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Translational Brain Mapping at the University of Rochester Medical Center: Preserving the Mind Through Personalized Brain Mapping

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Right anterior cingulate cortex infarction and transient speech aspontaneity.

Chiung-Chih Chang¹, Yu Chang Lee, Chun-Chung Lui

¹Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Archives of Neurology

|March 14, 2007

Summary

Transient speech initiation difficulties were observed in two patients following a right anterior cingulate cortex (ACC) stroke. Tractography revealed unique fiber connections, suggesting the right ACC’s role in speech initiation beyond the dominant left hemisphere language network.

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Area of Science:

Neuroscience
Neurology
Speech Pathology

Background:

The medial frontal lobe of the dominant hemisphere is implicated in word generation and speech initiation.
Speech arrest secondary to right anterior cingulate cortex (ACC) lesions with preserved facial expression has not been previously documented.

Observation:

Two female patients presented with acute, transient speech initiation difficulties.
Clinical evaluation revealed pure speech initiation problems, with intact facial praxis and expression. Writing ability was preserved in one patient.

Findings:

Magnetic resonance imaging (MRI) showed acute right ACC infarction, with involvement of the anterior and/or posterior corpus callosum.
Tractography indicated crossing fibers from the right ACC and reduced connections between the right supplementary motor area and the ACC, differing from left ACC findings.

Implications:

This case series is the first to report right ACC stroke associated with transient speech initiation problems.
Findings suggest the right ACC participates in speech initiation, complementing the left hemisphere's language network.
Tractography results highlight potential novel pathways involved in speech production.