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Gerstmann Syndrome (Dysgraphia, Dyscalculia, Finger Agnosia, and Left-Right Disorientation)
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
Damage to a part of the brain called the angular gyrus, located near where the parietal and temporal lobes meet, appears to be enough to produce this syndrome. However, there are reports of people developing some of the symptoms even with brain damage in different areas (Bhattacharyya et al., 2014). For example, dyscalculia can be a symptom of damage to many different brain locations, including frontal, temporal, parietal, and subcortical structures, although the angular gyrus is probably the most frequently implicated (e.g., Grafman et al., 1982; Willmes, 2008). Importantly, Gerstmann syndrome is commonly associated with damage to the dominant hemisphere of a person's brain (Tucha et al., 1997). In right-handed people, the left side of the brain is usually dominant, and because most people are right-handed, Gerstmann syndrome is usually associated with damage to the left half of the brain. Therefore, Gerstmann syndrome is most frequently associated with left-sided damage of the angular gyrus… but there are exceptions to all of this (Lebrun, 2005). In fact, there are a lot of exceptions to the guidelines of this syndrome, which brings us to an important question.
Biological Basis of Behavior
Published in Mohamed Ahmed Abd El-Hay, Understanding Psychology for Medicine and Nursing, 2019
Parts of the midparietal lobe of the dominant hemisphere are involved in abilities, such as calculation, writing, left-right orientation, and finger recognition. Lesions in the angular gyrus can cause deficits in writing, calculating, left-right disorientation, and finger-naming (Gerstmann syndrome).
Signs and Symptoms in Psychiatry
Published in Mohamed Ahmed Abd El-Hay, Essentials of Psychiatric Assessment, 2018
Ideational apraxia: the inability to perform an organized motor sequence, although the individual components can be performed separately. It is possibly due to fear about how to carry out a movement, but once the patient has been cued he/she produces the correct response. It could be tested by asking the patient to show how he/she folds a letter, places it in an envelope, and then seals and stamps the envelope; lighting a candle with matches; or making a cup of coffee. To the observer, the patient gives the appearance of being naïve or unfamiliar with the sequence of activities that should occur. These patients fail to use everyday objects correctly. Ideational apraxia affects the limbs on both sides. It results from lesions in the region of the left angular gyrus.
Virtual prism adaptation for spatial neglect: A double-blind study
Published in Neuropsychological Rehabilitation, 2022
Alexia Bourgeois, Francesco Turri, Armin Schnider, Radek Ptak
Figure 1(a) shows the rendering of the patient’s lesions in an overlap plot. A volumetric mask was created for each patient by delineating her/his lesion manually on the available clinical T1- or T2-weighted MRI scan using MRIcron software (Rorden et al., 2007). Structural images were then normalized to the MNI space with the Clinical Toolbox (Rorden et al., 2012). Normalization produced images of 2 mm × 2 mm × 2 mm voxel size. We observed a maximal overlap (8 patients) in the right angular gyrus (MNI, x, y, z; 47, −50, 31) and in the middle temporal gyrus (x, y, z; 41, −54, 20), as well as in the right superior longitudinal fasciculus (x, y, z; 39, −45, 21), in good agreement with the anatomical correlates responsible of neglect (Bartolomeo et al., 2007; Bourgeois et al., 2015; Corbetta et al., 2005; Pedrazzini & Ptak, 2020).
Dysfunction of the left angular gyrus may be associated with writing errors in ALS
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2021
Toru Sakurai, Shigeki Hirano, Midori Abe, Yuriko Uji, Keisuke Shimizu, Masahide Suzuki, Yoshikazu Nakano, Ai Ishikawa, Kazuho Kojima, Kazumoto Shibuya, Atsushi Murata, Satoshi Kuwabara
A positive relationship was noted between the severity of writing deficits and the left angular gyrus and angular white matter. Damage to the angular gyrus has consequences on a range of skills, including speech comprehension, finger agnosia, spatial disorientation, acalculia and agraphia (37–39). There is substantial evidence that the angular gyrus is the functional center for kana writing (40,41). The auditory memory images in Wernicke’s area and the hand motor area in the frontal lobe play an important role in normal kana writing. Moreover, lesion studies have revealed that the left angular gyrus and its posterior area are involved in kana writing. Transposition in writing implies a failure in successive phoneme-to-grapheme conversion, which may involve verbal working memory and inferior supramarginal gyrus (41,42). Indeed, the kana errors observed in patients with ALS are related to difficulties in the processing of phonological units as represented by omissions and substitutions of kana letters (17). The omission and substitution of kana letters affects picture description sub-test (WAB-VI B), which accounts for approximately 30% of the writing score (32/100). Errors in the picture description test (WAB-VI B) and probably errors related to kana characters were linked to the angular gyrus activity and were not related with executive function.
White matter—Maximien Parchappe and the integration of articulate language
Published in Journal of the History of the Neurosciences, 2020
Two paradigms dominated the Imperial Academy of Medicine’s spring discussions on language and aphasia: the holistic view of cerebral function, and the doctrine that structurally symmetrical organs subserve identical functions. Both were challenged, the first by Bouillaud’s localization of articulate language to the frontal lobes, and the second by Marc Dax’s lateralization of language to the left hemisphere of the brain. Parchappe’s address to the academy can be seen as an attempt to unite these two Janus-like heads to the same body, through a network of fiber tracts, fascicles, and commissures. Parchappe recognized that speech is too complex a function to be restricted to a single area of the brain; but before the discoveries of Wernicke’s area, the role of the angular gyrus in the interpretation and expression of written language, and of the role of the dominant supplementary motor area in speech, he could not specifically identify how these areas were linked in the function of language. Nonetheless, he had the insight to conceive that such a functional network was necessary. Establishing the relationship of functional areas of the brain with the white-matter tracts that links them has been a gradual process; but with the advent of modern functional imaging, it has become as important today as it was for Maximien Parchappe de Vinay almost two centuries ago.