Differential recovery of languages in a bilingual patient: a case study using selective amytal test.

We performed a selective Wada test on a bilingual patient. While a left middle cerebral artery (MCA) injection produced global aphasia for both (Spanish and English) languages, the patient could only speak Spanish (his mother tongue) 1 min after he started to speak English. No language disturbances were observed after a right MCA amytal injection. These findings suggest that all of a multilingual's languages are stored within the verbal-dominant perisylvian region, and while the second language may be organized within the central Sylvian core, the first language may be better represented in more distal perisylvian areas.     

Bilateral language: Is the left hemisphere still dominant?

A 13-year-old left-handed boy with a left fronto-parietal vascular malformation evidenced bilateral symmetrical language representation at intracarotid amytal testing. Surgical resection of the parietal motor and frontal premotor area (sparing classical perisylvian language regions) for seizure control resulted in an acute aphasia. Language deficits were still apparent 3 months and to a lesser degree 1 year after surgery. This suggests that when language is bilateral and symmetrical, the left hemisphere may still be dominant or both hemispheres may be necessary to sustain full language competence. Explanations for atypical language localization within the left hemisphere are also discussed.     

The signing brain: the neurobiology of sign language

Most of our knowledge about the neurobiological bases of language comes from studies of spoken languages. By studying signed languages, we can determine whether what we have learnt so far is characteristic of language per se or whether it is specific to languages that are spoken and heard. Overwhelmingly, lesion and neuroimaging studies indicate that the neural systems supporting signed and spoken language are very similar: both involve a predominantly left-lateralised perisylvian network. Recent studies have also highlighted processing differences between languages in these different modalities. These studies provide rich insights into language and communication processes in deaf and hearing people.     

Processing of basic speech acts following localized brain damage: a new light on the neuroanatomy of language

We examined the effect of localized brain lesions on processing of the basic speech acts (BSAs) of question, assertion, request, and command. Both left and right cerebral damage produced significant deficits relative to normal controls, and left brain damaged patients performed worse than patients with right-sided lesions. This finding argues against the common conjecture that the right hemisphere of most right-handers plays a dominant role in natural language pragmatics. In right-hemisphere damaged patients, there was no correlation between location and extent of lesion in perisylvian cortex and performance on BSAs. By contrast, processing of the different BSAs by left hemisphere-damaged patients was strongly affected by perisylvian lesion location, with each BSA showing a distinct pattern of localization. This finding raises the possibility that the classical left perisylvian localization of language functions, as measured by clinical aphasia batteries, partly reflects the localization of the BSAs required to perform these functions.     

Using fMRI to study recovery from acquired dysphasia

We have used functional magnetic resonance imaging (fMRI) to characterize brain activations associated with two distinct language tasks performed by a 28-year-old woman after partial recovery from dysphasia due to a left frontal hemispheric ischemic stroke. MRI showed that her ischemic lesion extended posteriorly from the left inferior frontal to the perisylvian cortex. fMRI scans of both language tasks revealed substantial differences in activation pattern relative to controls. The nature of this difference was task-specific. During performance of a verbal semantic decision task, the patient, in contrast to controls, activated a network of brain areas that excluded the inferior frontal gyrus (in either hemisphere). A second task involving rhyme judgment was designed to place a heavier cognitive load on language production processes and activated the left inferior frontal gyrus (Broca's area) strongly in normal controls. During this task, the most prominent frontal activation in the patient occurred in the right homologue of Broca's area. Subsequent analysis of this data by methods able to deal with responses of changing amplitude revealed additional, less sustained recruitment by the patient of cortex adjacent to the infarct in the region inferior to Broca's area during rhyming. These results suggest that in addition to changes in cognitive strategy, recovery from dysphasia could be mediated by both the preservation of neuronal networks in and around the infarct and the use of homologous regions in the contralateral hemisphere.     

Neural correlates of infant accent discrimination: an fNIRS study

The present study investigated the neural correlates of infant discrimination of very similar linguistic varieties (Quebecois and Parisian French) using functional Near InfraRed Spectroscopy. In line with previous behavioral and electrophysiological data, there was no evidence that 3‐month‐olds discriminated the two regional accents, whereas 5‐month‐olds did, with the locus of discrimination in left anterior perisylvian regions. These neuroimaging results suggest that a developing language network relying crucially on left perisylvian cortices sustains infants’ discrimination of similar linguistic varieties within this early period of infancy.     

Convergent cortical representation of semantic processing in bilinguals

This study examined whether semantic processes in two languages (English and Spanish) are mediated by a common neural system in fluent bilinguals who acquired their second language years after acquiring their first language. Functional magnetic resonance imaging was performed while bilingual participants made semantic and nonsemantic decisions about words in Spanish and English. There was greater activation for semantic relative to nonsemantic decisions in left and right frontal regions, with greater left frontal activation. The locations of activations were similar for both languages, and no differences were found when semantic decisions for English and Spanish words were compared directly. These results demonstrate a shared frontal lobe system for semantic analysis of the languages and are consistent with cognitive research on bilingualism indicating that the two languages of a bilingual person access a common semantic system.     

MRI findings in the parents and siblings of specifically language-impaired boys

Four families that include a specifically language-impaired (SLI) boy were studied to test the hypothesis that developmental language disorders are biologically transmittable. A majority of the parents of the SLI boys had experienced communication difficulty (i.e., difficulty with speech, language, or academic skills) as children. Evidence of communication difficulty was paired on an individual basis with neuroanatomical data obtained through quantitative analysis of magnetic resonance imaging scans. Atypical perisylvian asymmetries were documented in a majority of the parents and were frequently associated with a history of communication difficulty. Atypical perisylvian asymmetries and disordered language skills were also documented for siblings of SLI boys. These findings suggest that atypical perisylvian asymmetries reflect a transmittable, biological factor that places some families at risk for language impairment.     

Variability in subcortical aphasia is due to variable sites of cortical hypoperfusion

A variety of fluent and nonfluent aphasias have been reported after left basal ganglia stroke. It has been speculated that this heterogeneity may reflect variations in cortical hypoperfusion resulting from large vessel stenosis. To test this hypothesis, a consecutive series of 24 patients with left caudate infarct identified with diffusion-weighted imaging underwent language testing and perfusion-weighted imaging < 24h from onset of symptoms. Specific regions in perisylvian cortex were rated for the percentage of the region that was hypoperfused. Aphasia type was determined on the basis of speech fluency, comprehension, and repetition performance on the language tests. Association between aphasia type/language impairment and regions of hypoperfusion were identified with Fisher's exact tests. Results demonstrated that in patients with acute left caudate infarct, the presence and type of aphasia reflected regions of hypoperfusion, and generally followed predictions based on chronic lesion studies, regarding anatomical lesions associated with classic aphasia types.     

Laterality differences for word identification in bilinguals

Twenty-three Spanish-English bilinguals were tachistoscopically presented with four-letter common nouns. They viewed 20 word pairs, first in their native language, then in the other, for 40 msec under simultaneous bilateral exposure. This paradigm has previously shown a strong right visual field and therefore left hemisphere superiority for words in a single language. The results show a word identification advantage in the right visual field. This indicates a left hemisphere advantage for processing of both languages, regardless of which was learned first. There are nevertheless wide individual differences in the number of bilinguals showing the expected asymmetry, as compared with monolinguals. There may be a trend, therefore, for less unilaterality of language function in bilinguals, although both languages are seen as being equally lateralized.     

The neural basis of syntactic deficits in primary progressive aphasia

Patients with primary progressive aphasia (PPA) vary considerably in terms of which brain regions are impacted, as well as in the extent to which syntactic processing is impaired. Here we review the literature on the neural basis of syntactic deficits in PPA. Structural and functional imaging studies have most consistently associated syntactic deficits with damage to left inferior frontal cortex. Posterior perisylvian regions have been implicated in some studies. Damage to the superior longitudinal fasciculus, including its arcuate component, has been linked with syntactic deficits, even after gray matter atrophy is taken into account. These findings suggest that syntactic processing depends on left frontal and posterior perisylvian regions, as well as intact connectivity between them. In contrast, anterior temporal regions, and the ventral tracts that link frontal and temporal language regions, appear to be less important for syntax, since they are damaged in many PPA patients with spared syntactic processing.     

On the representation of multiple languages in the brain: old problems and new directions

This paper has attempted to show that when the relevant literature is critically scrutinized there is very little evidence for the idea that the right hemisphere participates in multiple languages in any way significantly different from the case of a single language. We have seen that most of the clinical data support the simple notion that the left hemisphere controls the first and subsequent languages to the same degree. The experimental data are full of contradictions, but many of the claims are invalid due to various methodological and analytical problems explained previously. It is suggested that future research concentrate on finer-grained questions than simply whether a language is left lateralized or not. These questions should make connections with other known neurological and neuropsychological facts. Of primary interest is obtaining converging evidence on the hypothesis of differential cerebral territories within the left hemisphere of bilinguals for different languages. In conclusion, we would be wise to consider the bilingual as a very rich potential source for testing various hypotheses about linguistic and neurolinguistic organization. But we should not lose the opportunity to test both more general and more specific hypotheses to which the multilingual gives us access. If treated with care the multilingual will tell us much, even though he may speak in many tongues.     

Bilingualism and brain functional asymmetry

The task of the neural organization of the native language, acquired by a direct method and of another language, studied at school, performed correspondingly by the left and the right hemispheres, was studied in the bilingual patient after unilateral electroconvulsive therapy used in psychiatry. It was established that in such a bilingual type the right hemisphere is concerned with the formation of deep semantic structures of the native language while the left hemisphere is responsible for the formation of second language deep structures and of surface structures of both languages. The effect of language learning method on cerebral organization of bilingualism is postulated.     

Shared and separate systems in bilingual language processing: converging evidence from eyetracking and brain imaging

The neurological and cognitive aspects of bilingual language processing were examined in late Russian-English bilinguals using headband-mounted eyetracking and functional neuroimaging. A series of three eyetracking studies suggested that, at early stages of word recognition, bilinguals can activate both languages in parallel, even when direct linguistic input is in one language only. A functional neuroimaging study suggested that, although the same general structures are active for both languages, differences within these general structures are present across languages and across levels of processing. For example, different centers of activation were associated with first versus second language processing within the left Inferior Frontal Gyrus, but not within the Superior Temporal Gyrus. We suggest that parallel activation (as found with eyetracking) and shared cortical structures (as found with fMRI) may be characteristic of early stages of language processing (such as phonetic processing), but the two languages may be using separate structures at later stages of processing (such as lexical processing).     

Involuntary language switching in two bilingual patients during the Wada test and intraoperative electrocortical stimulation

We present two bilingual patients without language disorders in whom involuntary language switching was induced. The first patient switched from Dutch to English during a left-sided amobarbital (Wada) test. Functional magnetic resonance imaging yielded a predominantly left-sided language distribution similar for both languages. The second patient switched from French to Chinese during intraoperative electrocortical stimulation of the left inferior frontal gyrus. We conclude that the observed language switching in both cases was not likely the result of a selective inhibition of one language, but the result of a temporary disruption of brain areas that are involved in language switching. These data complement the few lesion studies on (involuntary or unintentional) language switching, and add to the functional neuroimaging studies of switching, monitoring, and controlling the language in use.     

Visual-spatial processing in deaf brain-damaged signers

Sign language displays all the complex linguistic structure found in spoken languages, but conveys its syntax in large part by manipulating spatial relations. This study investigated whether deaf signers who rely on a visual-spatial language nonetheless show a principled cortical separation for language and nonlanguage visual-spatial functioning. Four unilaterally brain-damaged deaf signers, fluent in American Sign Language (ASL) before their strokes, served as subjects. Three had damage to the left hemisphere and one had damage to the right hemisphere. They were administered selected tests of nonlanguage visual-spatial processing. The pattern of performance of the four patients across this series of tests suggests that deaf signers show hemispheric specialization for nonlanguage visual-spatial processing that is similar to hearing speaking individuals. The patients with damage to the left hemisphere, in general, appropriately processed visual-spatial relationships, whereas, in contrast, the patient with damage to the right hemisphere showed consistent and severe visual-spatial impairment. The language behavior of these patients was much the opposite, however. Indeed, the most striking separation between linguistic and nonlanguage visual-spatial functions occurred in the left-hemisphere patient who was most severely aphasic for sign language. Her signing was grossly impaired, yet her visual-spatial capacities across the series of tests were surprisingly normal. These data suggest that the two cerebral hemispheres of congenitally deaf signers can develop separate functional specialization for nonlanguage visual-spatial processing and for language processing, even though sign language is conveyed in large part via visual-spatial manipulation.     

Left hemisphere language lateralization in bilinguals and monolinguals

Tachistoscopic studies of lateralization in bilinguals suggest that there is a greater degree of right hemisphere involvement in their processing of language than is typically found in monolinguals. However, most of the studies reviewed failed to control the sex, handedness, and degree of fluency of the subjects and did not include a monolingual comparison group. The present study used adult right-handed males (Portuguese-English bilinguals and English-speaking monolinguals) in a tachistoscopic word-reading task. In Experiment 1, the words from the bilinguals’ two languages were presented in mixed blocks, while in Experiment 2, they were presented in separate blocks. The results were: (1) a similar level of left hemisphere advantage for language in the bilingual and the monolingual groups, (2) no evidence of greater heterogeneity of asymmetry patterns in bilinguals, and (3) a significant correlation (r=.61) for lateralization levels of the bilinguals’ two languages. These results indicate that language is processed primarily in the left hemisphere of both bilinguals and monolinguals.     

MRI findings in boys with specific language impairment

Magnetic resonance imaging scans of specifically language-impaired (SLI) boys were examined to determine whether atypical cerebral findings could be documented in children whose primary deficits were in language skills. Clinical examination of the scans failed to reveal any visually obvious lesions or abnormalities. In contrast, measurement of the scans revealed atypical perisylvian asymmetries in most of these subjects. The distribution of perisylvian asymmetries in SLI subjects was significantly different from the distribution in controls (p less than .01). Measurement of other brain regions revealed that extraperisylvian areas were occasionally deviant in individual SLI subjects; but no one region was consistently deviant across the SLI group. Thus, only atypical perisylvian asymmetries were linked to the language disorder. These neuroanatomical findings suggest that a prenatal alteration of brain development underlies specific language impairment.     

Correlations between glucose metabolic rates in brain regions of healthy male adults at rest and during language stimulation

This study examines the effect of different behavioral conditions on patterns of correlation between regional cerebral metabolic rates for glucose. Cerebral glucose metabolism was determined with positron emission tomography and (11C)-deoxyglucose in 29 normal subjects between the ages of 23 and 55. Seventeen subjects were studied in an unstimulated (resting) condition and 12 subjects during a phoneme monitoring language stimulation. Partial correlation coefficients, controlling for whole brain glucose metabolism, were calculated for pairs of metabolic rates in 14 cortical and 2 subcortical regions. Both stimulated and unstimulated subjects showed statistically significant correlations between left and right hemisphere homologs. The stimulated subjects also showed significant within-hemisphere correlations between left but not right hemisphere regions. These included left perisylvian regions classically associated with language functions (left inferior frontal, left superior temporal and left transverse temporal cortical regions) as well as other regions. Significant correlations between left regions and a right superior temporal region were also found. In general, these findings show a pattern of cross-hemisphere symmetry at rest and of hemisphere asymmetry during stimulation. Moreover, the asymmetry observed during stimulation appears to be superimposed upon a pattern of cross-hemisphere symmetry similar to that observed in the unstimulated state.