org/10.1080/13554790500263529 http://dx.doi.org/10.1080/13554790500263529 Rilling, J., & Glasser, M. (2008, March 24). Wired for language. Retrieved June 10, 2013, from http://news.sciencemag.org/sciencenow/2008/03/24-02.html Slide 23 References Robinson, G., Blair, J., & Cipolotti, L. (1998). Dynamic aphasia: an inability to select between competing verbal responses? Brain, 121(1), 77-89. http://dx.doi.org/10.1093/brain/121.1.77http://dx.doi.org/10.1093/brain/121.1.77 Rohrer, J. D., Knight, W. D., Warren, J. E., Fox, N. C., Rossor, M. N., & Warren, J. D. (2007). Word-finding difficulty: a clinical analysis of the progressive aphasias. Brain, 131(1), 8-38. http://dx.doi.org/10.1093/brain/awm251 http://dx.doi.org/10.1093/brain/awm251 Stem Cell Treatment. (n.d.). Motor neuron tract [Photograph]. Retrieved from http://stemcelltreatments.org/wp- content/uploads/2012/01/als-stem-cell-treatment-300x237.jpg Slide 24 Thanks for watching! This presentation is available at: www.YiddishSLP.com/clinical- resources.html