Apraxia of Speech with Phonological Alexia and Agraphia Following Resection of the Left Middle Precentral Gyrus: Illustrative Case | Levy et al.

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Importance

Date Added

8.28.26

TLDR

Removing left middle precentral gyrus/55b produced a deficit in sequencing phonemes into motor plans for both speaking and writing, without causing a general language, motor, or cognitive deficit.

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A 36-year-old woman underwent resection affecting left precentral gyrus, postcentral gyrus, and area 55b.
Six months later she retained normal language, comprehension, naming, cognition, nonverbal praxis, and nonspeech orofacial movement, with no aphasia.
She had apraxia of speech and impaired reading and spelling of nonwords.
- Errors increased with nonword status $(\beta = 3.59)$ and syllable count $(\beta = 1.89)$ .
- Reading and spelling did not differ $(\beta = 0.21, p = 0.61)$ .
The nonword deficit was not articulatory: she could repeat the same four-syllable nonwords that she could not read aloud.
She also made anticipatory writing errors, writing a later letter early while saying the correct letter aloud. The cross-modal pattern points to a sequencing failure rather than articulation alone.