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Broca's area aphasias

Aphasia after lesions including the frontal operculum

Aphasia Research Center and Department of Neurology (Drs. Alexander and Naeser, and Ms. Palumbo), Boston University School of Medicine, Boston; Aphasia Programs (Dr. Alexander), Braintree Hospital, Braintree; and Psychology Research (Dr. Naeser and Ms. Palumbo), Boston Veteran's Administration Medical Center, Boston, MA.

We report 9 cases of aphasia following lesions in the region of the left frontal operculum. It is not possible to capture their variety of clinical manifestations with the simple labels of "Broca's aphasia" or "Broca's area aphasia." Analysis of the breakdown of various components of speech and language in these cases suggests that the operculum, lower motor cortex, and subjacent subcortical and periventricular white matter contain critical parts of different language systems. These systems can be independently impaired. There are several common language syndromes that follow damage that includes the left frontal operculum. These syndromes reflect the effects of the direction and extent of the lesion in the various language systems.

Address correspondence and reprint requests to Dr. Michael P. Alexander, Aphasia Programs, Braintree Hospital, 250 Pond Street, Braintree, MA 02184.

Supported in part by USPHS Grant NS 06209 and by the Research Service of the Veteran's Administration.

Received November 10, 1987. Accepted for publication in final form July 17, 1989.

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