Damage to Broca’s area does not contribute to long-term speech production outcome after stroke
Open accessAbstract
Broca’s area in the posterior half of the left inferior frontal gyrus has long been thought to be critical for speech production. The current view is that long-term speech production outcome in patients with Broca’s area damage is best explained by the combination of damage to Broca’s area and neighbouring regions including the underlying white matter, which was also damaged in Paul Broca’s two historic cases. Here, we dissociate the effect of damage to Broca’s area from the effect of damage to surrounding areas by studying long-term speech production outcome in 134 stroke survivors with relatively circumscribed left frontal lobe lesions that spared posterior speech production areas in lateral inferior parietal and superior temporal association cortices. Collectively, these patients had varying degrees of damage to one or more of nine atlas-based grey or white matter regions: Brodmann areas 44 and 45 (together known as Broca’s area), ventral premotor cortex, primary motor cortex, insula, putamen, the anterior segment of the arcuate fasciculus, uncinate fasciculus and frontal aslant tract. Spoken picture description scores from the Comprehensive Aphasia Test were used as the outcome measure. Multiple regression analyses allowed us to tease apart the contribution of other variables influencing speech production abilities such as total lesion volume and time post-stroke. We found that, in our sample of patients with left frontal damage, long-term speech production impairments (lasting beyond 3 months post-stroke) were solely predicted by the degree of damage to white matter, directly above the insula, in the vicinity of the anterior part of the arcuate fasciculus, with no contribution from the degree of damage to Broca’s area (as confirmed with Bayesian statistics). The effect of white matter damage cannot be explained by a disconnection of Broca’s area, because speech production scores were worse after damage to the anterior arcuate fasciculus with relative sparing of Broca’s area than after damage to Broca’s area with relative sparing of the anterior arcuate fasciculus. Our findings provide evidence for three novel conclusions: (i) Broca’s area damage does not contribute to long-term speech production outcome after left frontal lobe strokes; (ii) persistent speech production impairments after damage to the anterior arcuate fasciculus cannot be explained by a disconnection of Broca’s area; and (iii) the prior association between persistent speech production impairments and Broca’s area damage can be explained by co-occurring white matter damage, above the insula, in the vicinity of the anterior part of the arcuate fasciculus.
AI snapshot
Written from the paper’s full text.
TL;DR
In 134 stroke survivors with relatively circumscribed left frontal lobe lesions, long-term speech production outcome was predicted by damage to white matter above the insula near the anterior arcuate fasciculus, not by damage to Broca’s area. The authors conclude that the prior association between Broca’s area damage and persistent speech production impairments can be explained by co-occurring damage to this white matter region.
Key findings
- In multiple regression Model 2, only lesion load in the anterior arcuate fasciculus (aAF) significantly predicted spoken picture description scores (P = 0.008), whereas BA44 did not (P = 0.567); the model accounted for R² = 0.515.
- Bayesian analysis gave BF = 0.116 for BA44, interpreted as more than eight times stronger evidence for the null than the alternative, and BF = 4.389 for aAF, interpreted as more than four times stronger evidence for the alternative than the null.
- Mediation analyses showed that >70% of the influence of BA45, BA44, ventral premotor cortex, or primary motor cortex damage on speech production was mediated by co-occurring aAF damage (IE/TE = 0.968, 0.791, 0.837, and 0.727, respectively).
- In matched post hoc groups, the aAF group performed significantly worse than the BA44 group on spoken picture description (mean ± SD = 55.4 ± 5.7 versus 62.9 ± 4.1; P = 0.013), with no significant difference between the aAF and BA44+aAF groups (55.4 ± 5.7 versus 55.5 ± 5.3; P = 0.979).
Methods
- Lesion-symptom study of 134 patients from the PLORAS database with unilateral left frontal lobe stroke, at least 3 months post-stroke and <10 years since onset; mean age at scan was 60.1 years, mean months since stroke was 30.1, and mean total lesion volume was 25.5 cm³.
- Nine atlas-defined regions of interest were examined: BA44, BA45, ventral premotor cortex, primary motor cortex, superior central insula, putamen, anterior arcuate fasciculus, uncinate fasciculus, and frontal aslant tract. The outcome was the Comprehensive Aphasia Test spoken picture description T-score, with semantic memory scores and other variables included as regressors of no interest.
- Analyses included multiple regression Models 1–4, Bayesian statistics, regression-based mediation, and post hoc ANOVA/ANCOVA on small groups matched for total lesion volume, age, and time post-stroke.
Limitations
- Stated in the paper: anterior and long segments of the arcuate fasciculus were highly collinear (r = 0.915), so their effects could not be dissociated; atlas-based lesion load may miss functionally critical subparts of regions; it is unclear which cortical areas are disconnected by aAF damage; other white matter tracts were not examined; and the study did not address acute-phase impairments or recovery/reorganization.
- Stated in the paper: the post hoc group analyses had small numbers, and pairwise comparisons used Fisher’s LSD without controlling family-wise error; the authors also note they did not correct for multiple comparisons in Model 2, arguing that type I error risk was prioritized over type II.
- Evident from the text: the design is cross-sectional and cannot establish causal recovery trajectories; the sample is selected for left frontal lesions sparing posterior speech areas, so findings may not generalize to other lesion distributions or to patients with more extensive posterior damage.
Model-written summary. Check it against the paper before relying on it.
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Claims the paper makes
0 of 65 cited sources checked · 0 supported · 0 flagged
- Findingown data
Speech production scores were worse after damage to the anterior arcuate fasciculus with relative sparing of Broca's area than after damage to Broca's area with relative sparing of the anterior arcuate fasciculus.
“speech production scores were worse after damage to the anterior arcuate fasciculus with relative sparing of Broca’s area than after damage to Broca’s area with relative sparing of the anterior arcuate fasciculus”
Quote in the paperSubstantial claim - Findingown data
In the patient sample, lesion load in the anterior segment of the arcuate fasciculus was highly correlated with lesion load in the long segment of the arcuate fasciculus (r(134) = 0.915).
“in our patient sample, lesion load in the anterior segment of the arcuate fasciculus was highly correlated [r(134) = 0.915] with lesion load in the long segment of the arcuate fasciculus”
Quote in the paperSubstantial claim - Findingown data
In the sample of 134 patients with left frontal damage, the degree of damage to Broca's area did not contribute to long-term speech production impairments.
“with no contribution from the degree of damage to Broca’s area (as confirmed with Bayesian statistics)”
Quote in the paperSubstantial claim - Findingown data
In the sample of 134 patients with left frontal damage, long-term speech production impairments (lasting beyond 3 months post-stroke) were solely predicted by the degree of damage to white matter directly above the insula, in the vicinity of the anterior part of the arcuate fasciculus.
“We found that, in our sample of patients with left frontal damage, long-term speech production impairments (lasting beyond 3 months post-stroke) were solely predicted by the degree of damage to white matter, directly above the insula, in the vicinity of the anterior part of the arcuate fasciculus, with no contribution from the degree of damage to Broca’s area (as confirmed with Bayesian statistics”
Quote in the paperSubstantial claim - Findingown data
When paired with lesion load in aAF, each of BA45, BA44, vPMC, or M1 stopped being statistically significant (direct effect).
“However, when paired with lesion load in aAF (i.e. two regressors), each of these left posterior inferior frontal cortical regions stopped being statistically significant (see direct effect in Table 4).”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Rests on an assumption: The mediation analyses assume no unmeasured confounding of the relationships among cortical damage, aAF damage, and speech production.
- Findingown data
The aAF group had poorer appropriate information carrying words than the BA44 group (mean = 19.0 versus 28.0, t(12) = 1.97, P = 0.036 one-tailed).
“appropriate information carrying words [mean = 19.0 versus 28.0, t(12) = 1.97, P = 0.036 one-tailed]”
Quote in the paperNot a substantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
In mediation analyses, when considered separately, lesion load in each of BA45, BA44, vPMC, or M1 made a significant contribution to the prediction of speech production scores (total effect).
“Regression-based mediation analyses showed that, when considered separately (i.e. one regressor only), lesion load in each of our left posterior inferior frontal cortical regions (BA45, BA44, vPMC or M1) made a significant contribution to the prediction of speech production scores (see total effect in Table 4).”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Rests on an assumption: The mediation analyses assume no unmeasured confounding of the relationships among cortical damage, aAF damage, and speech production.
- Findingown data
There was no evidence that the effect of BA44 damage on speech production abilities was moderated by the degree of co-occurring aAF damage (Model 3b).
“Nor was there any evidence that the effect of BA44 damage on speech production abilities was moderated (i.e. the interaction term) by the degree of co-occurring aAF damage (i.e. Model 3b in Table 3).”
Quote in the paperNot a substantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
The aAF group had poorer speed of speech production than the BA44 group (mean = 1.6 versus 2.4, U = 8.0, P = 0.019 one-tailed).
“speed of speech production (mean = 1.6 versus 2.4, U = 8.0, P = 0.019 one-tailed) ratings.”
Quote in the paperNot a substantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
The two-region model with BA44 and BA45 accounted for only a small proportion of the variability in speech production scores (R2 = 0.194, P < 0.001).
“this two-region model only accounted for a small proportion of the variability in speech production scores (R2 = 0.194, P < 0.001).”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
In Model 2, when damage to neighbouring regions was taken into account, lesion load in BA44 no longer explained speech production scores (P = 0.567).
“When the effect of damage to regions neighbouring Broca’s area was taken into account (i.e. Model 2 in Table 3), lesion load in BA44 no longer explained speech production scores (P = 0.567).”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
The post hoc results did not change after covarying out inter-patient differences in lesion load in the superior central insula and putamen.
“Critically, these results did not change after covarying out inter-patient differences in lesion load in the superior central insula and putamen, which were concurrently damaged in some of the patients from the aAF group”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
The results did not change after segregating BA44 into dorsal and ventral components (Models 3c and 3d).
“Moreover, these results did not change after segregating BA44 into dorsal and ventral components (i.e. Model 3c and Model 3d in Table 3).”
Quote in the paperNot a substantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
92% (123 of 134) of the patients in the sample were in the chronic phase post-stroke (>6 months).
“Since 92% (123 of 134; Supplementary Fig. 1) of the patients in our sample were in the chronic phase post-stroke (>6 months)”
Quote in the paperSubstantial claim - Findingown data
The aAF group had poorer syntactic variety than the BA44 group (mean = 3.4 versus 5.3, U = 6.5, P = 0.009 one-tailed).
“syntactic variety (mean = 3.4 versus 5.3, U = 6.5, P = 0.009 one-tailed)”
Quote in the paperNot a substantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
When the unique effect of BA44 damage on speech production scores was re-expressed as Bayes factors, the evidence in favour of the null was more than eight times stronger (BF = 0.116) than that in favour of the alternative.
“the evidence in favour of the null (i.e. damage to BA44 does not explain variance in speech production abilities) was more than eight times stronger (BF = 0.116) than that in favour of the alternative”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
There was no indication of a non-linear relationship between BA44 damage and speech production abilities when aAF damage was controlled for (Model 3a).
“there was not any indication of the existence of a non-linear relationship between BA44 damage and speech production abilities (i.e. the quadratic term) when aAF damage was controlled for (i.e. Model 3a in Table 3).”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
In Model 2, among eight anatomical predictors, only lesion load in aAF reached statistical significance (P = 0.008).
“Across all eight anatomical predictors included in Model 2, only lesion load in aAF reached statistical significance (P = 0.008).”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
The aAF group had poorer grammatical well-formedness than the BA44 group (mean = 3.6 versus 5.1, U = 11.5, P = 0.049 one-tailed).
“grammatical well-formedness (mean = 3.6 versus 5.1, U = 11.5, P = 0.049 one-tailed)”
Quote in the paperNot a substantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
A one-way ANOVA indicated a significant effect of group on speech production [F(2,19) = 5.028, P = 0.018].
“A one-way ANOVA indicated that there was a significant effect of group on speech production [F(2,19) = 5.028, P = 0.018].”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
More than 70% of the influence of BA45, BA44, vPMC, or M1 damage on speech production was mediated by co-occurring damage to aAF.
“these four analyses revealed that >70% of the influence of BA45, BA44, vPMC or M1 damage on speech production was mediated by co-occurring damage to aAF.”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Rests on an assumption: The mediation analyses assume no unmeasured confounding of the relationships among cortical damage, aAF damage, and speech production.
- Findingown data
aAF damage co-occurred significantly more with BA44 damage than with BA45 damage (r(134) = 0.627 versus 0.450; z = 3.487, P < 0.001).
“we found that aAF damage co-occurred significantly more with BA44 damage than BA45 damage [r(134) = 0.627 versus 0.450; z = 3.487, P < 0.001]”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
For aAF, the evidence in favour of the alternative was more than four times stronger (BF = 4.389) than that in favour of the null.
“Conversely, for aAF, the evidence in favour of the alternative was more than four times stronger (BF = 4.389) than that in favour of the null.”
Quote in the paperNot a substantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
In Model 2, aAF was the only significant anatomical predictor of speech production scores.
“aAF was the only significant anatomical predictor in Model 2”
Quote in the paperSubstantial claim - Findingown data
There were no significant differences between the aAF group and the BA44+aAF group on the spoken picture description task (mean ± SD = 55.4 ± 5.7 versus 55.5 ± 5.3; P = 0.979).
“with no significant differences between the aAF group, and the BA44+aAF group (mean ± SD = 55.4 ± 5.7 versus 55.5 ± 5.3; P = 0.979).”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
Model 1 indicated that lesion load in BA45 was not a significant predictor of speech production scores.
“Lesion load in BA45 was excluded because Model 1 indicated it was not a significant predictor”
Quote in the paperSubstantial claim - Findingown data
None of the patients with Broca's area damage in the sample completely preserved all neighbouring brain regions.
“none of the patients with Broca’s area damage in our sample completely preserved all neighbouring brain regions.”
Quote in the paperSubstantial claim- Rests on an assumption: The sample of 134 left frontal lobe stroke patients is representative of patients with relatively circumscribed left frontal lobe strokes.
- Findingown data
The aAF group performed significantly worse than the BA44 group on the spoken picture description task (mean ± SD = 55.4 ± 5.7 versus 62.9 ± 4.1; P = 0.013).
“A Fisher’s LSD post hoc test showed that this occurred because the aAF group performed significantly worse than the BA44 group on the spoken picture description task [mean ± standard deviation (SD) = 55.4 ± 5.7 versus 62.9 ± 4.1; P = 0.013]”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
When regions of interest were considered in isolation, there was a significant association between damage and persistent speech production impairments.
“when these regions (e.g. BA44) were considered in isolation, there was a significant association between damage and persistent speech production impairments.”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
Compared to Broca's area damage, damage to the aAF region of interest reduced the quality and quantity of speech output in terms of syntactic variety, grammatical well-formedness, speed and appropriate information carrying words.
“we found that, compared to Broca’s area damage, damage to our aAF region of interest reduced the quality and quantity of speech output in terms of its syntactic variety, grammatical well-formedness, speed and appropriate information carrying words.”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
When regions were considered in combination, the only significant predictor of long-term speech production outcome was the degree of damage to white matter, above the insula, in the vicinity of aAF.
“when these regions were considered in combination, the only significant predictor of long-term speech production outcome was the degree of damage to white matter, above the insula, in the vicinity of aAF.”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
Damage to BA44 and BA45 does not contribute to long-term speech production impairments after left frontal lobe strokes.
“Our results indicate that damage to BA44 and BA45 does not contribute to long-term speech production impairments after left frontal lobe strokes.”
Quote in the paperSubstantial claim - Findingown data
When the effect of co-occurring damage to the aAF region of interest was controlled for, the relationship between damage and persistent speech production impairments was no longer significant for any other region.
“when the effect of co-occurring damage to our aAF region of interest was controlled for, the relationship between damage and persistent speech production impairments was no longer significant for any other region.”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Findingown data
A significant relationship between lesion load and speech production impairments was found when the regions were considered in isolation.
“a significant relationship between lesion load and speech production impairments was found when the regions were considered in isolation.”
Quote in the paperSubstantial claim - Interpretationown data
The effect of white matter damage on speech production cannot be explained by a disconnection of Broca's area.
“The effect of white matter damage cannot be explained by a disconnection of Broca’s area”
Quote in the paperSubstantial claim - Interpretationown data
The prior association between persistent speech production impairments and Broca's area damage can be explained by co-occurring white matter damage, above the insula, in the vicinity of the anterior part of the arcuate fasciculus.
“the prior association between persistent speech production impairments and Broca’s area damage can be explained by co-occurring white matter damage, above the insula, in the vicinity of the anterior part of the arcuate fasciculus”
Quote in the paperSubstantial claim - Interpretationown data
Broca's area damage does not contribute to long-term speech production outcome after left frontal lobe strokes.
“Broca’s area damage does not contribute to long-term speech production outcome after left frontal lobe strokes”
Quote in the paperSubstantial claim- Rests on an assumption: The 134 patients with left frontal lobe damage are representative of the broader population of left frontal lobe stroke patients, so that the study's conclusions generalise beyond the sample.
- Interpretationreasoning
Stroke damage to white matter above the insula in the vicinity of the anterior part of the arcuate fasciculus is highly likely to affect fibres from both the anterior and long segments of the arcuate fasciculus, as well as other crossing white matter tracts.
“stroke damage to white matter, above the insula, in the vicinity of the anterior part of the arcuate fasciculus (aAF) is highly likely to affect fibres from both the anterior and long segments of the arcuate fasciculus, as well as other crossing white matter tracts”
Quote in the paperSubstantial claim - Study design and conductown data
High collinearity between damage to the anterior and long segments of the arcuate fasciculus makes it impossible to dissociate their effects in the current study.
“makes it impossible to dissociate their effects in the current study”
Quote in the paperSubstantial claim - Interpretationown data
The long-lasting effect of damage to white matter, above the insula, in the vicinity of aAF on speech production cannot be explained in terms of a disconnection of Broca's area.
“the long-lasting effect of damage to white matter, above the insula, in the vicinity of aAF on speech production cannot be explained in terms of a disconnection of Broca’s area”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Rests on an assumption: The sample of 134 left frontal lobe stroke patients is representative of patients with relatively circumscribed left frontal lobe strokes.
- Interpretationown data
Greater co-occurring aAF damage after BA44 damage than BA45 damage provides an explanation for the results of Model 1.
“Greater co-occurring aAF damage after BA44 damage than BA45 damage provides an explanation for the results of our first regression analysis (i.e. Model 1).”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Premisecitation
There are long association white matter tracts that link the left inferior frontal gyrus with other nodes of the speech network.
“there are a number of long association white matter tracts that are known to link the left inferior frontal gyrus with other nodes of the speech network”
Quote in the paperSubstantial claim0 of 2 sources checked - Interpretationown data
The Bayes factor for aAF can be interpreted as positive evidence for the presence of a unique long-lasting effect of aAF damage on speech production abilities.
“This can be interpreted as positive evidence (Raftery, 1995) for the presence of a unique long-lasting effect of aAF damage on speech production abilities.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Raftery, 1995 source
Not checked in the free run.
- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Interpretationown data
The analyses strongly imply that damage to aAF, not BA44, is critical for explaining long-lasting impairments in speech production abilities.
“Our analyses strongly imply that damage to aAF, not BA44, is critical for explaining long-lasting impairments in speech production abilities.”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Rests on an assumption: The mediation analyses assume no unmeasured confounding of the relationships among cortical damage, aAF damage, and speech production.
- Interpretationown data
The Bayes factor for BA44 can be interpreted as positive evidence for the absence of a unique long-lasting effect of Broca's area damage on speech production abilities.
“This can be interpreted as positive evidence (Raftery, 1995) for the absence of a unique long-lasting effect of Broca’s area damage on speech production abilities.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Raftery, 1995 source
Not checked in the free run.
- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Interpretationreasoning
The prior association between Broca's area damage and long-lasting speech production impairments can be accounted for by co-occurring damage to white matter, above the insula, in the vicinity of aAF, which is highly likely to include fibres from both the anterior and long segments of the arcuate fasciculus, as well as other crossing white matter tracts.
“the prior association between Broca’s area damage and long-lasting speech production impairments can be accounted for by co-occurring damage to white matter, above the insula, in the vicinity of aAF, which is highly likely to include fibres from both the anterior and long segments of the arcuate fasciculus, as well as other crossing white matter tracts.”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Rests on an assumption: The sample of 134 left frontal lobe stroke patients is representative of patients with relatively circumscribed left frontal lobe strokes.
- Interpretationown data
Broca's area damage does not contribute to long-term speech production outcome after relatively circumscribed left frontal lobe strokes.
“Broca’s area damage does not contribute to long-term speech production outcome after relatively circumscribed left frontal lobe strokes”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Rests on an assumption: The sample of 134 left frontal lobe stroke patients is representative of patients with relatively circumscribed left frontal lobe strokes.
- Premisecitation
Previous studies were not able to tease apart the impact of damage to Broca's area and surrounding areas because focal damage to Broca's area is rare post-stroke, particularly in ischaemic injuries.
“Previous studies were not able to tease apart the impact of damage to Broca’s area and surrounding areas because focal damage to Broca’s area is rare post-stroke; particularly in the context of ischaemic injuries (Mah et al., 2014; Sperber and Karnath, 2017)”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Mah et al., 2014 source
Not checked in the free run.
- cites Sperber and Karnath, 2017
Not checked in the free run.
- Premisereasoning
It is difficult to determine which part of the lesion site is driving observed behavioural effects.
“In all cases, it is therefore difficult to determine which part of the lesion site is driving the observed behavioural effects”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
A previous well-powered lesion study was unable to establish a significant relationship between persistent speech production impairments and damage to either the inferior fronto-occipital fasciculus or the long segment of the arcuate fasciculus after controlling for damage to the anterior segment of the arcuate fasciculus.
“a previous well-powered lesion study was unable to establish a significant relationship between persistent speech production impairments and damage to either of these white matter tracts after controlling for damage to the anterior segment of the arcuate fasciculus (Fridriksson et al., 2013)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Fridriksson et al., 2013 source
Not checked in the free run.
- Premisecitation
The frontal region associated with speech articulation in functional imaging studies of the neurologically-intact brain is the more posterior precentral cortex.
“The frontal region associated with speech articulation in functional imaging studies of the neurologically-intact brain is, by contrast, the more posterior precentral cortex (Wise et al., 1999; Price, 2012).”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
Long-term speech production impairments are the consequence of co-occurring damage to cortical and subcortical regions in and around Broca's area.
“This along with other findings (Mohr et al., 1978) led to the conclusion that long-term speech production impairments are the consequence of co-occurring damage to cortical and subcortical regions in and around Broca’s area.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Mohr et al., 1978 source
Not checked in the free run.
- Interpretationcitation
The function of the regions of interest, with the exception of aAF, can be compensated for by other undamaged regions, for example after functional reorganization.
“they suggest that the function of our regions of interest, with the exception of aAF, can be compensated for by other undamaged regions (e.g. after functional reorganization; Young et al., 2020).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Young et al., 2020 source
Not checked in the free run.
- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Interpretationown data
Broca's area disconnection cannot explain why patients with direct damage to Broca's area and relative sparing of aAF had better speech production abilities than patients with damage to aAF and relative sparing of Broca's area.
“Broca’s area disconnection cannot explain why patients with direct damage to Broca’s area and relative sparing of aAF had better speech production abilities than patients with damage to aAF and relative sparing of Broca’s area.”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Premisecitation
Tract disconnection metrics are generally more sensitive than tract lesion load per se.
“demonstrated that tract disconnection metrics were generally more sensitive than tract lesion load per se.”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
The association between persistent speech production impairments and white matter damage aligns with prior evidence suggesting that white matter damage poses a major constraint on brain plasticity.
“The association between persistent speech production impairments and white matter damage aligns well with prior evidence suggesting that white matter damage poses a major constraint on brain plasticity (Duffau, 2014; Herbet et al., 2016; Griffis et al., 2019).”
Quote in the paperSubstantial claim0 of 3 sources checked - Interpretationcitation
The findings support prior conclusions that white matter, above the insula, in the vicinity of aAF is important for speech production.
“Our findings support prior conclusions that white matter, above the insula, in the vicinity of aAF is important for speech production (Fridriksson et al., 2013)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Fridriksson et al., 2013 source
Not checked in the free run.
- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Premisenone given
Prior studies did not rule out the possibility that the effect of damage or disruption to aAF on speech production could be explained in terms of a disconnection of Broca's area.
“In contrast to our work, however, these studies did not rule out the possibility that the effect of damage/disruption to aAF on speech production could be explained in terms of a disconnection of Broca’s area.”
Quote in the paperSubstantial claim - Study design and conductreasoning
Including large numbers of patients with varying degrees of damage to the regions of interest maximizes available variance for analysis, ensuring sufficient statistical power to detect lesion effects.
“This maximizes the available variance for analysis, ensuring sufficient statistical power to detect lesion effects”
Quote in the paperSubstantial claim - Interpretationreasoning
If initial speech production impairments are observed after damage to Broca's area, with relative sparing of aAF, they are likely to resolve.
“if initial speech production impairments are observed after damage to Broca’s area, with relative sparing of aAF, they are likely to resolve.”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Interpretationreasoning
Relatively circumscribed white matter damage, above the insula, in the vicinity of aAF is likely to have a long-lasting detrimental effect that may be the consequence of disrupted functional integration among multiple regions in inferior frontal, inferior parietal and superior temporal cortices involved in sensorimotor control of speech production, irrespective of whether Broca's area has been Dis
“relatively circumscribed white matter damage, above the insula, in the vicinity of aAF is likely to have a long-lasting detrimental effect that may be the consequence of disrupted functional integration among the multiple regions in inferior frontal, inferior parietal and superior temporal cortices involved in the sensorimotor control of speech production”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
- Interpretationcitation
The white matter pathway most likely to be affected in the aAF region is the anterior part of the arcuate fasciculus, according to a normative DTI-based atlas and post-mortem fibre dissection studies.
“The white matter pathway most likely to be affected is the anterior part of the arcuate fasciculus, according to a normative DTI-based atlas of human brain connections (Catani and Thiebaut de Schotten, 2008; Thiebaut de Schotten et al., 2011) and post-mortem fibre dissection studies (Martino et al., 2013).”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
The lesion sites observed in Paul Broca's two historic cases (Leborgne and Lelong) involved other cortical and subcortical areas neighbouring the left posterior inferior frontal gyrus, including the white matter underlying BA44 and BA45.
“the lesion sites observed in Paul Broca’s two historic cases (Leborgne and Lelong) involved other cortical and subcortical areas neighbouring the left posterior inferior frontal gyrus, including the white matter underlying BA44 and BA45 (Dronkers et al., 2007).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Dronkers et al., 2007 source
Not checked in the free run.
- Premisecitation
The definition of the course of the medial subcallosal fasciculus and periventricular white matter tracts and their cortical terminations are not yet available in any published tractography-based atlases of human brain connections.
“Currently, the definition of the course of these tracts and their cortical terminations are not yet available in any of the published tractography-based atlases of human brain connections (see Forkel et al., 2014 for relevant discussion).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Forkel et al., 2014 source
Not checked in the free run.
- Interpretationreasoning
Estimating the effect of damage only in terms of lesion load in atlas-based regions of interest may lead to false negative results.
“Estimating the effect of damage only in terms of lesion load in atlas-based regions of interest may therefore lead to false negative results.”
Quote in the paperSubstantial claim - Interpretationown data
The findings challenge the long established association of Broca's area damage with persistent speech production impairments.
“As well as challenging the long established association of Broca’s area damage with persistent speech production impairments, our findings suggest that:”
Quote in the paperSubstantial claim - Interpretationreasoning
Because the anterior and long segments of the arcuate fasciculus run closely together in fronto-parietal white matter above the insula, the study cannot distinguish whether long-lasting speech production impairments were exclusively caused by damage to one segment or by a combination of both segments, and possibly other crossing tracts.
“because of how closely the anterior and long segments of the arcuate fasciculus run in the fronto-parietal white matter above the insula, we cannot distinguish whether long-lasting speech production impairments were exclusively caused by damage to one of these segments or by a combination of damage to both these segments (as well as plausibly other crossing white matter tracts in this region).”
Quote in the paperSubstantial claim
- May combine two claims. 6
- Classified as probably not a substantial claim. 26
May combine two claims.
Findingown dataLesion load in BA44, but not BA45, significantly predicted speech production scores in Model 1.
“Lesion load in BA44 but not BA45 significantly predicted speech production scores (Table 3).”
Quote in the paperSubstantial claim- Rests on an assumption: The spoken picture description task and CAT scores validly measure long-term speech production abilities.
Probably not a substantial claim: may not pass S4 (based).
Findingown dataStroke lesions only very rarely affect grey matter in the absence of co-occurring white matter damage and vice versa, as shown in this study.
“stroke lesions only very rarely affect grey matter in the absence of co-occurring white matter damage and vice versa (as we have shown here).”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationDamage to each of the selected white/grey matter regions has been associated with speech production impairments in prior lesion studies.
“Damage to each of these white/grey matter regions has been associated with speech production impairments in prior lesion studies”
Quote in the paperSubstantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationDamage to both banks of the superior central sulcus centred at MNI coordinates [−36, 1, 10] has consistently been associated with speech production impairments after stroke.
“damage to both banks of the superior central sulcus centred at MNI coordinates [−36, 1, 10] has consistently been associated with speech production impairments after stroke”
Quote in the paperNot a substantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationBroca's area plays a role in normal speech production.
“We do not question the role that Broca’s area has been shown to play in normal speech production”
Quote in the paperNot a substantial claim0 of 3 sources checkedClassified as probably not a substantial claim.
Study design and conductreasoningFor Models 2 and 3, variance unrelated to lesion site was factored out by including total lesion volume, months post-stroke, age at stroke, and CAT semantic memory scores as regressors of no interest.
“For Models 2 and 3 below, we factored out variance that was unrelated to lesion site by including the following regressors of no interest: (i) total lesion volume; (ii) months post-stroke; (iii) age at stroke; and (iv) scores from the CAT semantic memory task”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationBA44 and BA45 can be dissociated based on function, with BA44 more important for phonological processing and BA45 more important for semantic processing.
“BA44 and BA45 can be dissociated based on their function, with BA44 being more important for phonological processing (i.e. related to the encoding or decoding of the sound structure of words) and BA45 being more important for semantic processing (i.e. related to the meaning of words)”
Quote in the paperNot a substantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIt was not until 2007 that the full extent of the lesions incurred by Broca's two famous cases was revealed in an MRI study showing damage to multiple subcortical grey and white matter regions.
“It was not until 2007 that the full extent of the lesions incurred by Broca’s two famous cases (Broca, 1861a, b) was revealed in an MRI study showing damage to multiple subcortical grey and white matter regions (Dronkers et al., 2007)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Dronkers et al., 2007 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe borders of the regions were determined using a probability threshold of 50% for grey matter and 25% for white matter.
“The borders of the regions were determined using a probability threshold of 50% for grey matter and 25% for white matter”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe study used probabilistic human brain atlases that explicitly accommodate inter-subject variability in anatomy to define the borders of the grey and white matter regions of interest.
“Three probabilistic human brain atlases that explicitly accommodate inter-subject variability in anatomy were used to define the borders of the grey and white matter regions of interest”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisenone givenThe two M1 subregions used are implicated in the motor control of the speech articulators (face, tongue and larynx).
“we used the two (of five) M1 subregions from the Brainnetome atlas that are implicated in the motor control of the speech articulators (i.e. face, tongue and larynx)”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe main result (Model 2) is replicated using white matter masks derived exclusively from the Rojkova et al. (2016) atlas.
“In Supplementary Table 1 we replicate our main result (i.e. Model 2 reported below) using white matter masks derived exclusively from the Rojkova et al. (2016) atlas”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Rojkova et al., 2016 source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductcitationThe CAT spoken picture description task was administered and scored following standardized procedures described in the assessment battery manual.
“The CAT spoken picture description task was administered to each patient and the spoken responses scored following standardized procedures described in the assessment battery manual”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Swinburn et al., 2004
Not checked in the free run.
May combine two claims.
PremisecitationBA44 and BA45 are differentiated in cyto-architecture, receptor-architecture, structural/functional connectivity, and function.
“given the well-established differentiation between these two regions in terms of cyto-architecture (Amunts et al., 1999), receptor-architecture (Amunts et al., 2010), structural/functional connectivity (Anwander et al., 2006; Margulies and Petrides, 2013) and, more importantly, function (Gough et al., 2005; Klaus and Hartwigsen, 2019)”
Quote in the paperSubstantial claim0 of 3 sources checkedClassified as probably not a substantial claim.
InterpretationreasoningThe CAT spoken picture description task is a reasonable proxy for natural speech production.
“The CAT spoken picture description task is a reasonable proxy for natural speech production, because it requires patients to interpret a complex scene and report their interpretation in a coherent, free-form manner”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe anterior segment of the arcuate fasciculus connects the posterior inferior frontal cortex with the parieto-temporal cortex.
“the anterior segment of the arcuate fasciculus (also referred to as the third branch of the superior longitudinal fasciculus or SLF III) that connects the posterior inferior frontal cortex with the parieto-temporal cortex”
Quote in the paperNot a substantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThese probability thresholds are within the range of those used in previous studies.
“These probability thresholds are within the range of those used in previous studies”
Quote in the paperNot a substantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe uncinate fasciculus connects the medial and lateral orbitofrontal cortex with anterior parts of the temporal lobe.
“the uncinate fasciculus that connects the medial and lateral orbitofrontal cortex with anterior parts of the temporal lobe”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Catani and Thiebaut de Schotten, 2008
Not checked in the free run.
- cites Martino et al., 2011 source
Not checked in the free run.
May combine two claims.
PremisecitationAlthough damage to Broca's area typically co-occurs with damage to neighbouring areas, damage to neighbouring areas can occur without damage to Broca's area.
“although damage to Broca’s area typically co-occurs with damage to these neighbouring areas, damage to neighbouring areas can occur without damage to Broca’s area.”
Quote in the paperSubstantial claim0 of 2 sources checkedClassified as probably not a substantial claim. May combine two claims.
Study design and conductown dataThe data met all core assumptions for multiple regression, with the exception of high multicollinearity for vPMC, frontal aslant tract, and total lesion volume.
“we established that our data met all core assumptions for multiple regression, with the exception of ‘high multicollinearity’ for two regressors of interest (vPMC and frontal aslant tract) and one regressor of no interest (total lesion volume)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Field, 2018
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe frontal aslant tract connects the posterior inferior frontal cortex with the supplementary/pre-supplementary motor area.
“the frontal aslant tract that connects the posterior inferior frontal cortex with the supplementary/pre-supplementary motor area”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Catani et al., 2012a
Not checked in the free run.
- cites Vergani et al., 2014 source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductnone givenFor each patient, the binary lesion image was visually inspected and checked against the normalized T1-weighted anatomical whole-brain volume/neurologist's lesion description, and improved if necessary.
“For each patient, the binary lesion image was visually inspected and checked against the normalized T1-weighted anatomical whole-brain volume/neurologist’s lesion description, and improved if necessary”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPersistent speech production impairments as a consequence of stroke damage to aAF have been reported in prior studies that did and did not collect DTI data.
“persistent speech production impairments as a consequence of stroke damage to aAF have been reported in prior studies that did (Marchina et al., 2011) and did not collect (Fridriksson et al., 2013) DTI data to quantify structural abnormality in white matter pathways.”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
Study design and conductreasoningUsing regions with a high probability of being the tract of interest according to normative atlases ensured that the regions were representative of the general population, minimizing inter-subject variability without completely removing it.
“This ensured that the regions were representative of the general population, minimizing inter-subject variability without completely removing it.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Catani et al., 2012b
Not checked in the free run.
- cites Eickhoff et al., 2018 source
Not checked in the free run.
Probably not a substantial claim: may not pass S1 (asserted).
PremisecitationBroca's area damage is associated with short-term speech production impairments.
“the association of Broca’s area damage with short-term speech production impairments (Ochfeld et al., 2010) should be re-evaluated after controlling for damage to aAF.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Ochfeld et al., 2010 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
InterpretationcitationOne explanation for the constraint is that white matter can act as a bottleneck for multiple processing tracts from multiple neural networks, all of which are affected when the bottleneck is damaged, thereby limiting resources for recovery.
“One explanation for this is that white matter can act as a bottle neck for multiple processing tracts from multiple neural networks, all of which are affected when the bottle neck is damaged, thereby limiting resources for recovery (Griffis et al., 2017).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Griffis et al., 2017 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCombined stroke damage to the medial subcallosal fasciculus and periventricular white matter has previously been associated with persistent non-fluent speech production.
“there are other white matter tracts where combined stroke damage has previously been associated with persistent non-fluent speech production. These fibre pathways are more deeply situated (i.e. adjacent to the lateral ventricle) than the ones studied here and comprise the medial subcallosal fasciculus and periventricular white matter (Naeser et al., 1989; Naeser and Palumbo, 1994).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Naeser et al., 1989 source
Not checked in the free run.
- cites Naeser and Palumbo, 1994
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationSpeech production impairments have been induced after aAF disruption by direct electrical stimulation.
“Speech production impairments have also been induced after aAF disruption by means of direct electrical stimulation (van Geemen et al., 2014).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites van Geemen et al., 2014 source
Not checked in the free run.
Classified as probably not a substantial claim.
Premisenone givenPaul Broca's seminal work associated persistent speech production impairments with damage to the third convolution of the left frontal lobe (i.e. inferior frontal gyrus, particularly its posterior half).
“Paul Broca’s seminal work associated persistent speech production impairments with damage to the third convolution of the left frontal lobe (i.e. inferior frontal gyrus, particularly its posterior half).”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningIt cannot be entirely certain which cortical areas are disconnected as a result of damage to the aAF region of interest.
“We can therefore not be entirely sure which cortical areas are disconnected as a result of damage to our aAF region of interest.”
Quote in the paperNot a substantial claim- Rests on an assumption: White matter lesions are likely to damage fibres with a range of different cortical projections.
The paper relies on this without support.
The 134 patients with left frontal lobe damage are representative of the broader population of left frontal lobe stroke patients, so that the study's conclusions generalise beyond the sample.
“in our sample of patients with left frontal damage”
“after left frontal lobe strokes”
The paper relies on this without support.
The nine selected atlas-defined grey and white matter regions are sufficient to capture the relevant brain regions for testing whether Broca's area damage contributes to long-term speech production outcome.
“Given the methodological constraints described above, it was not feasible to investigate, within the same study, all the grey or white matter regions that have previously been associated with speech production”
The paper relies on this without support.
The spoken picture description task and CAT scores validly measure long-term speech production abilities.
“The speech production scores for the BA44, aAF, and BA44+aAF groups were submitted to a one-way ANOVA.”
The paper relies on this without support.
The atlas-defined BA44 and BA45 regions correspond to Broca’s area.
“BA44 and BA45 (together known as Broca’s area)”
The paper relies on this without support.
The mediation analyses assume no unmeasured confounding of the relationships among cortical damage, aAF damage, and speech production.
“This allowed us to estimate the degree to which the effect of damage to different parts of the left posterior inferior frontal cortex on our speech production scores was explained by co-occurring damage to the underlying white matter.”
The paper relies on this without support.
The sample of 134 left frontal lobe stroke patients is representative of patients with relatively circumscribed left frontal lobe strokes.
“Within our sample of 134 patients”
The paper relies on this without support.
White matter lesions are likely to damage fibres with a range of different cortical projections.
“white matter lesions are likely to damage fibres with a range of different cortical projections.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The absence of production-related neural activity in area 44 is consistent with some recent work questioning the traditional role of Broca's area in speech.
“The absence of production-related neural activity in area 44 is consistent with some recent work questioning the traditional role of Broca’s area in speech15–18.”
From A high-performance speech neuroprosthesis (2023) · cites this paper as [17]
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Consistentz = 3.487reported p < .001 · recomputed p < .001
“z = 3.487, p < .001”
- ConsistentF(2, 19) = 5.028reported p = .018 · recomputed p = .018
“F(2,19) = 5.028, p = .018”
- Consistentt(12) = 1.97reported p = .036 · recomputed p = .072
“t(12) = 1.97, p = .036”
The paper states a one-tailed test
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Self-check results appear here once an independent check has confirmed them.
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“, 2005), and connect multiple regions implicated in speech production such as the pars opercularis, ventral precentral gyrus, supramarginal gyrus and posterior superior temporal gyrus (Catani et al., 2005; Martino et al., 2013; Bernard et al., 2019).”
BackgroundInfluentialNeural organization of speech production: A lesion-based study of error patterns in connected speech
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Research works printed but not linked: 1
- Marie, 1906, The third frontal convolution plays no special role in the function of language, Sem Méd, 26, 241
Cited by
Sorted by citations
A high-performance speech neuroprosthesis
Willett, F. R., Kunz, E. M., Fan, C., Avansino, D. T., Wilson, G. H., Choi, E. Y., Kamdar, F., Glasser, M. F., Hochberg, L. R., Druckmann, S., et al. (2023) · Nature · doi:10.1038/s41586-023-06377-x · Cited by 581 · see citing works
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A Neurosurgical Functional Dissection of the Middle Precentral Gyrus during Speech Production
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Dissociation of Broca’s area from Broca’s aphasia in patients undergoing neurosurgical resections
Andrews, J. P., Cahn, N., Speidel, B. A., Chung, J. E., Levy, D. F., Wilson, S. M., Berger, M. S., & Chang, E. F. (2023) · Journal of Neurosurgery · doi:10.3171/2022.6.jns2297 · Cited by 37 · see citing works
- Authors
- Gajardo-Vidal, A., Lorca-Puls, D. L., team, P., Warner, H., Pshdary, B., Crinion, J. T., Leff, A. P., Hope, T. M. H., Geva, S., Seghier, M. L., Green, D. W., Bowman, H., & Price, C. J.
- Affiliations
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
- Wellcome Centre for Human Neuroimaging (GB)
- Institute of Cognitive Neuroscience, University College London, London, UK
- UCL Queen Square Institute of Neurology (GB)
- Emirates College for Advanced Education (AE)
- University College London (GB)
- University of Kent (GB)
- ORCID
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-01-31
- Volume
- 144
- Issue
- 3
- Pages
- 817-832
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- PMC
- PMC8041045
- OpenAlex
- W3128748244
- Cited by
- 150
- References
- 122
- Citations by year
- 2026: 13 · 2025: 28 · 2024: 42 · 2023: 26 · 2022: 25 · 2021: 15 · 2013: 1
- FWCI
- 8.86
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Brain (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Kent Academic Repository (University of Kent) (acceptedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by)
- Griffith Research Online (submittedVersion, cc-by)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Wellcome (203147/Z/16/Z, 205103/Z/16/Z)
- Medical Research Council (MR/M023672/1)
- Stroke Association (2014/02)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hemispheric Asymmetry in Neuroscience
- Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
- Keywords
- Broca's area, stroke, speech production, Broca's aphasia, arcuate fasciculus, white matter injury, insula, long-term outcomes, ventral premotor cortex, frontal aslant tract, uncinate fasciculus
- MeSH terms
- Adult, Aged, Aged, 80 and over, Aphasia, Broca, Female, Frontal Lobe, Humans, Male, Middle Aged, Stroke, Broca Area
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-08.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-08.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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