Cited by 172Neurobiology of Language and BilingualismHemispheric Asymmetry in NeuroscienceLanguage Development and Disorders

Damage to the anterior arcuate fasciculus predicts non-fluent speech production in aphasia

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Fridriksson, Julius, Guo, Dazhou, Fillmore, Paul, Holland, Audrey, Rorden, Chris·2013·Brain

Abstract

Non-fluent aphasia implies a relatively straightforward neurological condition characterized by limited speech output. However, it is an umbrella term for different underlying impairments affecting speech production. Several studies have sought the critical lesion location that gives rise to non-fluent aphasia. The results have been mixed but typically implicate anterior cortical regions such as Broca's area, the left anterior insula, and deep white matter regions. To provide a clearer picture of cortical damage in non-fluent aphasia, the current study examined brain damage that negatively influences speech fluency in patients with aphasia. It controlled for some basic speech and language comprehension factors in order to better isolate the contribution of different mechanisms to fluency, or its lack. Cortical damage was related to overall speech fluency, as estimated by clinical judgements using the Western Aphasia Battery speech fluency scale, diadochokinetic rate, rudimentary auditory language comprehension, and executive functioning (scores on a matrix reasoning test) in 64 patients with chronic left hemisphere stroke. A region of interest analysis that included brain regions typically implicated in speech and language processing revealed that non-fluency in aphasia is primarily predicted by damage to the anterior segment of the left arcuate fasciculus. An improved prediction model also included the left uncinate fasciculus, a white matter tract connecting the middle and anterior temporal lobe with frontal lobe regions, including the pars triangularis. Models that controlled for diadochokinetic rate, picture-word recognition, or executive functioning also revealed a strong relationship between anterior segment involvement and speech fluency. Whole brain analyses corroborated the findings from the region of interest analyses. An additional exploratory analysis revealed that involvement of the uncinate fasciculus adjudicated between Broca's and global aphasia, the two most common kinds of non-fluent aphasia. In summary, the current results suggest that the anterior segment of the left arcuate fasciculus, a white matter tract that lies deep to posterior portions of Broca's area and the sensory-motor cortex, is a robust predictor of impaired speech fluency in aphasic patients, even when motor speech, lexical processing, and executive functioning are included as co-factors. Simply put, damage to those regions results in non-fluent aphasic speech; when they are undamaged, fluent aphasias result.

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Crossref · 10.1093/brain/awt267

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  • Damage 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”
  • 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)”
  • These 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”
  • 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)”
  • Persistent 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.”

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Cites

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1 of the 61 references couldn’t be matched to a known paper.

Research works printed but not linked: 7

  1. Broca, 1861, Remarques sur le sie‘ge de la faculté du langage articulé: suivies d’une observation d’aphemie, Bull Soc Anat, 6, 330
  2. Dabul, 2000, Apraxia battery for adults
  3. Goodglass, 2000, Boston Diagnostic Aphasia Examination-Third edition (BDAE-3)
  4. McNeil, 1982, The nature of aphasia in adults, 692
  5. Nielsen, 1939, The unsolved problems in aphasia. II. Alexia resulting from a temporal lesion, Bull Los Angeles Neurol Soc, 4, 168
  6. Poeck, 1989, Fluency, 23
  7. Wechsler, 1997, Weschler Adult Intelligence Scale

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Authors
Fridriksson, J., Guo, D., Fillmore, P., Holland, A., & Rorden, C.
Affiliations
  • University of South Carolina (US)
  • University of Arizona (US)
Venue
Brain
Published
2013-10-15
Volume
136
Issue
11
Pages
3451-3460
ISSN
  • 0006-8950 (ISSN-L)
  • 1460-2156
OpenAlex
W2124041025
Cited by
172
References
61
Citations by year
2026: 10 · 2025: 11 · 2024: 13 · 2023: 14 · 2022: 22 · 2021: 16 · 2020: 18 · 2019: 14 · 2018: 12 · 2017: 14 · 2016: 9 · 2015: 11 · 2014: 7 · 2012: 1
FWCI
4.94
Type
journal article
Language
en
Open access
Locations
  • Brain (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Deafness and Other Communication Disorders (R01DC008355, R01DC009571, DC-009571, DC008355)
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
non-fluent aphasia, arcuate fasciculus, uncinate fasciculus, speech fluency, left hemisphere stroke, Broca's area, white matter tracts, global aphasia, Broca's aphasia, executive function, diadochokinesis, auditory language comprehension
MeSH terms
Aged, Aphasia, Broca, Cerebral Cortex, Female, Humans, Language Tests, Magnetic Resonance Imaging, Male, Middle Aged, Neural Pathways, Neuropsychological Tests, Predictive Value of Tests, Cohort Studies, Cerebrum

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