Speech disorder called apraxia can progress to neurodegenerative disease

Two Mayo Clinic researchers have spent more than a decade uncovering clues to apraxia of speech and have discovered that people might eventually become mute from primary progressive apraxia of speech, a disorder related to degenerative neurologic disease.

A speech disorder called apraxia can evolve into a neurologic disorder if left untreated, causing difficulty with eye movement, use of limbs, and

walking that worsens as time passes, scientists say.

Some patients eventually become mute from primary progressive apraxia of speech, a disorder related to degenerative neurologic disease. Because patients and even many medical professionals do not recognize apraxia of speech.

Two Mayo Clinic researchers have spent more than a decade uncovering clues to apraxia of speech. Keith Josephs, M.D., a neurologist, and Joseph R. Duffy, Ph.D., a speech pathologist, will present "My Words Come Out Wrong: When Thought and Language Are Disconnected from Speech" on Sunday, Feb. 14, at the American Association for the Advancement of Science annual meeting in Washington, D.C.

Because patients and even many medical professionals don't recognize apraxia of speech, treatment typically is sought in later stages of the disease, says Dr. Josephs. As apraxia progresses, it frequently is misdiagnosed as Alzheimer's disease or amyotrophic lateral sclerosis. One patient received vocal cord injections of Botox by a physician who thought the issue was muscle spasms of the larynx. Apraxia of speech even has been diagnosed as mental illness.

The benefit to getting an early and correct diagnosis is that people can receive appropriate therapy. "It would be good if people recognized that changes in speech can be the first signs of neurologic disease," Dr. Duffy says. "An important part of treatment is providing information about the condition."

People with apraxia of speech or their loved ones may notice: Slow speech rate¸ inconsistent mistakes, such as saying a word or sound correctly sometimes and not others; impaired rhythm of speech; groping of the mouth to make sounds; better automatic speech, such as greetings, compared with purposeful speech

The findings were published in the journals Brain, Neurology, the American Journal of Alzheimer's Disease and Other Dementias, and the Journal of Neurology.

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