History-taking model
Kaji Sritharan, Vivian A Elwell, Sachi Sivananthan in Essential OSCE Topics for Medical and Surgical Finals, 2007
Differential diagnosis of dysphasia Broca’s (expressive) dysphasia: Broca’s area is the area of the cerebral motor cortex that is responsible for the initiation of speech. Expressive dysphagia results in a reduction in the number of words used, non-fluent speech, and errors in grammar and syntax.Wernicke’s (receptive) dysphasia: this results in fluent speech with abnormal content, incorrect words, incorrect letters and nonsense words.Conductive dysphasia: this results in the inability of the patient to repeat phrases or words.Global dysphasia: this results in both Broca’s and Wernicke’s dysphasias.
The Problems
John Greene, Ian Bone in Understanding Neurology a problem-orientated approach, 2007
The comprehension of language will be described first. The heard word is initially processed by auditory cortex in the temporal lobes. The signal is then sent upstream to Wernicke’s area in the superior temporal gyrus. This area allows comprehension of language and initiation of speech output. This is then passed forward to Broca’s area (inferior frontal gyrus), which is responsible for supervising the production of language (86). Adjacent motor cortex then prepares the motor act of speech, and signals are sent down cortico-bulbar fibres to the muscles controlling speech. These descending fibres are modulated by the cerebellum and basal ganglia and terminate on motor nuclei of cranial nerves controlling tongue and larynx. The appropriate muscle action results in desired articulation and speech (87).
The nervous system
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella in Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Sensory input to the language areas comes from either the auditory cortex (hearing) or the visual cortex (reading). This input goes first to Wernicke’s area, which is located within the left cerebral cortex near the junction between the parietal, temporal and occipital lobes. This area is involved with language comprehension and is important for understanding both spoken and written messages. It is also responsible for formulating coherent patterns of speech. In other words, this area enables an individual to attach meaning to words and to choose the appropriate words to convey their thoughts. Impulses are then transmitted to Broca’s area, which is found in the left frontal lobe in close association with the motor areas of the cortex that control the muscles necessary for articulation. Broca’s area is, therefore, responsible for the mechanical aspects of speaking.
Effects of transcranial direct current stimulation over the Broca’s area on tongue twister production
Published in International Journal of Speech-Language Pathology, 2019
Min Ney Wong, Yanky Chan, Manwa L. Ng, Frank F. Zhu
Although our present knowledge of the relationship between Broca’s area and speech production is still limited, it is undeniable that Broca’s area plays a role in the neural circuitry of speech production (Kent, Kent, Weismer, & Duffy, 2000). Some studies have tried to explore the connection between Broca’s area and speech production by examining speech production in individuals with a brain injury (e.g. stroke), reporting that Broca’s area may play a crucial role in speech articulation (Hillis et al., 2004; Marangolo, Fiori, Calpagnano, et al., 2013; Marangolo, Fiori, Cipollari, et al., 2013; Marangolo et al., 2011). Hillis et al. (2004) examined the relationship between dysfunctional brain regions and speech articulation using MRI in 80 post-stroke patients. Results showed a strong association between apraxia of speech and dysfunction of Broca’s area. As such, they concluded that the inferior frontal gyrus region, where Broca’s area was located, was strongly and critically involved in speech articulation. In a tDCS study, Marangolo et al. (2011) applied anodal tDCS for 20 min over the left inferior frontal gyrus of three chronic aphasic patients while performing a speech repetition task. After five consecutive days of tDCS with concurrent language therapy, greater response accuracy was reported following the anodic stimulation. Similar positive effects on articulation were reported in another study with eight chronic patients who underwent bihemispheric stimulation over the left and right frontal regions together with concurrent speech therapy (Marangolo, Fiori, Cipollari, et al., 2013).
mRNA expression of the P5 ATPase ATP13A4 is increased in Broca’s area from subjects with schizophrenia
Published in The World Journal of Biological Psychiatry, 2020
Andrew S. Gibbons, Laura M. Bell, Madhara Udawela, Brian Dean
It is also notable that we have shown changes in ATP13A4 levels in BA 44 of Broca’s area. Broca’s area plays an important role in speech and language conceptualisation (Nishitani et al. 2005). Neuroimaging studies highlight a role for Broca’s area in verbal hallucinations and language fluency deficits in schizophrenia (Bleich-Cohen et al. 2009; Li et al. 2017; McGuire et al. 1993; Weiss et al. 2004). Furthermore, a clinical case study has reported language impairments in a patient with a chromosomal inversion that disrupted the ATP13A4 gene highlighting a role for this gene in language (Kwasnicka-Crawford et al. 2005). Therefore, increased ATP13A4 expression in BA 44 may be involved in the auditory verbal hallucinations or speech-related symptoms of schizophrenia. Our previous findings of increased ATP13A4 expression in BA 9, an area thought to be involved in executive functions, suggest that abnormal ATPA134 expression may have broader effects on schizophrenia-related symptoms, such as cognitive deficits.
A preliminary study of atypical cortical change ability of dynamic whole-brain functional connectivity in autism spectrum disorder
Published in International Journal of Neuroscience, 2022
The edges and regions show the asymmetry of C-scores. At the level of edge C-scores, abnormal edges are more spread over left hemisphere and inter-hemisphere. At the level of region C-scores, a large proportion of abnormal regions are located in the left hemisphere. Importantly, the C-scores of global left and right cerebral hemispheres are all abnormal in the ASD patients. Because each hemisphere has unique functional superiority, it is more accurate to conceive of hemispheres as complementarily specialized. For instance, the Broca’s area and Wernicke’s area are functionally located in the left hemisphere for most people. The abnormal C-scores of hemispheres may further point to disrupted inter-hemispheric information transferring. It captures important histopathologically examined aspects that brain function laterality destroy caused by diseased conditions in ASD patients, which may be interpreted as the evidence for amyloid deposition, dysconnectivity, cortical sulcal depth, cortical gyral length, GMV, SA, CT of abnormal cerebral asymmetries. Indeed, a series of abnormal asymmetry of diffuse cortex (such as medial frontal, orbitofrontal, cingulate and inferior temporal areas) are obtained by diverse analyzing indices ofCT [52], GMV [85], and inter hemispheric FCs in ASD brains [86,87].
Related Knowledge Centers
- Brodmann Area
- Cerebral Hemisphere
- Expressive Aphasia
- Gyrus
- Inferior Frontal Gyrus
- Brain
- Speech Production
- Aphasia
- Brodmann Area 44
- Brodmann Area 45