{"doi":"10.3171/case22504","title":"Apraxia of speech with phonological alexia and agraphia following resection of the left middle precentral gyrus: illustrative case","abstract":"BACKGROUND: Apraxia of speech is a disorder of speech-motor planning in which articulation is effortful and error-prone despite normal strength of the articulators. Phonological alexia and agraphia are disorders of reading and writing disproportionately affecting unfamiliar words. These disorders are almost always accompanied by aphasia. OBSERVATIONS: A 36-year-old woman underwent resection of a grade IV astrocytoma based in the left middle precentral gyrus, including a cortical site associated with speech arrest during electrocortical stimulation mapping. Following surgery, she exhibited moderate apraxia of speech and difficulty with reading and spelling, both of which improved but persisted 6 months after surgery. A battery of speech and language assessments was administered, revealing preserved comprehension, naming, cognition, and orofacial praxis, with largely isolated deficits in speech-motor planning and the spelling and reading of nonwords. LESSONS: This case describes a specific constellation of speech-motor and written language symptoms-apraxia of speech, phonological agraphia, and phonological alexia in the absence of aphasia-which the authors theorize may be attributable to disruption of a single process of \"motor-phonological sequencing.\" The middle precentral gyrus may play an important role in the planning of motorically complex phonological sequences for production, independent of output modality.","journal":"Journal of Neurosurgery Case Lessons","year":2023,"id":345853,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9557,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":683584,"name":"Andrew Revell","orcid":"0000-0003-0838-4136","position":1,"is_corresponding":false},{"id":469131,"name":"Terri L. Scott","orcid":"0000-0001-9205-8581","position":2,"is_corresponding":false},{"id":615531,"name":"Jessie R. Liu","orcid":"0000-0001-9316-7624","position":3,"is_corresponding":false},{"id":804275,"name":"Sarah Harper","orcid":"0000-0002-8453-9454","position":4,"is_corresponding":false},{"id":815104,"name":"Lingyun Zhao","orcid":"0000-0003-4394-4063","position":5,"is_corresponding":false},{"id":490767,"name":"Patrick W. Hullett","orcid":"0000-0002-0894-1767","position":6,"is_corresponding":false},{"id":323791,"name":"Garret Kurteff","orcid":"0000-0001-5800-546X","position":7,"is_corresponding":false},{"id":779279,"name":"Stephen M. Wilson","orcid":"0000-0001-9884-2852","position":8,"is_corresponding":false},{"id":413753,"name":"Matthew K. Leonard","orcid":"0000-0002-8530-880X","position":9,"is_corresponding":false},{"id":233106,"name":"Edward F. Chang","orcid":"0000-0003-2480-4700","position":10,"is_corresponding":false},{"id":655632,"name":"Deborah F. Levy","orcid":"0000-0002-1389-2525","position":0,"is_corresponding":true}],"reference_count":47,"raw_metadata":null,"created_at":"2026-07-19T01:11:44.152490Z","pmid":"37014023","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}