Skip to main content
SpringerLink
Log in

Primary face motor area as the motor representation of articulation

  • ORIGINAL COMMUNICATION
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

No clinical data have yet been presented to show that a lesion localized to the primary motor area (M1) can cause severe transient impairment of articulation, although a motor representation for articulation has been suggested to exist within M1. Here we describe three cases of patients who developed severe dysarthria, temporarily mimicking speech arrest or aphemia, due to a localized brain lesion near the left face representation of the human primary motor cortex (face-M1). Speech was slow, effortful, lacking normal prosody, and more affected than expected from the degree of facial or tongue palsy. There was a mild deficit in tongue movements in the sagittal plane that impaired palatolingual contact and rapid tongue movements. The speech disturbance was limited to verbal output, without aphasia or orofacial apraxia. Overlay of magnetic resonance images revealed a localized cortical region near face-M1, which displayed high intensity on diffusion weighted images, while the main portion of the corticobulbar fibers arising from the lower third of the motor cortex was preserved. The cases suggest the existence of a localized brain region specialized for articulation near face-M1. Cortico-cortical fibers connecting face-M1 with the lower premotor areas including Broca's area may also be important for articulatory control.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Fodor JA (1983) The modularity of mind: An essay on faculty psychology. MIT press, Cambridge

    Google Scholar 

  2. Lecours AR, Lhermitte F (1976) The pure form of the phonetic disintegration syndrome (pure anarthria): anatomo-clinical report of a historical case. Brain Lang 3:88–113

    Article  PubMed  CAS  Google Scholar 

  3. Schiff HB, Alexander MP, Naeser MA, Galaburda AM (1983) Aphemia. Clinical- anatomic correlations. Arch Neurol 40:720–7

    PubMed  CAS  Google Scholar 

  4. Sugishita M, Konno K, Kabe S, Yunoki K, Togashi O, Kawamura M (1987) Electropalatographic analysis of apraxia of speech in a left hander and in a right hander. Brain 110:1393–417

    Article  PubMed  Google Scholar 

  5. Mori E, Yamadori A, Furumoto M (1989) Left precentral gyrus and Broca's aphasia: a clinicopathologic study. Neurology 39:51–4

    PubMed  CAS  Google Scholar 

  6. Alexander MP, Naeser MA, Palumbo C (1990) Broca's area aphasias: aphasia after lesions including the frontal operculum. Neurology 40:353–62

    PubMed  CAS  Google Scholar 

  7. Fox RJ, Kasner SE, Chatterjee A, Chalela JA (2001) Aphemia: an isolated disorder of articulation. Clin Neurol Neurosurg 103:123–6

    Article  PubMed  CAS  Google Scholar 

  8. Ichikawa K, Kageyama Y (1991) Clinical anatomic study of pure dysarthria. Stroke 22:809–12

    PubMed  CAS  Google Scholar 

  9. Kim JS (1994) Pure dysarthria, isolated facial paresis, or dysarthria-facial paresis syndrome. Stroke 25:1994–8

    PubMed  CAS  Google Scholar 

  10. Urban PP, Wicht S, Vukurevic G, Fitzek C, Fitzek S, Stoeter P, Hopf HC (2001) Dysarthria in acute ischemic stroke: lesion topography, clinicoradiologic correlation, and etiology. Neurology 56:1021–7

    PubMed  CAS  Google Scholar 

  11. Whitty CWM (1964) Cortical dysarthria and dysprosody of speech. J Neurol Neurosurg Psychiatry 27:507–510

    PubMed  CAS  Google Scholar 

  12. Dronkers NF (1996) A new brain region for coordinating speech articulation. Nature 384:159–61

    Article  PubMed  CAS  Google Scholar 

  13. Lotze M, Seggewies G, Erb M, Grodd W, Birbaumer N (2000) The representation of articulation in the primary sensorimotor cortex. Neuroreport 11:2985–9

    Article  PubMed  CAS  Google Scholar 

  14. Wise RJ, Greene J, Buchel C, Scott SK (1999) Brain regions involved in articulation. Lancet 353:1057–61

    Article  PubMed  CAS  Google Scholar 

  15. Riecker A, Ackermann H, Wildgruber D, Meyer J, Dogil G, Haider H, Grodd W (2000) Articulatory/phonetic sequencing at the level of the anterior perisylvian cortex: a functional magnetic resonance imaging (fMRI) study. Brain Lang 75:259–76

    Article  PubMed  CAS  Google Scholar 

  16. Epstein CM, Meador KJ, Loring DW, Wright RJ, Weissman JD, Sheppard S, Lah JJ, Puhalovich F, Gaitan L, Davey KR (1999) Localization and characterization of speech arrest during transcranial magnetic stimulation. Clin Neurophysiol 110:1073–9

    Article  PubMed  CAS  Google Scholar 

  17. Terao Y, Ugawa Y, Enomoto H, Furubayashi T, Shiio Y, Machii K, Hanajima R, Nishikawa M, Iwata NK, Saito Y, Kanazawa I (2001) Hemispheric lateralization in the cortical motor preparation for human vocalization. J Neurosci 21:1600–9

    PubMed  CAS  Google Scholar 

  18. Penfield W, Roberts L (1959) Speech and brain mechanisms. Princeton, Princeton, UP

  19. Masutani Y, Abe O, Aoki S, Hayashi N, Otomo K (2002) Tractography of brain white matter tracts based on analysis of MR diffusion tensor data: selective tractography with tracking reliability. Med Imag Tech 20:584–592

    Google Scholar 

  20. Yousry TA, Schmid UD, Alkadhi H, Schmidt D, Peraud A, Buettner A (1997) Localization of the motor hand area to a knob on the precentral gyrus. A new landmark. Brain 120:141–57

    Article  PubMed  Google Scholar 

  21. Fox PT, Huang A, Parsons LM, Xiong JH, Zamarippa F, Rainey L, Lancaster JL (2001) Location-probability profiles for the mouth region of human primary motor-sensory cortex: model and validation. Neuroimage 13:196–209

    Article  PubMed  CAS  Google Scholar 

  22. Fesl G, Moriggl B, Schmid UD, Naidich TP, Herholz K, Yousry TA (2003) Inferior central sulcus: variations of anatomy and function on the example of the motor tongue area. Neuroimage 20:601–10

    Article  PubMed  CAS  Google Scholar 

  23. Kim JS, Kwon SU, Lee TG. (2003) Pure dysarthria due to small cortical stroke. Neurology 60:1178–1180

    Article  PubMed  CAS  Google Scholar 

  24. LeRoux PD, Berger MS, Haglund MM, Pilcher WH, Ojemann GA (1991) Resection of intrinsic tumors from nondominant face motor cortex using stimulation mapping: report of two cases. Surg Neurol 36:44–8

    Article  PubMed  CAS  Google Scholar 

  25. Mao CC, Coull BM, Golper LA, Rau MT (1987) Anterior operculum syndrome. Neurology 37:923–929

    PubMed  Google Scholar 

  26. Saito Y, Kita Y, Bando M, Nagura H, Yamanouchi H, Ishii K (1997) Neuropsychological analysis in 2 cases of infarction in the left precentral gyrus– with special reference to apraxia of speech and agraphia. Rinsho Shinkeigaku 37:487–91 [Japanese]

    PubMed  CAS  Google Scholar 

  27. Sakurai Y, Matsumura K, Iwatsubo T, Momose T (1997) Frontal pure agraphia for kanji or kana: dissociation between morphology and phonology. Neurology 49:946–952

    PubMed  CAS  Google Scholar 

  28. Takayama Y, Sugishita M, Kido T, Ogawa M, Akiguchi I (1993) A case of foreign accent syndrome without aphasia caused by a lesion of the left precentral gyrus. Neurology 43:1361–1363

    PubMed  CAS  Google Scholar 

  29. Urban PP, Wicht S, Hopf HC, Fleischer S, Nickel O (1999) Isolated dysarthria due to extracerebellar lacunar stroke: a central monoparesis of the tongue. J Neurol Neurosurg Psychiatry 66:495–501

    Article  PubMed  CAS  Google Scholar 

  30. Nakasato N, Itoh H, Hatanaka K, Nakahara H, Kanno A, Yoshimoto T (2001) Movement-related magnetic fields to tongue protrusion. Neuroimage 14:924–35

    Article  PubMed  CAS  Google Scholar 

  31. Wildgruber D, Kischka U, Ackermann H, Klose U, Grodd W (1999) Dynamic pattern of brain activation during sequencing of word strings evaluated by fMRI. Brain Res Cogn Brain Res 7:285–94

    Article  PubMed  CAS  Google Scholar 

  32. Woolsey CN, Erickson TC, Gilson WE (1979) Localization in somatic sensory and motor areas of human cerebral cortex as determined by direct recording of evoked potentials and electrical stimulation. Neurosurgery 51:476–506

    CAS  Google Scholar 

  33. Preuss TM, Stepniewska I, Kaas JH (1996) Movement representation in the dorsal and ventral premotor areas of owl monkeys: a microstimulation study. J Comp Neurol 371:649–76

    Article  PubMed  CAS  Google Scholar 

  34. Murray GM, Sessle BJ (1992) Functional properties of single neurons in the face primary motor cortex of the primate. I. Input and output features of tongue motor cortex. J Neurophysiol 67:747–58

    PubMed  CAS  Google Scholar 

  35. Martin RE, Murray GM, Kemppainen P, Masuda Y, Sessle BJ (1997) Functional Properties of Neurons in the Primate Tongue Primary Motor Cortex During Swallowing. J Neurophysiol 78:1516–30

    PubMed  CAS  Google Scholar 

  36. Yao D, Yamamura K, Narita N, Martin RE, Murray GM, Sessle BJ (2002) Neuronal activity patterns in primate primary motor cortex related to trained or semiautomatic jaw and tongue movements. J Neurophysiol 87:2531–2541

    PubMed  Google Scholar 

  37. Tokuno H, Takada M, Nambu A, Inase M (1997) Reevaluation of ipsilateral corticocortical inputs to the orofacial region of the primary motor cortex in the macaque monkey. J Comp Neurol 389:34–48

    Article  PubMed  CAS  Google Scholar 

  38. Sommer M, Koch MA, Paulus W, Weiller C, Buchel C (2002) Disconnection of speech-relevant brain areas in persistent developmental stuttering. Lancet 360:380–3

    Article  PubMed  Google Scholar 

  39. He AG, Tan LH, Tang Y, James GA, Wright P, Eckert MA, Fox PT, Liu Y (2003) Modulation of neural connectivity during tongue movement and reading. Human Brain Mapping 18:222–232

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dept. of Neurology, Division of Neuroscience, Graduate School of Medicine University of Tokyo, 7-3-1 Hongo Bunkyo-ku1, 13-8655, Tokyo, Japan

    Yasuo Terao MD, PhD, Yoshikazu Ugawa MD, PhD, Tomotaka Yamamoto MD, PhD & Shoji Tsuji MD, PhD

  2. Dept. of Neurology, Mitsui Memorial Hospital, Tokyo, Japan

    Yasuhisa Sakurai MD, PhD

  3. Dept. of Radiology and Bioengineering, Graduate School of Medicine University of Tokyo, Tokyo, Japan

    Tomohiko Masumoto MD, PhD, Osamu Abe MD, PhD, Yoshitaka Masutani MD, PhD & Shigeki Aoki MD, PhD

Authors
  1. Yasuo Terao MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoshikazu Ugawa MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tomotaka Yamamoto MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yasuhisa Sakurai MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tomohiko Masumoto MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Osamu Abe MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yoshitaka Masutani MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Shigeki Aoki MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Shoji Tsuji MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yasuo Terao MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Terao, Y., Ugawa, Y., Yamamoto, T. et al. Primary face motor area as the motor representation of articulation. J Neurol 254, 442–447 (2007). https://doi.org/10.1007/s00415-006-0385-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-006-0385-7

Key words

Search

Navigation