Recovery of Speech in Apraxia of Speech

Shuster, Linda

Abstract

Apraxia of speech (AOS) is considered to be a disorder of speech motor programming, and it is almost invariably accompanied by aphasia, a disorder of language. The most common etiology is stroke. Despite the availability of technologies to replace or augment speech, such as speech generating devices, the vast majority of individuals with AOS want to be able to speak normally again. Unfortunately, recovery from AOS is often poor, and data from treatment studies show that generalization of gains made in the clinical setting to everyday life has been virtually nonexistent. Individuals with AOS are often explicitly excluded from studies of language recovery in aphasia;thus, our knowledge of the factors that influence recovery of speech in AOS is very limited. Moreover, most studies (treatment studies and those investigating the behavioral characteristics of AOS) have investigated individuals with chronic AOS, so we have insufficient data on individuals who recover spontaneously or with minimal treatment. This situation is complicated by the fact that neither the site of the lesion that produces AOS nor the mechanisms underlying the disorder are universally agreed upon. We propose that a systematic study of the course of AOS over time will enable us to identify the factors that affect recovery of speech in AOS. Our long-range goal is to improve treatment for individuals with AOS and increase the generalization beyond the clinic. The objective of this proposal is to investigate the site of lesion(s) that produces AOS, as well as patterns of brain activity associated with recovery, using magnetic resonance imaging, functional magnetic resonance imaging, and acoustic and perceptual analyses of speech.

Public Health Relevance

This study seeks to improve our understanding of how the brain recovers speech abilities after a stroke. Knowledge gained from this study will aid us in developing better treatments for these speech problems, which have a major negative effect on the quality of life of the person with these speech problems, as well as on that of his/her significant others.