Apraxia of speech and cerebellar mutism syndrome: a case study

Background Cerebellar mutism syndrome (CMS) or posterior fossa syndrome (PFS) consists of a constellation of neuropsychiatric, neuropsychological and neurogenic speech and language deficits. It is most commonly observed in children after posterior fossa tumor surgery. The most prominent feature of CMS is mutism, which generally starts after a few days after the operation, has a limited duration and is typically followed by motor speech deficits. However, the core speech disorder subserving CMS is still unclear. Case presentation This study investigates the speech and language symptoms following posterior fossa medulloblastoma surgery in a 12-year-old right-handed boy. An extensive battery of formal speech (DIAS = Diagnostic Instrument Apraxia of Speech) and language tests were administered during a follow-up of 6 weeks after surgery. Although the neurological and neuropsychological (affective, cognitive) symptoms of this patient are consistent with Schmahmann’s syndrome, the speech and language symptoms were markedly different from what is typically described in the literature. In-depth analyses of speech production revealed features consistent with a diagnosis of apraxia of speech (AoS) while ataxic dysarthria was completely absent. In addition, language assessments showed genuine aphasic deficits as reflected by distorted language production and perception, wordfinding difficulties, grammatical disturbances and verbal fluency deficits. Conclusion To the best of our knowledge this case might be the first example that clearly demonstrates that a higher level motor planning disorder (apraxia) may be the origin of disrupted speech in CMS. In addition, identification of non-motor linguistic disturbances during follow-up add to the view that the cerebellum not only plays a crucial role in the planning and execution of speech but also in linguistic processing. Whether the cerebellum has a direct or indirect role in motor speech planning needs to be further investigated

Relationships between seasonal changes in diet of multimammate rat (Mastomys natalensis) and its breeding patterns in semi-arid areas in Tanzania

The diet and breeding patterns of Mastomys natalensis in semi-arid areas of Isimani division, Iringa region, Tanzania were investigated in maize fields and fallow land. The aim was to investigate the influence of diet on breeding patterns of M. natalensis. Removal trapping was used to capture rodents and analyse diet categories while Capture-mark-release trapping was used to investigate breeding patterns of female M. natalensis. Mastomys natalensis comprised 94%of the total capture, and the remaining 6% comprised of six other species. Statistical analysis of food preferences indicated that both vegetative materials and seeds were significantly higher in the overall diet of M. natalensis compared with other food materials. Significant differences in the proportions of vegetativematerials and seeds were found between seasons (dry, wet), but not between habitats (fallow, maize). There was a clear seasonal pattern in the proportion of reproductively active females with peaks in April and troughs in October. The proportion of vegetative materialswas highest during thewet season and correlated positively with reproductive activity, suggesting that vegetative materials contain certain compounds (e.g. 6-MBOA) that trigger reproductive activity in M. natalensis. The breeding activity of M. natalensis in semi-arid areas might, thus, be reduced by limiting access to fresh vegetative food (e.g. young sprouting grass)

Constraint-induced Aphasia Therapy versus Intensive Semantic Treatment in Fluent Aphasia

Objective: To compare the effectiveness of two intensive therapy methods: Constraint- 4 Induced Aphasia Therapy (CIAT) and semantic therapy (BOX). Method: Nine patients with chronic fluent aphasia participated in a therapy programme 6 to establish behavioral treatment outcomes. Participants were randomly assigned to one of two groups (CIAT or BOX). Results: Intensive therapy significantly improved verbal communication. However, BOX 9 treatment showed a more pronounced improvement on two communication measures, namely on a standardized assessment for verbal communication, the Amsterdam Nijmegen Everyday Language Test (Blomert, Koster, & Kean, 1995) and on a subjective rating scale, the Communicative Effectiveness Index (Lomas et al., 1989). All 13 participants significantly improved on one (or more) subtests of the Aachen Aphasia Test (Graetz et al., 1992), an impairment-focused assessment. There was a treatment-specific effect. Therapy with BOX had a significant effect on language comprehension and on semantics, while of CIAT affected language production and phonology. Conclusion: The findings indicate that in patients with fluent aphasia (1) intensive treatment has a significant effect on language and verbal communication, (2) intensive therapy results in selective treatment effects and (3) an intensive semantic treatment shows a more striking mean improvement on verbal communication in comparison to communication-based CIAT-treatment

Grammar disruption in a patient with Neuro-Sweet syndrome

This paper for the first time reports detailed neurolinguistic findings in a patient with Neuro-Sweet syndrome. In this patient the presenting symptoms of central nervous system (CNS) involvement primarily consisted of a selective grammar deficit restricted to spontaneous speech. On MRI a left prefrontal ischemic stroke (superior part BA 6) and two small subcortical left parietal infarctions were found. Neurolinguistic analyses, however, did not reveal a profile consistent with any observations of agrammatism caused by structural damage to the language areas critically involved in grammatical processing. It is hypothesized that selectively distorted grammar might reflect disruption of the frontosubcortical network involved in language processing. Prefrontal neurobehavioral abnormalities associated with functional disruption of the inferior medial frontal regions as demonstrated by SPECT, additionally suggest that agrammatic symptoms may be linked to a higher-level cognitive disorder following encephalopathic CNS involvement

Home ranges, sex ratio and recruitment of the multimammate rat (Mastomys natalensis) in semi-arid areas in Tanzania

Investigation of home ranges, sex ratio and recruitment of the multimammate rat (Mastomys natalensis) in semi-arid areas of Tanzania was conducted in maize and fallow fields using the capture-mark-release (CMR) technique. The aim of this study was to generate useful data for the management of M. natalensis. The relative home range size of M. natalensis was significantly higher during the wet [544 m2±25 standard error (SE)] than during the dry (447 m2 ±18 SE) season, in males (521 m2 ±23 SE) than in females (450 m2 ±17 SE) and in adults (576 m2 ±34 SE) than in juveniles (459 m2 ±16 SE). However, there were no significant differences between habitats. Sex ratio was not significantly different (p=0.44) between habitats. Recruitment was significantly higher (p=0.000) in maize fields (mean=0.43) than in fallow land (mean=0.32) and differed significantly over time (p=0.0001) with the highest recruitment recorded from April to July and the lowest from October to December. Management strategies should focus on managing rodents inhabiting maize fields using methods that affect their recruitment in order to reduce the population increase of M. natalensi

Cerebellar Asymmetry and Cortical Connectivity in Monozygotic Twins with Discordant Handedness

Handedness differentiates patterns of neural asymmetry and interhemispheric connectivity in cortical systems that underpin manual and language functions. Contemporary models of cerebellar function incorporate complex motor behaviour and higher-order cognition, expanding upon earlier, traditional associations between the cerebellum and motor control. Structural MRI defined cerebellar volume asymmetries and correlations with corpus callosum (CC) size were compared in 19 pairs of adult female monozygotic twins strongly discordant for handedness (MZHd). Volume and asymmetry of cerebellar lobules were obtained using automated parcellation.CC area and regional widths were obtained from midsagittal planimetric measurements. Within the cerebellum and CC, neurofunctional distinctions were drawn between motor and higher-order cognitive systems. Relationships amongst regional cerebellar asymmetry and cortical connectivity (as indicated by CC widths) were investigated. Interactions between hemisphere and handedness in the anterior cerebellum were due to a larger right-greater-than-left hemispheric asymmetry in right-handed (RH) compared to left-handed (LH) twins. In LH twins only, anterior cerebellar lobule volumes (IV, V) for motor control were associated with CC size, particularly in callosal regions associated with motor cortex connectivity. Superior posterior cerebellar lobule volumes (VI, Crus I, Crus II, VIIb) showed no correlation with CC size in either handedness group. These novel results reflected distinct patterns of cerebellar-cortical relationships delineated by specific CC regions and an anterior-posterior cerebellar topographical mapping. Hence, anterior cerebellar asymmetry may contribute to the greater degree of bilateral cortical organisation of frontal motor function in LH individuals