Abstract

Specific regions of the cerebellum are activated when neurologically intact adults speak, and cerebellar damage can impair speech production early after stroke, but how the brain supports accurate speech production years after cerebellar damage remains unknown. We investigated this in patients with cerebellar lesions affecting regions that are normally recruited during speech production. Functional MRI activation in these patients, measured during various single word production tasks, was compared to that of neurologically intact controls, and patient controls with lesions that spared the cerebellar speech production regions. Our analyses revealed that, during a range of speech production tasks, patients with damage to cerebellar speech production regions had greater activation in the right dorsal premotor cortex (r-PMd) and right supplementary motor area (r-SMA) compared to neurologically intact controls.The loci of increased activation in cerebral motor speech areas motivate future studies to delineate the functional contributions of different parts of the speech production network, and test whether non-invasive stimulation to r-PMd and r-SMA facilitates speech recovery after cerebellar stroke.

Highlights

  • Many prior studies of stroke patients have shown cerebellar involvement in various aspects of motor control, including motor con­ trol of speech

  • Our analyses revealed that, during a range of speech production tasks, patients with damage to cerebellar speech production regions had greater activation in the right dorsal premotor cortex (r-PMd) and right supplementary motor area (r-SMA) compared to neurologically intact controls

  • Dys­ arthric or apraxic behaviours were rare in our dataset: 1 patient of in­ terest and 4 patient controls had a score of 1, indicating one occurrence of dysarthric/apraxic behaviour, while the others had a score of 0

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Summary

Introduction

Many prior studies of stroke patients have shown cerebellar involvement in various aspects of motor control, including motor con­ trol of speech (i.e. dysarthria). Damage to the superior cerebellar artery (SCA) territory has been associated with dysarthric symp­ toms in other studies (Ackermann et al, 1992; Lechtenberg and Gilman, 1978), with two-thirds of patients with SCA territory lesions diagnosed with dysarthria (Erdemoglu and Duman, 1998). The other half had lesions in the posterior and/ or anterior inferior cerebellar artery (PICA/AICA) territory, most commonly to the rostral paravermal region of the anterior lobe (Urban et al, 2003), consistent with a later lesion-symptom mapping study (Byoung et al, 2010). No patients with lesions in the terri­ tory of the lateral branch of the PICA were diagnosed as having devel­ oped dysarthria (Barth et al, 1994)

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