Functional neuroanatomy of language and its disorders

1. Functional neuroanatomy of language and its disorders A Concise Overview By: Shimon Neuman

2. Terminology Superior Anterior Inferior Posterior

3. Terminology Parietal Lobe Frontal Lobe Occipital Lobe Temporal Lobe

4. Broca’sArea Wernicke’sArea

5. (Rohrer et al., 2007)

6. 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)

7. Accessingthe 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)

8. 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)

9. 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)

10. 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)

11. Accessing the correct grammar • Occurs in the inferior posterior frontal gyrus (Broca’s area.) • What can go wrong? • Non fluent aphasia: Inability to produce fluent speech. • (Broca, 1861)

12. Preparing and organizing the phonology • Occurs in the inferior posterior frontal gyrus (Broca’s area.) • What can go wrong? • Non fluent aphasia: Inability to produce fluent speech. • (Broca, 1861)

13. Motor planning • Occurs in: • Broca’s 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)

14. Executing the articulation • Involves the motor neuron tract. • What can go wrong? • Ataxic dysarthria • Hyperkinetic dysarthria • Hypokinetic dysarthria • Spastic dysarthria • Flaccid dysarthria • (McCaffrey, 1999)

15. Ataxic dysarthria Effects the cerebellar Symptoms: • Articulation: • Irregular articulatory breakdowns. • Irregular speech alternating motion rate (AMR). • Distorted vowels • Prosody: • Excess and equal stress • Excess loudness variations • Responsible for: • Fine Movement Coordination • Muscle Tone (McCaffrey, 1999; "Mixed Dysarthria," n.d.)

16. Hyperkinetic dysarthria Effects the Extrapyramidal tract, specifically the basal ganglia Symptoms: • 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 • Responsible for: • involuntary reflexes and movement (McCaffrey, 1999; "Mixed Dysarthria," n.d.)

17. Hypokinetic dysarthria Effects the Substantianigra Symptoms: • 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 • Responsible for: • Control of voluntary Movement (McCaffrey, 1999; "Mixed Dysarthria," n.d.)

18. Spastic dysarthria Effects the pyramidal tract Symptoms: • 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 • Responsible for: • Transmission of voluntary Movement (McCaffrey, 1999; "Mixed Dysarthria," n.d.)

19. Flaccid dysarthria Effects motor units of cranial or spinal nerves Symptoms: • Phonation: • Breathy & harsh voice • Audible inspiration • Short phrases • Articulation: • Imprecise consonants • Resonance: • Hypernasality • Prosody: • Monoloudness • Monopitch • Responsible for: • Transmission of voluntary Movement (McCaffrey, 1999; "Mixed Dysarthria," n.d.)

20. 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_brain_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 SociétéAnthropologique, 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

21. 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 McCaffrey, P. (1999). Dysarthria at a glance [Fact sheet]. Retrieved June 10, 2013, from http://www.csuchico.edu/~pmccaffrey//CMSD642StudyGuide.pdf Mixed dysarthria. (n.d.). Retrieved June 10, 2013, from 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 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

22. 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/121.1.77 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 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

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