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Agrammatism and paragrammatism: a cortical double dissociation revealed by lesion-symptom mapping

View ORCID ProfileWilliam Matchin, View ORCID ProfileAlexandra Basilakos, View ORCID ProfileBrielle C. Stark, View ORCID ProfileDirk-Bart den Ouden, Julius Fridriksson, Gregory Hickok
doi: https://doi.org/10.1101/2020.03.24.006759
William Matchin
1Dept. of Communication sciences and Disorders, University of South Carolina
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  • For correspondence: matchin@mailbox.sc.edu
Alexandra Basilakos
1Dept. of Communication sciences and Disorders, University of South Carolina
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Brielle C. Stark
2Dept. of Speech and Hearing Sciences, Program in Neuroscience, Indiana University Bloomington
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Dirk-Bart den Ouden
1Dept. of Communication sciences and Disorders, University of South Carolina
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Julius Fridriksson
1Dept. of Communication sciences and Disorders, University of South Carolina
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Gregory Hickok
3Dept. of Cognitive Sciences, Dept. of Language Science, University of California, Irvine
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Abstract

The fundamental distinction of grammatical deficits in aphasia, agrammatism and paragrammatism, was made over a century ago. However, the extent to which the agrammatism/paragrammatism distinction exists independently of differences in speech fluency has not clearly been investigated. Despite much research on agrammatism, the lesion correlates of paragrammatism are essentially unknown. Lesion-symptom mapping was used to investigate the degree to which the lesion correlates of agrammatism and paragrammatism overlap or dissociate. Four expert raters assessed videos of 53 right-handed patients with aphasia following chronic left hemisphere stroke retelling the Cinderella story. Consensus discussion determined each subject’s classification with respect to grammatical deficits as Agrammatic, Paragrammatic, Both, or No Grammatical Deficit. Each subject’s lesion was manually drawn on a high-resolution MRI and warped to standard space for group analyses. Lesion-symptom mapping analyses were performed in NiiStat including lesion volume as a covariate. Secondary analyses included speech rate (words per minute) as an additional covariate. Region of interest analyses identified a double dissociation between these syndromes: damage to Broca’s area was significantly associated with agrammatism, p = 0.001 (but not paragrammatism, p = 0.930), while damage to the left posterior superior and middle temporal gyri was significantly associated with paragrammatism, p < 0.001 (but not agrammatism, p = 0.873). The same results obtained when regressing out the effect of speech rate, and non-overlapping lesion distributions between the syndromes were confirmed by uncorrected whole brain analyses. Our results support a fundamental distinction between agrammatism and paragrammatism.

Footnotes

  • Funding Sources: This research was funded by grants from the National Institutes of Health National Institute on Deafness and Other Communication Disorders grants to JF: P50 DC014664 and U01 DC011739. Author AB was supported by T32 DC 014435 (trainee).

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The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license.
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Posted March 25, 2020.
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Agrammatism and paragrammatism: a cortical double dissociation revealed by lesion-symptom mapping
William Matchin, Alexandra Basilakos, Brielle C. Stark, Dirk-Bart den Ouden, Julius Fridriksson, Gregory Hickok
bioRxiv 2020.03.24.006759; doi: https://doi.org/10.1101/2020.03.24.006759
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Agrammatism and paragrammatism: a cortical double dissociation revealed by lesion-symptom mapping
William Matchin, Alexandra Basilakos, Brielle C. Stark, Dirk-Bart den Ouden, Julius Fridriksson, Gregory Hickok
bioRxiv 2020.03.24.006759; doi: https://doi.org/10.1101/2020.03.24.006759

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