Abstract
Stroke
is the third leading cause of death in the developed world and the
primary cause of adult disability. The most common site of stroke is the
middle cerebral artery (MCA), an artery that supplies a range of areas
involved in both language and motor function. As a consequence, many
stroke patients experience a combination of language and motor deficits.
Indeed, those suffering from Broca’s aphasia have an 80% chance of also
suffering hemiplegia. Despite the prevalence of multifaceted disability
in patients, the current trend in both clinical trials and clinical
practice is toward compartmentalization of dysfunction. In this article,
we review evidence that aphasia and hemiplegia do not just coexist, but
that they interact. We review a number of clinical reports describing
how therapies for one type of deficit can improve recovery in the other
and vice versa. We go on to describe how language deficits should be
seen as a warning to clinicians that the patient is likely to experience
motor impairment and slower motor recovery, aiding clinicians to
optimize their choice of therapy. We explore these findings and offer a
tentative link between language and arm function through their shared
need for sequential action, which we term fluency. We propose that area
BA44 (part of Broca’s area) acts as a hub for fluency in both movement
and language, both in terms of production and comprehension.
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