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1.
J Cogn Neurosci ; : 1-17, 2024 Aug 15.
Article in English | MEDLINE | ID: mdl-39145759

ABSTRACT

Whether small number magnitudes are inherently represented as lying to the left of larger ones, the space-number association (SNA), is an important issue in mathematical cognition. In this fMRI study, we used a go/no-go implicit association task to investigate the brain activity and functional connectivity underlying the SNA. Arabic digits lower or higher than 5 and left- or right-pointing arrows were alternated as central targets. In a single-code task condition, participants responded to a specific number magnitude and to all arrows or to a specific arrow direction and to all number magnitudes. In a joint-code (JC) condition, responses were provided after congruent, for example, "go when a number is lower than 5 or an arrow points left," or incongruent, for example, "go when a number is lower than 5 or an arrow points right," SNAs. The SNA was only found in the JC condition, where responses were faster with congruent instructions. Analyses of fMRI functional connectivity showed that the SNA was matched with enhanced excitatory inputs from ACC, the left TPJ, and the left inferior frontal gyrus to the left and right intraparietal sulcus (IPS). Incongruent JC trials were associated with enhanced excitatory modulation from ACC to the left and right IPS. These results show that the SNA is associated with enhanced activation of top-down brain control and changes in the functional interaction between the left and right IPS. We conclude that the SNA does not depend on an inherent and bottom-up spatial coding of number magnitudes.

2.
Atten Percept Psychophys ; 86(3): 1048-1055, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38413505

ABSTRACT

Humans use space to think of and communicate the flow of time. This spatial representation of time is influenced by cultural habits so that in left-to-right reading cultures, short durations and past events are mentally positioned to the left of long durations and future events. The STEARC effect (Space Temporal Association of Response Codes) shows a faster classification of short durations/past events with responses on the left side of space and of long durations/future events with responses on the right side. We have recently showed that during the classification of time durations, space is a late heuristic of time because in this case, the STEARC appears only when manual responses are slow, not when they are fast. Here, we wished to extend this observation to the semantic classification of words as referring to the 'past' or the 'future'. We hypothesised that the semantic processing of 'past' and 'future' concepts would have engaged slower decision processes than the classification of short versus long time durations. According to dual-route models of conflict tasks, if the task-dependent classification/decision process were to proceed relatively slowly, then the effects of direct activation of culturally preferred links between stimulus and response (S-R), i.e., past/left and future/right in the case of the present task, should attain higher amplitudes before the instruction-dependent correct response is selected. This would imply that, at variance with the faster classification of time durations, during the slower semantic classification of time concepts, in incongruent trials, the direct activation of culturally preferred S-R links should introduce significant reaction time (RT) costs and a corresponding STEARC at the fastest manual responses in the experiment too. The study's results confirmed this hypothesis and showed that in the classification of temporal words, the STEARC also increased as a function of the length of RTs. Taken together, the results from sensory duration and semantic classification STEARC tasks show that the occurrence, strength and time course of the STEARC varies significantly as a function of the speed and level of cognitive processing required in the task.


Subject(s)
Reaction Time , Semantics , Space Perception , Time Perception , Humans , Female , Male , Orientation , Young Adult , Adult , Decision Making , Reading , Pattern Recognition, Visual/physiology , Functional Laterality , Attention
3.
Brain Sci ; 14(1)2024 Jan 12.
Article in English | MEDLINE | ID: mdl-38248293

ABSTRACT

BACKGROUND: Previous investigations on healthy humans showed conflicting evidence regarding the impact of mood on working memory performance. A systematic investigation of how mood affects apathy levels in healthy participants is currently missing. METHODS: We administered a visuospatial (VS) and a numerical (N) n-back task to a sample of 120 healthy individuals. In these participants, using a series of questionnaires, we also evaluated apathy, mood, working memory, perceived stress, PTSD symptoms caused by the COVID-19 pandemic outbreak, and general psychiatric symptoms. Successively, we investigated their performance in the n-back task as a function of scores to these questionnaires. RESULTS: Participants performed better in the N block than in the VS one. Their accuracy decreased as a function of the n-back difficulty. We reported no differences in working memory performance or apathy as a function of mood, stress, or PTSD symptoms. We found that phobic anxiety negatively predicted accuracy to the numerical n-back task and that subjects with greater anxiety and difficulty in regulating emotions also showed higher levels of withdrawal from the task. CONCLUSION: The study's results suggest that while mood did not significantly affect working memory performance, strong associations were found between WMQ scores and working memory capabilities.

4.
Cortex ; 171: 60-74, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37979232

ABSTRACT

Cholinergic (Ach), Noradrenergic (NE), and Dopaminergic (DA) pathways play an important role in the regulation of spatial attention. The same neurotransmitters are also responsible for inter-individual differences in temperamental traits. Here we explored whether biologically defined temperamental traits determine differences in the ability to orient spatial attention as a function of the probabilistic association between cues and targets. To this aim, we administered the Structure of Temperament Questionnaire (STQ-77) to a sample of 151 participants who also performed a Posner task with central endogenous predictive (80 % valid/20 % invalid) or non-predictive cues (50 % valid/50 % invalid). We found that only participants with high scores in Plasticity and Intellectual Endurance showed a selective abatement of attentional costs with non-predictive cues. In addition, stepwise regression showed that costs in the non-predictive condition were negatively predicted by scores in Plasticity and positively predicted by scores in Probabilistic Thinking. These results show that stable temperamental characteristics play an important role in defining the inter-individual differences in attentional behaviour, especially in the presence of different probabilistic organisations of the sensory environment. These findings emphasize the importance of considering temperamental and personality traits in social and professional environments where the ability to control one's attention is a crucial functional skill.


Subject(s)
Attention , Temperament , Humans , Temperament/physiology , Attention/physiology , Mood Disorders , Dopamine , Norepinephrine/physiology , Cues
5.
Sci Rep ; 13(1): 21098, 2023 11 30.
Article in English | MEDLINE | ID: mdl-38036544

ABSTRACT

Previous studies have reported that larger visual stimuli are perceived as lasting longer than smaller ones. However, this effect disappears when participants provide a qualitative judgment, by stating whether two stimuli have the "same or different" duration, instead of providing an explicit quantitative judgment (which stimulus lasts longer). Here, we extended these observations to the interaction between the numerosity of visual stimuli, i.e. clouds of dots, and their duration. With "longer vs shorter" responses, participants judged larger numerosities as lasting longer than smaller ones, both when the responses were related to the order (Experiment 1) or color (Experiment 4) of stimuli. In contrast, no similar effect was found with "same vs different" responses (Experiment 2) and in a time motor reproduction task (Experiment 3). The numerosity-time interference in Experiment 1 and Experiment 4 was not due to task difficulty, as sensory precision was equivalent to that of Experiment 2. We conclude that in humans the functional interaction between numerosity and time is not guided, in the main, by a shared bottom-up mechanism of magnitude coding. Rather, high-level and top-down processes involved in decision-making and guided by the use of "magnitude-related" response codes play a crucial role in triggering interference among different magnitude domains.


Subject(s)
Judgment , Visual Perception , Humans , Mathematical Concepts
7.
Atten Percept Psychophys ; 85(7): 2321-2336, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37468788

ABSTRACT

Left-to-right readers classify faster past events with motor responses on the left side of space and future events with responses on the right side. This suggests a left-to-right spatial organization in the mental representation of time. Here, we show that the significance and reliability of this representation are linked to the joint use of temporal and spatial codes in the task at hand. In a first unimanual Go/No-Go Implicit Association Test (IAT), attending selectively to "past" or to "future" words did not activate corresponding "left" or "right" spatial concepts and vice versa. In a second IAT, attending to both temporal (i.e., "past" and "future") words and spatial targets (i.e., "left" and "right") pointing arrows produced faster responses for congruent rather than incongruent combinations of temporal and spatial concepts in task instructions (e.g., congruent = "Go with past words and left-pointing arrows"; incongruent = "Go with past words and right-pointing arrows"). This effect increased markedly in a STEARC task where spatial codes defined the selection between "left-side" and "right-side" button presses that were associated with "past" and "future" words. Two control experiments showed only partial or unreliable space-time congruency effects when (a) participants attended to superordinate semantic codes that included both spatial "left"/"right" or temporal "past/future" subordinate codes; (b) a primary speeded response was assigned to one dimension (e.g., "past vs. future") and a nonspeeded one to the other dimension (e.g., "left" vs. "right"). These results help to define the conditions that trigger a stable and reliable spatial representation of time-related concepts.


Subject(s)
Space Perception , Time Perception , Humans , Reaction Time/physiology , Reproducibility of Results , Space Perception/physiology , Time Perception/physiology , Semantics
8.
Cortex ; 164: 21-32, 2023 07.
Article in English | MEDLINE | ID: mdl-37148825

ABSTRACT

To get a concrete representation of its intangible flow, culture frames elapsing time along spatially oriented mental or graphical lines, which are organised according to reading habits, from left to right in western cultures. One of the strongest evidence for this spatial representation of time is the STEARC effect (Spatial-Temporal Association of Response Codes), which consists of faster coding of "short" durations with motor responses in the left side of space and of "long" durations with responses in the right side. Here, we investigated the STEARC as a function of response speed in two different experiments in healthy participants. Surprisingly, in both sub- and supra-second ranges, we found the STEARC only when decisions on time durations were slow, while no spatial representation of time was present with fast decisions. This first demonstrates that space slowly takes over faster non-spatial processing of time flow and that it is possible to empirically separate the behavioural manifestations of the non-spatial and the nurtured spatial mechanisms of time coding.


Subject(s)
Heuristics , Space Perception , Humans , Space Perception/physiology , Reaction Time/physiology , Time Factors
9.
Handb Clin Neurol ; 187: 161-177, 2022.
Article in English | MEDLINE | ID: mdl-35964969

ABSTRACT

In the human brain, the temporal-parietal junction (TPJ) is a histologically heterogenous area that includes the ventral portions of the parietal cortex and the caudal superior temporal gyrus sector adjacent to the posterior end of the Sylvian fissure. The anatomical heterogeneity of the TPJ is matched by its seemingly ubiquitous involvement in different cognitive functions that span from memory to language, attention, self-consciousness, and social behavior. In line with established clinical evidence, recent fMRI investigations have confirmed relevant hemispheric differences in the TPJ function. Most importantly, the same investigations have highlighted that, in each hemisphere, different subsectors of the TPJ are putatively involved in different cognitive functions. Here I review empirical evidence and theoretical proposals that were recently advanced to gain a unifying interpretation of TPJ function(s). In the final part of the review, a new overarching interpretation of the TPJ function is proposed. Current advances in cognitive neuroscience can provide important insights that help improve the clinical understanding of cognitive deficits experienced by patients with lesions centered in or involving the TPJ area.


Subject(s)
Parietal Lobe , Temporal Lobe , Brain , Brain Mapping , Humans , Magnetic Resonance Imaging , Parietal Lobe/diagnostic imaging , Temporal Lobe/diagnostic imaging
10.
Phys Life Rev ; 42: 56-92, 2022 09.
Article in English | MEDLINE | ID: mdl-35901654

ABSTRACT

Experimental and theoretical studies have tried to gain insights into the involvement of the Temporal Parietal Junction (TPJ) in a broad range of cognitive functions like memory, attention, language, self-agency and theory of mind. Recent investigations have demonstrated the partition of the TPJ in discrete subsectors. Nonetheless, whether these subsectors play different roles or implement an overarching function remains debated. Here, based on a review of available evidence, we propose that the left TPJ codes both matches and mismatches between expected and actual sensory, motor, or cognitive events while the right TPJ codes mismatches. These operations help keeping track of statistical contingencies in personal, environmental, and conceptual space. We show that this hypothesis can account for the participation of the TPJ in disparate cognitive functions, including "humour", and explain: a) the higher incidence of spatial neglect in right brain damage; b) the different emotional reactions that follow left and right brain damage; c) the hemispheric lateralisation of optimistic bias mechanisms; d) the lateralisation of mechanisms that regulate routine and novelty behaviours. We propose that match and mismatch operations are aimed at approximating "free energy", in terms of the free energy principle of decision-making. By approximating "free energy", the match/mismatch TPJ system supports both information seeking to update one's own beliefs and the pleasure of being right in one's own' current choices. This renewed view of the TPJ has relevant clinical implications because the misfunctioning of TPJ-related "match" and "mismatch" circuits in unilateral brain damage can produce low-dimensional deficits of active-inference and predictive coding that can be associated with different neuropsychological disorders.


Subject(s)
Magnetic Resonance Imaging , Perceptual Disorders , Attention/physiology , Brain Mapping , Cerebral Cortex/physiology , Cognition , Humans , Magnetic Resonance Imaging/methods
11.
Brain Sci ; 12(5)2022 May 12.
Article in English | MEDLINE | ID: mdl-35625026

ABSTRACT

Posterior cerebral artery (PCA) territory infarction involving occipital cortical damage can give rise to contralateral homonymous hemianopia. Here, we report two rare cases of patients with lesions in the left hemisphere PCA territory who developed right visuo-spatial neglect. One patient suffered right hemianopia and right visuo-spatial neglect after a stroke that damaged the left primary visual cortex and the callosal splenial fibers. The other unique case is of a patient who had a brain tumor in the posterior cerebral region in the left hemisphere and initially exhibited only right hemianopia that developed into right visuo-spatial neglect after tumor resection that included the splenial fibers. These cases indicate that, as in cases with damage in the right PCA territory, lesions in the left PCA yield visuo-spatial neglect when the damage produces contralateral hemianopia and concomitant disconnection of the splenium of the corpus callosum, which interferes with the arrival of visual inputs from the intact right to the lesioned left hemisphere. These results also emphasize the necessity of sparing the splenial fibers in surgical interventions in patients who exhibit hemianopia.

12.
J Pers Med ; 12(1)2022 Jan 14.
Article in English | MEDLINE | ID: mdl-35055426

ABSTRACT

COVID-19 vaccines are the most promising means of limiting the pandemic. The present study aims at determining the roles of several psychological variables in predicting vaccination intention in Italy. An online questionnaire was disseminated between 9 March and 9 May 2021. The sample included 971 participants. Results showed that most of the participants were willing to vaccinate. Acceptance rates were correlated with age, marital status, and area of residence. Intention to be vaccinated was positively correlated with perceived risk, pro-sociality, fear of COVID-19, use of preventive behaviors, and trust in government, in science, and in medical professionals. Intention to be vaccinated was negatively associated with belief in misinformation. The degree of acceptance is likely to be a result of the campaign tailored to address people's negative attitudes towards vaccines. Trust in government and trust in science were among the strongest psychological predictors of vaccination intention. Fear of COVID-19, but not perceived risk, was associated with increased vaccine uptake, suggesting that the affective component of risk perception was more important than the cognitive component in predicting participants' behaviors. Belief in misinformation was associated with reduced vaccination intention. Future studies will take into consideration these variables, to better understand the multifaceted process underlying vaccination intention.

13.
Behav Res Methods ; 54(3): 1403-1415, 2022 06.
Article in English | MEDLINE | ID: mdl-34595673

ABSTRACT

Attention involves three functionally and neuroanatomically distinct neural networks: alerting, orienting, and executive control. This study aimed to analyze the development of attentional networks in children aged between 3 and 6 years using a child-friendly version of the Attentional Network Test for Interaction (ANTI), the ANTI-Birds. The sample included 88 children divided into four age groups: 3-year-old, 4-year-old, 5-year-old, 6-year-old children. The results of this study would seem to indicate that between 4 and 6 years, there are no significant changes in attentional networks. Instead, between 3 and 4 years of age, children significantly improve all their attentional skills.


Subject(s)
Attention , Orientation , Child , Child, Preschool , Executive Function , Humans
14.
Psychiatry Res ; 308: 114346, 2022 02.
Article in English | MEDLINE | ID: mdl-34953202

ABSTRACT

The prevalence of late-life depression (LLD) depends on the study sample, measurements, and diagnostic approaches. We estimated the 30 item-Geriatric Depression Scale (GDS-30) accuracy against the gold standard LLD diagnosis made with the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders, focusing on the prevalence of a late-life major depressive disorder (MDD), in a population-based sample of 843 subjects aged>65 years, subdivided into three groups: normal cognition, subjective memory complaints, and mild cognitive impairment. At the optimal cut-off score (≥4), the GDS-30 showed 65.1% sensitivity and 68.4% specificity for LLD (63% and 66% for late-life MDD, respectively). Using the standard cut-off score (≥10), the GDS-30 specificity reached 91.2%, while sensitivity dropped to 37.7%, indicating a lower screening accuracy [area under the curve(AUC):0.728, 95% confidence interval(CI):0.67-0-78]. The GDS-30 performance was associated with educational level, but not with age, gender, cognition, apathy, and somatic/psychiatric multimorbidity. For subjective memory complaints subjects, at the optimal cut-off score (≥7), the GDS-30 showed better discrimination performances (AUC=0.792,95%CI:0.60-0.98), but again the educational level affected the diagnostic performance. In subjective memory complaints subjects, symptom-based scales like the GDS-30 may feature a better performance for diagnosing depression in older age, but the GDS-30 seems to require adjustment to the patient's educational level.


Subject(s)
Apathy , Depressive Disorder, Major , Aged , Depression/diagnosis , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/epidemiology , Geriatric Assessment , Humans , Psychiatric Status Rating Scales
15.
Brain Sci ; 11(9)2021 Aug 24.
Article in English | MEDLINE | ID: mdl-34573137

ABSTRACT

Many cognitive functions face a decline in the healthy elderly. Within the cognitive domains, both attentional processes and executive functions are impaired with aging. Attention includes three attentional networks, i.e., alerting, orienting, and executive control, showing a hemispheric lateralized pattern in adults. This lateralized pattern could play a role in modulating the efficiency of attentional networks. For these reasons, it could be relevant to analyze the age-related change of the hemispheric specialization of attentional networks. This study aims to clarify this aspect with a lateralized version of the Attentional Network Test for Interaction (ANTI)-Fruit. One hundred seventy-one participants took part in this study. They were divided in three age groups: youth (N = 57; range: 20-30); adults (N = 57; range 31-64), and elderly/older people (N = 57; range: 65-87). The results confirmed the previous outcomes on the efficiency and interactions among attentional networks. Moreover, an age-related generalized slowness was evidenced. These findings also support the hypothesis of a hemispheric asymmetry reduction in elderly/older adults.

16.
Heliyon ; 7(7): e07515, 2021 Jul.
Article in English | MEDLINE | ID: mdl-34345726

ABSTRACT

The virtual-reality full-body illusion paradigm has been suggested to not only trigger the illusory ownership of the avatar's body but also the attitudinal and behavioral components stereotypically associated to that kind of virtual body. In the present study, we investigated whether this was true for stereotypes related to body size: body satisfaction and eating control behavior. Healthy participants underwent the full-body illusion paradigm with an avatar having either a larger or a slimmer body than their own, and were assessed for implicit attitudes towards body image and food calorie content at baseline and after each full-body illusion session. Results showed that the illusion emerged regardless of the avatar's body size, whereas the perceived dimension of the own body size changed according to the avatar's body size (i.e., participants felt to be slimmer after embodying their slim avatar and larger after embodying their large avatar). Crucially, we found that implicit attitudes towards food, but not those towards one's own body, were modulated by the size of the virtual body. Compared to baseline, ownership of a slimmer avatar increased the avoidance of high-calorie food, whereas ownership of a larger avatar did not induce changes. Our findings suggest that the illusory feeling of being slimmer drives also the food-related stereotypes associated with that body size, increasing the regulation of eating behaviors.

17.
Exp Brain Res ; 239(10): 3023-3034, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34355249

ABSTRACT

It is debated whether the representation of numbers is endowed with a directional-spatial component so that perceiving small-magnitude numbers triggers leftward shifts of attention and perceiving large-magnitude numbers rightward shifts. Contrary to initial findings, recent investigations have demonstrated that centrally presented small-magnitude and large-magnitude Arabic numbers do not cause leftward and rightward shifts of attention, respectively. Here we verified whether perceiving small or large non-symbolic numerosities (i.e., clouds of dots) drives attention to the left or the right side of space, respectively. In experiment 1, participants were presented with central small (1, 2) vs large-numerosity (8, 9) clouds of dots followed by an imperative target in the left or right side of space. In experiment 2, a central cloud of dots (i.e., five dots) was followed by the simultaneous presentation of two identical dot-clouds, one on the left and one on the right side of space. Lateral clouds were both lower (1, 2) or higher in numerosity (8, 9) than the central cloud. After a variable delay, one of the two lateral clouds turned red and participants had to signal the colour change through a unimanual response. We found that (a) in Experiment 1, the small vs large numerosity of the central cloud of dots did not speed up the detection of left vs right targets, respectively, (b) in Experiment 2, the detection of colour change was not faster in the left side of space when lateral clouds were smaller in numerosity than the central reference and in the right side when clouds were larger in numerosity. These findings show that perceiving non-symbolic numerosity does not cause automatic shifts of spatial attention and suggests no inherent association between the representation of numerosity and that of directional space.


Subject(s)
Space Perception , Humans , Reaction Time
18.
Neurosci Lett ; 761: 136097, 2021 09 14.
Article in English | MEDLINE | ID: mdl-34237413

ABSTRACT

Electrophysiological group studies in brain-damaged patients can be run to capture the EEG correlates of specific cognitive impairments. Nonetheless, this procedure is not adequate to characterize the inter-individual variability present in major neuropsychological syndromes. We tested the possibility of getting a reliable individual EEG characterization of deficits of endogenous orienting of spatial attention in right-brain damaged (RBD) patients with left spatial neglect (N+). We used a single-trial topographical analysis (STTA; [39] of individual scalp EEG topographies recorded during leftward and rightward orienting of attention with central cues in RBD patients with and without (N-) neglect and in healthy controls (HC). We found that the STTA successfully decoded EEG signals related to leftward and rightward orienting in five out of the six N+, five out of the six N- patients and in all the six HC. In agreement with findings from conventional average-group studies, successful classifications of EEG signals in N+ were observed during the 400-800 ms period post-cue-onset, which reflects preserved voluntary engagement of attention resources (ADAN component). These results suggest the possibility of acquiring reliable individual EEG profiles of neglect patients.


Subject(s)
Attention , Perceptual Disorders/physiopathology , Spatial Behavior , Stroke/complications , Aged , Brain/physiopathology , Electroencephalography , Female , Functional Laterality , Humans , Male , Middle Aged , Perceptual Disorders/etiology
19.
Brain Commun ; 3(2): fcab111, 2021.
Article in English | MEDLINE | ID: mdl-34151266

ABSTRACT

Right brain-damaged patients with unilateral spatial neglect fail to explore the left side of space. Recent EEG and clinical evidence suggests that neglect patients might suffer deficits in predictive coding, i.e. in identifying and exploiting probabilistic associations among sensory stimuli in the environment. To gain direct insights on this issue, we focussed on the hierarchical components of predictive coding. We recorded EEG responses evoked by central, left-side or right-side tones that were presented at the end of sequences of four central tones. Left-side and right-side deviant tones produce a pre-attentive Mismatch Negativity that reflects a lower-order prediction error for the 'Local' deviation of the tone at the end of the sequence. Higher-order prediction errors for the frequency of these deviations in the acoustic environment, i.e. 'Global' deviation, are marked by the P3 response. We show that when neglect patients are immersed in an acoustic environment characterized by frequent left-side deviant tones, they display no pre-attentive Mismatch Negativity both for left-side deviant tones and infrequent omissions of the last tone, while they have Mismatch Negativity for infrequent right-side deviant tones. In the same condition, neglect patients show no P300 response to 'Global' prediction errors for deviant tones, including those in the non-neglected right-side, and omissions. In contrast to this, when right-side deviant tones are predominant in the acoustic environment, neglect patients have pre-attentive Mismatch Negativity both for right-side deviant tones and infrequent omissions, while they display no Mismatch Negativity for infrequent left-side deviant tones. Most importantly, in the same condition neglect patients show enhanced P300 response to infrequent left-side deviant tones, notwithstanding that these tones evoked no pre-attentive Mismatch Negativity. This latter finding indicates that 'Global' predictions are independent of 'Local' error signals provided by the Mismatch Negativity. These results qualify deficits of predictive coding in the spatial neglect syndrome and show that neglect patients base their predictive behaviour only on statistical regularities that are related to the frequent occurrence of sensory events on the right side of space.

20.
Cereb Cortex ; 31(8): 3723-3731, 2021 07 05.
Article in English | MEDLINE | ID: mdl-33825880

ABSTRACT

Apraxia of speech is a motor disorder characterized by the impaired ability to coordinate the sequential articulatory movements necessary to produce speech. The critical cortical area(s) involved in speech apraxia remain controversial because many of the previously reported cases had additional aphasic impairments, preventing localization of the specific cortical circuit necessary for the somatomotor execution of speech. Four patients with "pure speech apraxia" (i.e., who had no aphasic and orofacial motor impairments) are reported here. The critical lesion in all four patients involved, in the left hemisphere, the precentral gyrus of the insula (gyrus brevis III) and, to a lesser extent, the nearby areas with which it is strongly connected: the adjacent subcentral opercular cortex (part of secondary somatosensory cortex) and the most inferior part of the central sulcus where the orofacial musculature is represented. There was no damage to rostrally adjacent Broca's area in the inferior frontal gyrus. The present study demonstrates the critical circuit for the coordination of complex articulatory movements prior to and during the execution of the motor speech plans. Importantly, this specific cortical circuit is different from those that relate to the cognitive aspects of language production (e.g., Broca's area on the inferior frontal gyrus).


Subject(s)
Articulation Disorders/physiopathology , Insular Cortex/physiopathology , Nerve Net/physiopathology , Aged , Aged, 80 and over , Apraxias , Articulation Disorders/rehabilitation , Brain Mapping , Broca Area , Dyskinesias/diagnosis , Dyskinesias/physiopathology , Female , Humans , Language , Male , Middle Aged , Neuropsychological Tests , Psychomotor Performance , Speech Articulation Tests , Stroke/complications , Stroke Rehabilitation
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