The role of connected speech in distinguishing types of apraxia of speech following brain damage

Authors

  • Chris Code University of Exeter
  • Jeremy Tree Swansea University
  • Nicole Müller University College Cork

DOI:

https://doi.org/10.1558/jcs.31105

Keywords:

apraxia of speech, stroke induced apraxia of speech, progressive apraxia of speech, connected speech, language recovery, language dissolution

Abstract

Apraxia of speech (AOS) is a common condition resulting from brain damage causing impairments to speech planning and programming that is distinct from aphasia and dysarthria. Following a stroke, AOS is most often seen as a part of nonfluent Broca’s aphasia. Recovery and dissolution of speech in stroke induced apraxia of speech (sAOS) and progressive AOS (pAOS) appear on a symptomatic level to be reversals of each other, but the existing evidence shows that sAOS is distinct from pAOS. This suggests different causes that have relevance for management of pAOS.

In this article, we examine the similarities and differences between sAOS and pAOS and conclude that while the two conditions present similarly, certain features differ significantly, which may suggest different mechanisms underlying their manifestation. The role of connected speech as opposed to single word utterances is noted.

Author Biographies

  • Chris Code, University of Exeter

    Chris Code is Professorial Research Fellow in the School of Psychology, Washington Singer Labs, University of Exeter, England. He is the Foundation Professor of Communication Sciences and Disorders at the University of Sydney, past Research Manager for Speakability, and Speakability’s National Adviser on Aphasia. He is past Patron of Aphasia Now. He is also co-founding editor of the journal Aphasiology. His research interests include the cognitive neuroscience of language and speech, psychosocial consequences of aphasia, recovery and treatment of aphasia, number processing, and apraxia. He is also interested in the contribution of speech and language impairments to the evolution of speech and language theory. He is a Fellow of the British Psychological Society (FBPsS) and the Royal College of Speech and Language Therapists (FRCSLT).

  • Jeremy Tree, Swansea University

    Jeremy Tree has a long-standing interest in the consequences of brain damage on specific cognitive functions (cognitive neuropsychology) – in particular, disorders of reading (dyslexia), speech production (aphasia), memory (amnesia), and face processing (prosopagnosia). In each case his work seeks to better illuminate the processing components of these specific functions in the normal population. He is co-director of the Psychology Dementia Research Group and co-founder of the Face Research Swansea (FaReS) lab. He is a Registered Chartered Psychologist (C. Psychol.), Fellow of the British Psychological Society (FBPsS), member of the Health Professionals Council, and Fellow of the Higher Education Academy (HEA).

  • Nicole Müller, University College Cork

    Nicole Müller is Professor of Speech and Hearing Sciences at University College Cork, Ireland. She also holds a visiting professorship at Linköping University, Sweden. In the past, she has held academic appointments in England, Wales, the USA, and Sweden. Her research interests are in clinical linguistics and phonetics, multilingualism, and adult-acquired impairments of communication and cognition, for example in consequence to neurodegeneration, brain injury, or stroke. She is a legacy editor of the journal Clinical Linguistics and Phonetics.

References

Ball, M. J., Code, C., Tree, J., Dawe, K., & Kay, J. (2004). Phonetic and phonological analysis of progressive speech degeneration: A case study. Clinical Linguistics & Phonetics, 18(6–8), 447–462. https://doi.org/10.1080/02699200410001703646

Ballard, K.J., Azizi, L., Duffy, J. R., McNeil, M. R., Halaki, M., O’Dwyer, N., Layfield, C., Scholl, D. I., Vogel, A. P., Robin, D. A. (2016) A predictive model for diagnosing stroke-related apraxia of speech. Neuropsychologia, 81, 129–139. https://doi.org/10.1016/j.neuropsychologia.2015.12.010

Buckingham, H. (1991) Explanations in apraxia with consequences for the concept of apraxia of speech. In M. T. Sarno (Ed.), Acquired aphasia in adults (2nd. ed.) (pp. 271–312). New York: Academic Press.

Berndt, R. S. & Caramazza, A. (1980) A redefinition of the syndrome of Broca’s aphasia: Implications for a neuropsychological model of language. Applied Psycholinguistics, 1(3), 225–278. https://doi.org/10.1017/S0142716400000552

Blomert, L. (1998). Recovery from language disorders: interactions between brain and rehabilitation. In Steemer, B. & Whitaker, H. (Eds.), Handbook of neurolinguistics (pp. 547–557). New York: Academic Press.

Broca, P. (1861). Remarks on the seat of the faculty of articulated language, following an observation of aphemia (loss of speech). Bulletin de la Société Anatomique, 6(2e. ser.), 330–357.

Broussolle, E., Bakchine, S., Tommasi, M., Laurent, B., Bazin, B., Cinotti, L., Cohen, L., & Chazot, G. (1996). Slowly progressive anarthria with late anterior opercular syndrome: A variant form of frontal cortical atrophy syndromes. Journal of the Neurological Sciences, 144(1–2), 44–58. https://doi.org/10.1016/S0022-510X(96)00096-2

Chapman, S. B., Rosenberg, R. N., Weiner, M. F., & Shobe, A. (1997). Autosomal dominant progressive syndrome of motor-speech loss without dementia. Neurology, 49(5), 1298–1306. https://doi.org/10.1212/WNL.49.5.1298

Code, C. (1998). Models, theories and heuristics in apraxia of speech. Clinical Linguistics & Phonetics, 12(1), 47–65. https://doi.org/10.3109/02699209808985212

Code, C. (2001). Multifactorial processes in recovery from aphasia: Developing the foundations for a multileveled framework. Brain and Language, 77(1), 25–44. https://doi.org/10.1006/brln.2000.2420

Code, C., Ball, M., Tree, J., & Dawe, K. (2013). The effects of initiation, termination and inhibition impairments on speech rate in a case of progressive nonfluent aphasia with progressive apraxia of speech with frontotemporal degeneration. Journal of Neurolinguistics, 26(6), 602–618. https://doi.org/10.1016/j.jneuroling.2013.04.003

Code, C., Müller, N., Tree, J., & Ball, M. J. (2006) Syntactic impairments can emerge later: Progressive agrammatic agraphia and syntactic comprehension impairment. Aphasiology, 20(9), 1035–1058. https://doi.org/10.1080/02687030600739539

Code, C., Tree, J., & Ball, M. J. (2011) The influence of psycholinguistic variables on articulatory errors in naming in progressive motor speech degeneration. Clinical Linguistics & Phonetics, 25(11–12), 1074–1080. https://doi.org/10.3109/02699206.2011.601390

Code, C., Tree, J., & Dawe, K. (2009) Opportunities to say ‘yes’: Rare speech automatisms in a case of progressive nonfluent aphasia and apraxia. Neurocase, 15(6), 445–458. https://doi.org/10.1080/13554790902911634

Cohen, L., Benoit, N., Van Eeckhout, P., Ducarne, B., & Brunet, P. (1993). Pure progressive aphemia. Journal of Neurology, Neurosurgery, and Psychiatry, 56(8), 923–924. https://doi.org/10.1136/jnnp.56.8.923

Croot, K., Patterson, K., & Hodges, J. R. (1998). Single word production in nonfluent progressive aphasia. Brain and Language, 61(2), 226–273. https://doi.org/10.1006/brln.1997.1852

Dabul, B. (2000). Apraxia battery for adults (2nd ed.). Austin, TX: Pro-Ed.

Darley, F., Aronson, A., & and Brown, J. (1975). Motor speech disorders. Philadelphia: W. B. Saunders.

Dronkers, N. (1996). A new brain region for coordinating speech articulation. Nature, 384(6605), 159–161. https://doi.org/10.1038/384159a0

Duffy, J. R. (2005). Motor speech disorders: Substrates, differential diagnosis, and management (2nd edition). St. Louis: Mosby.

Duffy, J. R. (2006). Apraxia of speech in degenerative disease. Aphasiology, 20(6), 511–527. https://doi.org/10.1080/02687030600597358

Garrard, P., & Hodges, J. R. (1999). Semantic dementia: Implications for the neural basis of language and meaning. Aphasiology, 13(8), 609–623. https://doi.org/10.1080/026870399401966

Goldenberg, G. (2013) Apraxia: The cognitive side of motor control. Oxford: Oxford University Press.

Gorno-Tempini, M., Hillis, A. E., Weintraub, S., Kertesz, A., Mendez, M., Cappa, S. F., et al. (2011). Classification of primary progressive aphasia and its variants. Neurology, 76(11), 1006–1014. https://doi.org/10.1212/WNL.0b013e31821103e6

Goodglass, H., & Kaplan, E. (1983). The assessment of aphasia and related disorders (2nd ed.). Philadelphia: Lea & Febiger.

Graham, N., Patterson, K., & Hodges, J. R. (2004). When more yields less: Speaking and writing deficits in nonfluent progressive aphasia. Neurocase, 10(2), 141-155. https://doi.org/10.1080/13554790409609945

Hart, R. P., Beach, W. A., & Taylor, J. R. (1997). A case of progressive apraxia of speech and non-fluent aphasia. Aphasiology, 11(1), 73–82. https://doi.org/10.1080/02687039708248456

Hillis, A. E., Work, M., Barker, P. B., Jacobs, M. A., Breese, E. L., & Maurer, K. (2004). Re-examining the brain regions crucial for orchestrating speech articulation. Brain, 127(7), 1479–1487. https://doi.org/10.1093/brain/awh172

Itoh, M., & Sasanuma, S. (1984). Articulatory movements in apraxia of speech. In J. C. Rosenbek, M.R. McNeil, & A.E. Aronson (Eds.), Apraxia of speech: Physiology, acoustics, linguistics, management (pp. 135–165) San Diego: College-Hill Press.

Josephs, K. A., Duffy, J. R., Strand, E. A., Whitwell, J. L., Layton, K. F., Parisi, J. E., Hauser, M. F., Witte, R. J., Boeve, B. F., Knopman, D. S., Dickson, D. W., Jack, C. R., Jr, & Petersen, R. C. (2006). Clinicopathological and imaging correlates of progressive aphasia and apraxia of speech. Brain, 129(6), 1385–1398. https://doi.org/10.1093/brain/awl078

Josephs, K. A., Duffy, J. R., Strand, E. A., Machulda, M. M., Senjem, M. L., Master, A. V., Lowe, V. J., Jack, C. R., Jr, & Whitwell, J. L. (2012). Characterizing a neurodegenerative syndrome: Primary progressive apraxia of speech. Brain, 135(5), 1522–1536. https://doi.org/10.1093/brain/aws032

Josephs, K. A., Duffy, J. R., Clark, H. M., Utianski, R. L., Strand, E. A., Machulda, M. M., Botha, H., Martin, P. R., Pham, N. T. T., Stierwalt, J., Ali, F., Buciuc, M., Baker, M., Fernandez De Castro, C. H., Spychalla, A. J., Schwarz, C. G., Reid, R. I., Senjem, M. L., Jack, C. R., … Whitwell, J. L. (2021). A molecular pathology, neurobiology, biochemical, genetic and neuroimaging study of progressive apraxia of speech. Nature Communications, 12(1), 3452. https://doi.org/10.1038/s41467-021-23687-8

Kertesz, A. (1979). Aphasia and associated disorders: Taxonomy, localization, and recovery. New York: Grune & Stratton.

Knibb, J. A., Woollams, A. M., Hodges, J. R., & Patterson, K. (2009). Making sense of progressive non-fluent aphasia: An analysis of conversational speech. Brain, 132(10), 2734–2746. https://doi.org/10.1093/brain/awp207

Levelt, W. J. M. (1989). Speaking: From intention to articulation. Cambridge, MA.: The MIT Press.

Liepmann, H. (1900). Das krankheitsbild der apraxie (motorischen asymbolie) auf grund eines falles von einseitiger apraxie [The clinical presentation of apraxia (motoric asymbolia) based on a case of unilateral apraxia]. Monatschrift für Psychiatrie und Neurologie, 8(1–3), 15–40, 102–132, 182–197.

Marquardt, T. P., & Sussman, H. (1984). The elusive lesion-apraxia of speech link in Broca’s aphasia. In J. C. Rosenbek, M. R. McNeil, & A. E. Aronson (Eds.), Apraxia of speech: Physiology, acoustics, linguistics, management (pp. 91–112). San Diego: College-Hill Press.

McNeil, M. R., Robin, D. A., & Schmidt, R. A. (1997). Apraxia of speech: Definition, differentiation, and treatment. In McNeil, M. R. (Ed.), Clinical management of sensorimotor speech disorders (pp. 311–344). New York: Thieme.

McNeil, M. R., Doyle, P., & Wambaugh, J. (2000). Apraxia of speech: A treatable disorder of motor planning and programming. In S. E. Nadeau, L. J. G. Rothi, & B. A. Crosson (Eds.), Aphasia and language: Theory to practice (pp. 221–266). New York: Guilford Press.

Mesulam, M. M. (1982). Slowly progressive aphasia without generalized dementia. Annals of Neurology, 11(6), 592–598. https://doi.org/10.1002/ana.410110607

Mohr, J. P., Pessin, M. S., Finkelstein, S., Funkenstein, H. H., Duncan, G. W., & Davis, K. R. (1978). Broca aphasia: Pathologic and clinical. Neurology, 28(4), 311–324. https://doi.org/10.1212/wnl.28.4.311

Morrison, C. M., Chappell, T. D., & Ellis, A. W. (1997). Age of acquisition norms for a large set of object names and their relation to adult estimates and other variables. The Quarterly Journal of Experimental Psychology Section A, 50(3), 528–559. https://doi.org/10.1080/027249897392017

Patterson, K., Graham, N., Lambon-Ralph, M., & Hodges, J. (2006). Progressive non-fluent aphasia is not a progressive form of non-fluent (post-stroke) aphasia. Aphasiology, 20(9), 1018–1034. https://doi.org/10.1080/02687030600739463

Ricci, M., Magarelli, M., Todino, V., Bianchini, A., Calandriello, E., & Tramutoli, R. (2008). Progressive apraxia of speech presenting as isolated disorder of speech articulation and prosody: A case report. Neurocase, 14(2), 162–168. https://doi.org/10.1080/13554790802060839

Rosenbek, J. C., Kent, R. D., & LaPointe, L. L. (1984). Apraxia of speech: An overview and some perspectives. In J. C. Rosenbek, M.R. McNeil, & A.E. Aronson (Eds.), Apraxia of speech: Physiology, acoustics, linguistics, management (pp. 1–72). San Diego: College-Hill Press.

Sajjadi, S. A., Patterson, K., Tomek, M., & Nestor, P. J. (2012a). Abnormalities of connected speech in semantic dementia vs Alzheimer’s disease. Aphasiology, 26(6), 847–866. https://doi.org/10.1080/02687038.2012.654933

Sajjadi, S. A., Patterson, K., Tomek, M., & Nestor, P. J. (2012b). Abnormalities of connected speech in the non-semantic variants of primary progressive aphasia. Aphasiology, 26(10), 1219–1237. https://doi.org/10.1080/02687038.2012.710318

Scholten, I. M., Kneebone, A. C., Benson, L. A., Fields, C. D., & Blumbergs, P. (1995). Primary progressive aphasia: Serial linguistic, neuropsychological and radiological findings with neuropathological results. Aphasiology, 9(5), 495-516. https://doi.org/10.1080/02687039508248711

Silveri, M. C., Cappa, A., & Salvigni, B. L. (2003) Speech and language in primary progressive anarthria. Neurocase, 9(3), 213–220. https://doi.org/10.1076/neur.9.3.213.15555

Snowden, J. S., Neary, D., & Mann, D. M. A. (2002). Frontotemporal dementia. British Journal of Psychiatry, 180(2), 140–143. https://doi.org/10.1192/bjp.180.2.140

Snowden, J., Goulding, P. J., & Neary, D. (1989). Semantic dementia: A form of circumscribed cerebral atrophy. Behavioural Neurology, 2(3), 167–182. https://doi.org/10.1155/1989/124043

Steinthal, H. (1871). Abriss der sprachwissenschaft [Outline of the science of language]. Berlin: Dümmler.

Thompson, C. K., Ballard, K. J., Tait, M. E., Weintraub, S., & Mesulam, M. (1997). Patterns of language decline in non-fluent primary progressive aphasia. Aphasiology, 11(4–5), 297–321. https://doi.org/10.1080/02687039708248473

Tree, J. J., & Kay, J. (2008). Longitudinal assessment of language and memory impairments in pathologically confirmed cortico-basal ganglionic degeneration. Cortex, 44(9), 1234–1247. https://doi.org/10.1016/j.cortex.2007.08.017

Tree, J. J., Kay, J., & Perfect, T. J. (2005). ‘Deep’ language disorders in nonfluent progressive Aphasia: An evaluation of the ‘summation’ account of semantic errors across language production tasks. Cognitive Neuropsychology, 22(6), 643–659. https://doi.org/10.1080/02643290442000220

Tree, J. J., Perfect, T. J., Hirsh, K. W., & Copstick, S. (2001). Deep dysphasic performance in non-fluent progressive aphasia: A case study. Neurocase, 7(6), 473-488. https://doi.org/10.1093/neucas/7.6.473

Tyrrell, P. J., Kartsounis, L. D., Frackowiak, R. S., Findley, L. J., & Rossor, M. N. (1991). Progressive loss of speech output and orofacial dyspraxia associated with frontal lobe hypometabolism. Journal of Neurology, Neurosurgery & Psychiatry, 54(4), 351–357. https://doi.org/10.1136/jnnp.54.4.351

Utianski, R. L., & Josephs, K. A. (2023). An update on apraxia of speech. Current Neurology and Neuroscience Reports, 23(7), 353–359. https://doi.org/10.1007/s11910023012751

van der Merwe, A. (1997). A theoretical framework for the characterization of pathologic speech sensorimotor control. In M. R. McNeil (Ed.), Clinical management of sensorimotor speech disorders (pp. 1–25). New York: Thieme.

van Der Merwe, A. (2021). New perspectives on speech motor planning and programming in the context of the four-level model and its implications for understanding the pathophysiology underlying apraxia of speech and other motor speech disorders. Aphasiology, 35(4), 397–423. https://doi.org/10.1080/02687038.2020.1765306

Wertz, R. T., LaPointe, L. L., & Rosenbek, J. C. (1984). Apraxia of speech: The disorder and its management. Orlando: Grune & Stratton.

Wilson, S. M., Henry, M. L., Besbris, M., Ogar, J. M., Dronkers, N. F., Jarrold, W., Miller, B. L., & Gorno-Tempini, M. L. (2010). Connected speech production in three variants of primary progressive aphasia. Brain, 133(7), 2069–2088. https://doi.org/10.1093/brain/awq129

Downloads

Published

2024-10-21

Issue

ADVANCE ACCESS TO FORTHCOMING ARTICLES

Section

Articles

How to Cite

Code, C., Tree, J., & Müller, N. (2024). The role of connected speech in distinguishing types of apraxia of speech following brain damage. Journal of Connected Speech. https://doi.org/10.1558/jcs.31105