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Speech apraxia without oral apraxia: can normal brain function explain the physiopathology?

Bonilha, Leonardoa b; Moser, Danaa; Rorden, Chrisa; Baylis, Gordon C.c; Fridriksson, Juliusa

doi: 10.1097/01.wnr.0000223388.28834.50

Apraxia of speech, usually associated with stroke, refers to the inability to perform speech motor movements typically with an intact ability to execute non-speech oral movements. It is uncertain whether apraxia of speech results from damage affecting the insula or the inferior frontal gyrus. The controversy started because of conflicting results from studies investigating patients with disrupted brain structure, when dysfunction of both sites can coexist. We conducted a functional magnetic resonance imaging study of individuals without neurological disorders comparing speech and non-speech movements. Speech movements did not recruit the insula, but activated the left inferior frontal gyrus, suggesting that Broca's area, but not the insula, is critical for speech articulation.

Departments of aCommunication Sciences and Disorders

bNeuropsychiatry and

cPsychology, University of South Carolina, Columbia, South Carolina, USA

Correspondence and requests for reprints to Julius Fridriksson, Office Number 605, Williams-Brice Nursing Building, Department of Communication Sciences & Disorders, University of South Carolina, Columbia, SC 29209, USA

Tel: +1 803 777 5931; fax: +1 803 777 3081; e-mail:

Received 24 March 2006; accepted 13 April 2006

© 2006 Lippincott Williams & Wilkins, Inc.