Verbal and Gestural Communication in Children With Bilateral Perisylvian Polymicrogyria

Abstract

We assessed intelligence and receptive and expressive language skills in 6 children, ages 7 years 9 months to 12 years 4 months, with bilateral perisylvian polymicrogyria of variable extent and with dysarthria of different severity. In view of the recent findings of a close relationship between word and gesture, we also examined the communicative use of gesture. We found that mental retardation was related to the extent of cortical malformation; lexical comprehension, but not morphosyntactic comprehension, and verbal production were more compromised than expected from nonverbal intellectual abilities; lack of verbal language was not compensated by the use of referential gestures. Results are discussed suggesting that compromised verbal and gestural communication in bilateral perisylvian polymicrogyria are not due simply to mental retardation and/or dysarthria but also to dysfunction of Sylvian fissure areas concerned with the totality of language processing.

Cognitive deficits and developmental language disorders in patients with malformations of cortical development

“…These findings suggested that the observed cognitive profiles were related to specific areas of cortical dysfunction and not just to global brain dysfunction. This conclusion was supported by a study of six children with bilateral perisylvian PMG (Saletti et al., 2007) in whom mental retardation was related to the extent of cortical malformation, lexical comprehension and verbal production were more compromised than expected from nonverbal intellectual abilities, and lack of verbal language was not compensated by the use of referential gestures. These results suggested that compromised verbal and gestural communication in bilateral perisylvian PMG is not due simply to mental retardation and/or dysarthria but also to dysfunction of the perisylvian areas concerned with the totality of language processing.…”

Speech and language in bilateral perisylvian polymicrogyria: a systematic review

“…Disprosody was reported in one patient. 18,42,49 It was unclear from the information provided whether these observations related to instances of hypo-, hyper-, or mixed nasality, or other conditions known to affect resonance, such as structural abnormalities of the palate or dysarthria. One participant had only 10 per cent intelligibility 48 while, at the other end of the spectrum, another had only mildly impaired phonemic word generation.…”

“…5,34,37,42,51 Six studies included participants who met diagnostic criteria for developmental language disorder. 2,5,18,19,28,49 Oliveira et al 28 analysed receptive language results according to BPP localization. 19,28,52 Semantic deficits were reported to be within the typical range by Boscariol et al 52 and impaired by Hage et al 19 and Kilinc et al 47 Three studies reported phonological awareness difficulties.…”

“…36,59 Functional deficits of the palate were also seen such as lack of elevation during phonation, 2,43 reduced motion, 4,37,47 and delayed movement. 49,51,59 Participants with limited ability to purse their lips 55,62 and a marked gag reflex leading to difficulty performing tongue movements and opening the mouth 62 were also reported. There was one reported instance each of tongue tie 12 and irregular dentition, 59 and three of micrognathia.…”

“…Seventeen studies reported the presence of dysphagia (including swallowing impairment and choking). 6,40,41,47,49,55,61,63 Patients requiring dietary modifications or assistance were reported in three papers, including 24 out of 28 participants in Clark et al 11 requiring a modified adult diet, and three out of 28 requiring tube feeding. 11 Impairment specific to the oral phase of swallow, including masticatory problems, was reported in eight studies.…”