Abstract
Background and purpose
Subcortical white matter (WM) plays an important role in speech production and language
processing. Most frequently, cerebral WM lesions are secondary to small vessel disease
in patients with vascular risk factors. We report the case of a 53-year-old man with
history of hypertension and ischemic subcortical lesions, who presented with speech
difficulties and mild cognitive impairment.
Methods
Language and cognitive assessment included Boston Diagnostic Aphasia Examination,
Boston Naming Test, Rey Auditory-Verbal Learning Test, Rey-Osterrieth Complex Figure
Test, Trail Making Test A and B, Wisconsin Card Sorting Test, Scale for Evaluation
of Perceptive Characteristics of Voice and Speech, and Multidimensional Evaluation
of Speech and Voice.
Results
Brain MRI showed ischemic WM lesions and lacunar infarcts in the brainstem and right
cerebellum. Cognitive testing revealed mild cognitive impairment, predominantly affecting
attention and executive functions. Speech and language analysis demonstrated dysarthria,
dysphonia with hypophonia, and imprecise articulation, as well as short rushes of
speech, palilalia and mild subcortical dysphasia.
Conclusions
Neurolinguistic and acoustic analysis in patients with ischemic WM lesions can provide
additional information in the understanding of language and speech disturbances, and
can assist in patient management.
Keywords
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Article info
Publication history
Published online: March 19, 2009
Identification
Copyright
© 2009 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
