Journal

The Japanese journal of neuropsychology

[Vol.25 No.4 contents]
Japanese/English

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ArticleTitle A personal view for the lecture of Professor Albert
Language J
AuthorList Mika Otsuki
Affiliation School of Psychological Sciences, Health Sciences University of Hokkaido
Publication Japanese Journal of Neuropsychology: 25 (4), 274-280, 2009
Received
Accepted
Abstract Having listened to the lecture, I cannot help conceiving the fact that the existence of a term will create a concept beyond only attaching the label on an established definition. Thus, it is significant to apply terms with discerning view and consensus. Here I try to present a personal view about 1) phonetic disintegration symptom (anartrhia: Lecours 1976), 2) whether Broca's area causes anarthria, and 3) transcortical sensory aphasia following the lesion in the left frontal lobe. 1) First, I have to point out that the term representing the speech impairment which we find in the patients with Broca's apahsia, pure anarthria or aphemia is requisite. It is an impairment purely isolated speech aspect: the utterances are distorted, syllabical, and dysprosodic, which varies, and are completely different from so-called dysarthria. It has been called as anarthria, phonetic disintegration, and apraxia of speech. It is not easy to unite to one term among the plethora of terms representing similar speech impairment. However, it is not adequate to use 'apraxia' for this phenomenon. The term aphemia indicates clinical syndrome or vascular syndrome embraces not only speech symptom but also some other symptoms such as initial muteness, occasional accompaniment of agraphia. Therefore it is reasonable to adopt the term anarthria for referring this symptom. Of course any term can be possible if it would be made under adequate and transparent definition. But I cannot dispense with this kind of term, only using dysarthria because we need to distinguish anarthria or apraxia of speech from dysarthria. 2) Broca's area never causes anarthria. Plenty of reports have been evidenced the fact that the lesion involving the inferior and posterior part of the left precentral gyrus causes anarthria. The result of overlapping methods of the lesions of the patients with anarthria, may indicate only vulnerability of the vascular regions. We can trust the studies of the patients with small circumscribed lesions, and these studies showed that Broca's area never causes anarthria. 3) Transcortical sensory apahsia (TCSA) following the left prefrontal lesion has been often deserved unfair interpretation. It is unreasonable that a patient who showed the profile of TCSA regarding language aspect unaccompanied with any other cognitive impairment is construed as having just confusional state! TCSA can be surely developed due to the frontal lesion. I wish to disucuss fully from every point to arrive at a consensus.
Keywords term, anarthria, Broca's area, transcortical sensory aphasia, frontal lesion

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