Contemporary Approaches to the Management of Post-stroke Apraxia of Speech.
Alexandra Basilakos
PMID 29359303WHAT IT FOUND
Objective acoustic tests and brain imaging may help distinguish post-stroke apraxia of speech from aphasia or dysarthria, but evidence is early.
Speech therapy should not rely on imaging alone; articulatory-kinematic treatment has support.
Key findings
01In a sample of 72 people, a vowel-timing measure from as few as five words, plus a sound-error measure, classified AOS with more than 90% positive predictive value against expert diagnosis.
02In 80 patients studied within 24 hours of stroke, 31 had AOS; 19 of them did not have damage to the superior precentral gyrus of the insula, and 26 had damage to Broca area.
03A cited systematic review suggests AOS treatment is effective, with articulatory-kinematic treatment supported; tDCS studies included three and eight participants, and a computer-based trial included 50 participants.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is a narrative review, not a primary study, so it reports no original methods or results and does not describe a systematic search. The paper says acoustic and imaging measures are preliminary, lack normative data, and have limited evidence in acute post-stroke AOS. Many cited studies are small, include chronic AOS, or mix PAOS with post-stroke AOS, so they may not apply to acute stroke care. Acoustic analysis may require specialized training, and automated tools are not yet widely available. Lesion studies do not agree on one brain site for AOS, and network evidence comes from a small study. Treatment evidence is uneven: articulatory-kinematic therapy has support, but tDCS samples were very small, and computer therapy has not tested established AOS motor approaches or acute or subacute recovery.
Declared interests
The supplied text does not include an author conflict-of-interest statement. Publication types list NIH extramural research support.
The easy way to misread this
Do not treat brief acoustic classification or brain imaging as ready-made diagnostic tests for AOS. The review says the work is preliminary, imaging should not be used alone, and tDCS and computer therapy evidence is small or not tested in acute recovery.