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From the Aphasia Unit, Department of Neurology, Boston Veterans Administration Medical Center, and Department of Neurology, Aphasia Research Center, Boston University School of Medicine, Boston, MA.
Analysis of language profiles and CT anatomy in transcortical motor aphasia (TCMA) suggests that the essential lesion is disruption of connections at sites between the supplementary motor area and the frontal perisylvian speech zone. If the lesion is extended, there may also be poor articulation (lesion deep to motor strip for face), impaired auditory comprehension (lesion in anterior head of caudate, anterior limb internal capsule, anterior putamen, and anterior portion of external capsule, claustrum, extreme capsule, and insula), or stuttering (lesion in pars opercularis and lower third of premotor region). This concept unifies disparate anatomic and psychophysiologic observations about three syndromes: classical TCMA, aphasia after left medial frontal infarction, and TCMA during recovery from Broca's aphasia.
Address correspondence and reprint requests to Dr. Alexander. Aphasia Unit, Veterans Administration Medical Center, 150 South Huntington Avenue, Boston, MA 02130.
This research was supported by the Ministry of Health. Ontario, Canada, and in part by grants NS06209and NS07615from the US Public Health Service, and NS11408 from NIH.
Presented in part at the thirty fourth annual meeting of the American Academy of Neurology, Washington, DC. April 1982.
Accepted for publication July 12, 1983.
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