Author: Brett McCardel, MS, CCC-SLP
What areas of the brain have been associated with agraphia when lesioned? ๐ง ๐ฅ โฃ
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Writing is a complex process, with ๐ ๐๐ก๐ฌ areas of the brain playing a role. This results in large neural networks responsible for the writing process โ๐ผ โฃ
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That being said, the traditional agraphia classifications do have lesion sites that are associated with them. They are as follows:โฃ
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โฃ๐พ๐๐๐๐๐ผ๐ ๐ผ๐๐๐ผ๐๐๐๐ผ๐โฃ
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๐ฆ๐๐ฟ๐ณ๐ฎ๐ฐ๐ฒ ๐ฎ๐ด๐ฟ๐ฎ๐ฝ๐ต๐ถ๐ฎ: left posterior inferior temporal cortexโฃ
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๐ฃ๐ต๐ผ๐ป๐ผ๐น๐ผ๐ด๐ถ๐ฐ๐ฎ๐น ๐ฎ๐ด๐ฟ๐ฎ๐ฝ๐ต๐ถ๐ฎ: left perisylvian cortexโฃ
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๐๐ฒ๐ฒ๐ฝ ๐ฎ๐ด๐ฟ๐ฎ๐ฝ๐ต๐ถ๐ฎ: left perisylvian cortex (lesions thought to be larger than the lesion seen in a phonological agraphia)โฃ
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๐ฆ๐ฒ๐บ๐ฎ๐ป๐๐ถ๐ฐ ๐ฎ๐ด๐ฟ๐ฎ๐ฝ๐ต๐ถ๐ฎ: extraperisylvian region, posterior tempoparietal areasโฃ
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๐๐ฟ๐ฎ๐ฝ๐ต๐ฒ๐บ๐ถ๐ฐ ๐๐๐ณ๐ณ๐ฒ๐ฟ ๐๐บ๐ฝ๐ฎ๐ถ๐ฟ๐บ๐ฒ๐ป๐: left hemisphere frontoparietal cortical system โฃ
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๐๐๐๐๐๐๐๐๐ผ๐ ๐ผ๐๐๐ผ๐๐๐๐ผ๐โฃ
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๐๐น๐น๐ผ๐ด๐ฟ๐ฎ๐ฝ๐ต๐ถ๐ฐ ๐ฎ๐ด๐ฟ๐ฎ๐ฝ๐ต๐ถ๐ฎ: left parieto-occipital regionโฃ
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๐๐ฝ๐ฟ๐ฎ๐
๐ถ๐ฐ ๐ฎ๐ด๐ฟ๐ฎ๐ฝ๐ต๐ถ๐ฎ: junction of the angular gyrus and the superior parietal lobe, premotor cortical areas, and the supplementary motor areaโฃ
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๐ ๐ผ๐๐ผ๐ฟ ๐ก๐ผ๐ป ๐๐ฝ๐ฟ๐ฎ๐
๐ถ๐ฐ ๐ฎ๐ด๐ฟ๐ฎ๐ฝ๐ต๐ถ๐ฎ: basal ganglia-thalamo-cortical and corticocerebellar motor loopsโฃ
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๐ฆ๐ฝ๐ฎ๐๐ถ๐ฎ๐น/๐๐ณ๐ณ๐ฒ๐ฟ๐ฒ๐ป๐ ๐ฎ๐ด๐ฟ๐ฎ๐ฝ๐ต๐ถ๐ฎ: non dominant parietal area, cerebellumโฃ
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From a clinical perspective, lesions in any of these areas are risk factors for an agraphia. That being said, a lesion in any of these areas does not automatically mean that a person will acquire writing problems. Conversely, people with agraphia may have lesions across the brain not specifically in these areas ๐ง โฃ
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Let lesion areas drive your formulation of a clinical hypothesis, and allow behavioral observation and patient report to determine whether agraphia assessment is warranted ๐ โฃ
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By being familiar with these classical lesion sites, youโll be all the better equipped to know what to look for and how best to help your patient before they even walk in the door! ๐๐ผโฃ
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#aphasiaawareness #writing #agraphia #neurologicaldisorder #strokeawareness