传导性失语症中基于发音器官的音位偏差:通过交叉性失语症发现的音素-发音转换功能障碍

IF 1.3 4区 医学 Q4 BEHAVIORAL SCIENCES
Hiroaki Kawashima, Michitaka Funayama, Yoshie Inaba, Mikoto Baba
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引用次数: 0

摘要

音位偏瘫是传导性失语症的常见特征,传统上被认为是语音表征功能障碍所致。另一种假说认为,音位性副失语症是由于将音素转化为相应的发音动作存在困难。然而,一直缺乏支持这一理论的详细病例研究。在本报告中,我们介绍了一名 61 岁右撇子男性患者的病例,他患有右颞顶叶梗塞,表现出交叉性失语,其特征是典型的传导性失语症状(如相对流利的言语和完整的理解力、频繁的音位偏位和明显的口语复述困难),但没有发音歪曲、音节分割和拟声障碍。尽管患者经常出现音位偏误和发音障碍,但他的语音表征仍然相对完整。他的音位偏误经常通过自我纠正来产生正确的反应,这一特征被称为 "conduit d'approche"。在口头重复单个语素(即日语中最小的语音单位)的过程中,我们观察到,尽管患者发音困难,但他始终能准确地描摹出相应的平假名音标。我们通过客观评估证实了这一现象,并认为这是交叉性失语症患者语言功能异常分离的结果--具体来说,就是右侧颞顶叶皮层的语音表征与左侧大脑半球的言语发音印记之间出现了脱节。在这种传导性失语症的病例中,基于发音的音位偏位可被视为无法将音素转换为适当的发音动作,而不是语音表征功能障碍或言语瘫痪。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Articulatory-based Phonemic Paraphasia in Conduction Aphasia: A Dysfunction in Phoneme-to-Articulation Conversion Uncovered Through Crossed Aphasia.

Phonemic paraphasia, a common characteristic of conduction aphasia, has traditionally been attributed to phonological representation dysfunction. An alternative hypothesis posits that phonemic paraphasia arises from difficulty converting phonemes into their corresponding articulatory maneuvers. However, detailed case studies supporting this theory have been lacking. In this report, we present the case of a 61-year-old right-handed man with right temporo-parietal infarction who exhibited crossed aphasia characterized by typical conduction aphasia symptoms (eg, relatively fluent speech with intact comprehension, frequent phonemic paraphasia, and pronounced difficulties in oral repetition) in the absence of distorted articulation, syllable segmentation, and prosody impairment. Despite the frequent occurrence of phonemic paraphasia and articulatory challenges, our patient's phonological representations remained relatively intact. His phonemic paraphasia was often self-corrected to produce correct responses, a feature known as conduit d'approche. During the oral repetition of individual mora (ie, the smallest unit of speech in Japanese), we observed that the patient consistently traced the corresponding Hiragana phonetic symbol accurately, despite his difficulties in articulation. We substantiated this phenomenon through objective assessment and posit that it resulted from an unusual separation of language functions in crossed aphasia-specifically, a disconnection between phonological representations in the right temporo-parietal cortex and speech articulation engrams in the left hemisphere. In this case of conduction aphasia, articulatory-based phonemic paraphasia may be viewed as an inability to convert phonemes into the appropriate articulatory maneuvers rather than as phonological representation dysfunction or apraxia of speech.

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来源期刊
CiteScore
2.40
自引率
7.10%
发文量
68
审稿时长
>12 weeks
期刊介绍: Cognitive and Behavioral Neurology (CBN) is a forum for advances in the neurologic understanding and possible treatment of human disorders that affect thinking, learning, memory, communication, and behavior. As an incubator for innovations in these fields, CBN helps transform theory into practice. The journal serves clinical research, patient care, education, and professional advancement. The journal welcomes contributions from neurology, cognitive neuroscience, neuropsychology, neuropsychiatry, and other relevant fields. The editors particularly encourage review articles (including reviews of clinical practice), experimental and observational case reports, instructional articles for interested students and professionals in other fields, and innovative articles that do not fit neatly into any category. Also welcome are therapeutic trials and other experimental and observational studies, brief reports, first-person accounts of neurologic experiences, position papers, hypotheses, opinion papers, commentaries, historical perspectives, and book reviews.
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