A Case of Afferent Apraxic Motor Aphasia? A Tribute to A.R.Luria
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1
Seton Hall University, Speech-Language Pathology, United States
Introduction
Luria (1966, 1970) proposed the category of afferent apraxic motor aphasia (AAMA) to account for the speech symptoms in cases with the left hemisphere (LH) parietal lobe damage. According to Luria, the difficulty in speech articulation in such cases was in finding the appropriate articulatory (schemata) movements for the production of individual sounds, and sound sequences and accompanied by positional apraxia of speech organ. Thus, Luria’s description of AAMA matches the contemporary definition of AOS but with an emphasis on the pivotal role of parietal lobe lesion. Contrarywise to the AAMA account, the Directions Into Velocities of Articulators (DIVA) model interprets AOS as the resultant of lesion in the left posterior inferior frontal gyrus and the premotor cortex, the site that stores the speech sound maps (Guenther & Hickok, 2016). Parietal cortex of both hemispheres, according to the DIVA model, are the neural substrate for somato-sensory feedback circuit. The current study reports on a case with apraxia of speech (AOS) resulting from parietal lesion and discusses implications for these two different positions about the role of parietal lobe in apraxia of speech.
Methods
Subject. RL, a 58-year-old right-handed male high school graduate, had a stroke-induced lesion in the left mid parietal region (see Figure 1.). Procedure. Clinical evaluation one month post-onset consisted of the use of Minnesota Test for Differential Diagnosis of Aphasia (MTDDA), Apraxia Battery for Adults (ABA), and Boston Naming Test (BNT). At one year post-onset, RL ‘s speech was evaluated by administering ABA, BNT, and Boston Diagnostic Aphasia Examination (BDAE). Two additional tasks, namely, Oral reading of the Grandfather’s passage, and spontaneous responsive speech elicited by the question “Tell me about the first job you ever had” were employed to gather additional data on speech production.
Results
RL’s speech disruptions during spontaneous speech primarily included 20 part-word repetition (PWR), 10 whole word repetitions (WWR), 10 single interjections (SI), 14 repeated interjections (RI), and 1 sound prolongation (SP). During the reading of the Grandfather Passage RL produced 26 (PWR), 11 (WWR), 22 (RI), and one sound prolongation (SP).
On the reading task, RL used seven types of phonological processes that had altered the segmental characteristics of the target words. The types and frequency of occurrence of each type of process were as follows: six vowel changes (VC), five initial consonant deletions (ICD), five final consonant deletions (FCD), four cluster reductions (CR), two frontings (FR), two backings (BK), and two stoppings (ST). RL’s spontaneous speech also evidenced such phonological simplifications.
Discussion
RL’s phonological simplification and positional apraxia of lips and tongue indicate the involvement of both phonological as well as phonetic encoding deficits. (Galluzzi et al, 2015; Wolk, 1984).The current study provides additional empirical proof for the notion of pluralistic sites of lesions associated with AOS, as opposed to the singular site of lesion advocated in the DIVA model. Luria’s
References
Galluzzi, C., Bureca, I., Guariglia, C., Romani, C. (2015). Phonological simplications, apraxia of speech and the interaction between phonological and phonetic processing. Neuopsychologia, 71, 64-83.
Guenther, F.H., & Hickok, G. (2016). Neural models of motor speech control. In G. Hickok, & S. Small (Eds). Neurobiology of language. London: Academic Press.
Luria, A.R., (1970). Traumatic aphasia: Its syndromes, psychology, and treatment. The Hague. Mouton
Luria, A.R. (1966). Higher cortical functions in man. New York: Basic books publishers.
Wolk, L. (1984). Phonological and neuroanatomical findings in three cases with apraxia of speech. The South African journal of communication disorders. 31, 36-45.
Keywords:
apraxia of speech,
Aphasia,
parietal lesion,
Neurobiological model,
Stroke
Conference:
Academy of Aphasia 55th Annual Meeting , Baltimore, United States, 5 Nov - 7 Nov, 2017.
Presentation Type:
poster or oral
Topic:
General Submission
Citation:
BALASUBRAMANIAN
V,
Teehan
K,
Aldera
MA and
Costello
M
(2019). A Case of Afferent Apraxic Motor Aphasia? A Tribute to A.R.Luria.
Conference Abstract:
Academy of Aphasia 55th Annual Meeting .
doi: 10.3389/conf.fnhum.2017.223.00068
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Received:
01 May 2017;
Published Online:
25 Jan 2019.
*
Correspondence:
Dr. VENU BALASUBRAMANIAN, Seton Hall University, Speech-Language Pathology, South Orange, NJ, United States, venugopal.balasubramanian@shu.edu