Visual short-term store can compensate for a defective phonological short-term store in patients with apraxia of speech.

Abstract

The aim of the study was to investigate whether, within the phonological short-term memory (STM) system, speech articulation disorders primarily due to cortical damage are associated with deficits in the phonological recoding of visual-verbal material, and whether the visual short-term store (STS) can compensate for inefficient access to the phonological STS, as suggested in previous reports. Two patients (AE and TM) with apraxia of speech due to atrophic cerebral damage were administered a battery of tasks devised to explore the organization of the phonological STM. AE's span was normal and TM's span was markedly reduced. Phonological similarity and word-length effects: Both patients showed the effects in visual presentation; the effect was less evident in verbal presentation. This suggests a phonological STS disorder and preserved rehearsal/phonological recoding, consistently with involvement of the left parietal regions, which was documented by the MRI in both patients. Unexpectedly, TM had a longer span for similar than for dissimilar words in visually presented stimuli. Silent phonology (on written material): At variance with controls, stress assignment improved during unattended speech both in AE and TM, while in both patients and controls a detrimental effect of unattended speech was documented in the initial sound task. To account for this unusual pattern of results, we hypothesized that whenever possible, AE and TM adopt the strategy that takes advantage of the visual STM store to compensate for a defective phonological STS.