Results of clinical and psychological examinations of 10 patients with various manifestations of speech akinesia are presented. Four of these patients have developed the syndrome of akinetic mutism. An analysis of the time course of the akinetic mutism formation and a comparison of the symptoms of its initial stage with the manifestations of the speech akinesia observed in the course of stereotaxic operations performed for therapeutic purpose in 6 patients with extrapyramid system diseases allow a conclusion that there exists a common mechanism of various manifestations of speech akinesia consisting in insufficiency of motivation stimulation. Data of anatomo-histopathological examination of the brain of 2 patients who had the akinetic mutism point to a great rle of the frontal divisions of the cortex and its associative connections in the complicated, multi-level structural and functional basis of speech akinesia.

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