Unilateral brain lesions in childhood: performance on the Revised Token Test

Comprehension of connected language as assessed by the Revised Token Test (RTT) was studied in 17 children with left hemisphere lesions (LL) and 11 with right hemisphere lesions (RL). LL children's significantly lower performance on several subtests than left controls (LC) matched by age, sex, race, and social class appeared to be related to the memory demands of these subtests rather than the limited syntactic elements assessed by the RTT. LL subjects requested significantly more command repetitions than control or RL subjects and when a repetition was not requested LL subjects often responded with immediacy. Although RL children tended to perform lower than right matched controls (RC), these differences were not significant nor readily related to either the memory or specific linguistic structures assessed. RL subjects required fewer command repetitions than LL subjects and exhibited a significantly greater frequency of immediate responses than controls or LL subjects. While based on few children, a trend for LL children with retrorolandic lesions to perform more poorly than those with left prerolandic lesions was suggested. No systematic difference in performance was apparent for children with left cortical vs. left subcortical lesions or among discrete sites of lesions within the right hemisphere. Children with left lesions prior to 1 year of age performed no better and, in several instances, significantly poorer than LL patients sustaining lesions after 1 year of age. Among RL subjects, those sustaining lesions after 1 year of age had greater difficulty than those with lesion onset before 1 year of age, especially on linguistic elements which seemed to be dependent upon visual spatial properties. Further studies are needed to evaluate the comprehension of more complex linguistic structures among children with unilateral brain lesions as well as to study the role of more basic factors such as memory and attention in explaining the present findings.     

Reorganization of the cerebro-cerebellar network of language production in patients with congenital left-hemispheric brain lesions

Patients with congenital lesions of the left cerebral hemisphere may reorganize language functions into the right hemisphere. In these patients, language production is represented homotopically to the left-hemispheric language areas. We studied cerebellar activation in five patients with congenital lesions of the left cerebral hemisphere to assess if the language network is reorganized completely in these patients, i.e. including also cerebellar language functions. As compared to a group of controls matched for age, sex, and verbal IQ, the patients recruited an area not in the right but in the left cerebellar hemisphere. The extent of laterality of the cerebellar activation correlated significantly with the laterality of the frontal activation. We suggest that the developing brain reacts to early focal lesions in the left hemisphere with a mirror-image organization of the entire cerebro-cerebellar network engaged in speech production.     

Patterns of hand preference for pairs of actions and the classification of handedness

Pairs of actions such as write × throw and throw × racquet were examined for items of the Annett hand preference questionnaire (AHPQ). Right (R) and left (L) responses were described for frequencies of RR, RL, LR, and LL pairings (write × throw etc.) in a large representative combined sample with the aim of discovering the distribution over the population as a whole. The frequencies of RL pairings varied significantly over the different item pairs but the frequencies of LR pairings were fairly constant. An important difference was found between primary actions (originally write, throw, racquet, match, toothbrush, hammer with the later addition of scissors for right‐handers) and non‐primary actions (needle and thread, broom, spade, dealing playing cards, and unscrewing the lid of a jar). For primary actions, there were similar numbers of right and left writers using the ‘other’ hand. For non‐primary actions more right‐handers used the left hand than for primary actions but more left‐handers did not use the right hand. That is, different frequencies of response to primary versus non‐primary actions were found for right‐handers but not for left‐handers. The pattern of findings was repeated for a corresponding analysis of left‐handed throwing × AHPQ actions. The findings have implications for the classification of hand preferences and for analyses of the nature of hand skill.     

First-Pass versus Second-Pass Parsing Processes in a Wernicke''s and a Broca''s Aphasic: Electrophysiological Evidence for a Double Dissociation

The present paper is a first attempt to integrate the classical brain lesion behavioral impairment approach of functional neuroanatomy and the electrophysiological brain mapping approach in the domain of syntactic processing. In a group of normal age-matched controls we identified three electrophysiological components previously observed in correlation with language comprehension processes: an early left anterior negativity normally seen in correlation with syntactic first-pass parsing processes (ELAN), a centroparietal negativity seen in correlation with processes of lexical-semantic integration (N400), and a late centroparietal positivity observed in correlation with secondary syntactic processes of reanalysis and repair (P600). The early left anterior negativity was absent in a patient with an extended lesion in the anterior part of the left hemisphere sparing the temporal lobe, although the late centroparietal positivity and the centroparietal N400 were present. In a patient with a left temporal-parietal lesion the early left anterior negativity was found to be present, whereas the N400 component was absent. These findings suggest that first-pass parsing and secondary processes are subserved by distinct brain systems.     

The Use of Non-invasive Brain Stimulation Techniques to Facilitate Recovery from Post-stroke Aphasia

Aphasia is a common symptom after left hemispheric stroke. Neuroimaging techniques over the last 10–15 years have described two general trends: Patients with small left hemisphere strokes tend to recruit perilesional areas, while patients with large left hemisphere lesions recruit mainly homotopic regions in the right hemisphere. Non-invasive brain stimulation techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have been employed to facilitate recovery by stimulating lesional and contralesional regions. The majority of these brain stimulation studies have attempted to block homotopic regions in the right posterior inferior frontal gyrus (IFG) to affect a presumed disinhibited right IFG (triangular portion). Other studies have used anodal or excitatory tDCS to stimulate the contralesional (right) fronto-temporal region or parts of the intact left IFG and perilesional regions to improve speech-motor output. It remains unclear whether the interhemispheric disinhibition model, which is the basis for motor cortex stimulation studies, also applies to the language system. Future studies could address a number of issues, including: the effect of lesion location on current density distribution, timing of the intervention with regard to stroke onset, whether brain stimulation should be combined with behavioral therapy, and whether multiple brain sites should be stimulated. A better understanding of the predictors of recovery from natural outcome studies would also help to inform study design, and the selection of clinically meaningful outcome measures in future studies.     

The role of the left and right thalamus in language asymmetry: dichotic listening in Parkinson patients undergoing stereotactic thalamotomy

Fourteen patients with Parkinson's disease (rigidity and unilateral tremor as main symptoms) were treated with stereotactic thalamotomy. The operation was performed in either the left or right ventrolateral thalamus, depending on which hand (or foot) was most affected with tremor. Nine patients were operated on the left side and four on the right side. All patients were tested for asymmetry of language functioning with dichotic presentations of consonant-vowel (CV) syllables. The patients had to indicate which of the two syllables he/she heard on each trial. Dichotic listening was performed before and after the operation, as well as during electrical stimulation of the VL nucleus just before the lesion was carried out. The results revealed essentially three things: an overall reduced right ear advantage (REA) in the patient group compared to what is known from studies of healthy individuals; an increase in REA during left-sided stimulations; and a marked reduction in REA after left-sided lesions. It is concluded that the present data support the notion put forward by Ojemann (e.g., 1975) of a lateralized activating gating mechanism in the left VL nucleus that gates access for language information to the appropriate cortical areas. The gating mechanism seems to be activated by stimulation, and deactivated after lesions. Dichotic listening may thus be a heuristic instrument in assessment of language functions in Parkinson patients.     

Co-localisation of abnormal brain structure and function in specific language impairment

We assessed the relationship between brain structure and function in 10 individuals with specific language impairment (SLI), compared to six unaffected siblings, and 16 unrelated control participants with typical language. Voxel-based morphometry indicated that grey matter in the SLI group, relative to controls, was increased in the left inferior frontal cortex and decreased in the right caudate nucleus and superior temporal cortex bilaterally. The unaffected siblings also showed reduced grey matter in the caudate nucleus relative to controls. In an auditory covert naming task, the SLI group showed reduced activation in the left inferior frontal cortex, right putamen, and in the superior temporal cortex bilaterally. Despite spatially coincident structural and functional abnormalities in frontal and temporal areas, the relationships between structure and function in these regions were different. These findings suggest multiple structural and functional abnormalities in SLI that are differently associated with receptive and expressive language processing.     

From the left to the right: How the brain compensates progressive loss of language function

In normal right-handed subjects language production usually is a function oft the left brain hemisphere. Patients with aphasia following brain damage to the left hemisphere have a considerable potential to compensate for the loss of this function. Sometimes, but not always, areas of the right hemisphere which are homologous to language areas of the left hemisphere in normal subjects are successfully employed for compensation but this integration process may need time to develop. We investigated right-handed patients with left hemisphere brain tumors as a model of continuously progressive brain damage to left hemisphere language areas using functional neuroimaging and transcranial magnetic stimulation (TMS) to identify factors which determine successful compensation of lost language function. Only patients with slowly progressing brain lesions recovered right-sided language function as detected by TMS. In patients with rapidly progressive lesions no right-sided language function was found and language performance was linearly correlated with the lateralization of language related brain activation to the left hemisphere. It can thus be concluded that time is the factor which determines successful integration of the right hemisphere into the language network for compensation of lost left hemisphere language function.     

Posterior superior temporal cortex connectivity is related to social communication in toddlers

The second year of life is a time when social communication skills typically develop, but this growth may be slower in toddlers with language delay. In the current study, we examined how brain functional connectivity is related to social communication abilities in a sample of 12-24 month-old toddlers including those with typical development (TD) and those with language delays (LD). We used an a-priori, seed-based approach to identify regions forming a functional network with the left posterior superior temporal cortex (LpSTC), a region associated with language and social communication in older children and adults. Social communication and language abilities were assessed using the Communication and Symbolic Behavior Scales (CSBS) and Mullen Scales of Early Learning. We found a significant association between concurrent CSBS scores and functional connectivity between the LpSTC and the right posterior superior temporal cortex (RpSTC), with greater connectivity between these regions associated with better social communication abilities. However, functional connectivity was not related to rate of change or language outcomes at 36 months of age. These data suggest an early marker of low communication abilities may be decreased connectivity between the left and right pSTC. Future longitudinal studies should test whether this neurobiological feature is predictive of later social or communication impairments.     

Interhemispheric dissociation of expressive and receptive language functions in patients with complex-partial seizures: An amobarbital study

Bilateral intracarotid amobarbital procedures (IAP) were performed in 144 patients with medically intractable complex-partial seizures. As a result of language testing, 29 patients (20.1%) were found to have bilateral language representation to different degrees. In four (2.8%) of these patients--all right-handers with early onset of epilepsy and/or evidence of early brain damage--there was strong evidence of an interhemispheric dissociation of expressive and receptive language functions. Two of these patients had circumscribed temporal foci (one left, one right), and receptive language functions were represented in the hemisphere contralateral to the focus. One patient with a right frontal focus showed left-hemisphere dominance for expressive functions, while the fourth patient exhibited left-hemisphere dominance for receptive functions associated with a right temporo-parietal focus. It is argued that in these four cases the circumscribed functional and/or structural impairments have led to a shift of the anatomically associated language functions to the opposite hemisphere (rather than to neighboring regions of the same hemisphere). These findings substantiate the hypothesis that in special circumstances the anterior (expressive) language area can be located in one hemisphere and the posterior (receptive) area in the other.     

Neurology of affective prosody and its functional-anatomic organization in right hemisphere

Unlike the aphasic syndromes, the organization of affective prosody in brain has remained controversial because affective-prosodic deficits may occur after left or right brain damage. However, different patterns of deficits are observed following left and right brain damage that suggest affective prosody is a dominant and lateralized function of the right hemisphere. Using the Aprosodia Battery, which was developed to differentiate left and right hemisphere patterns of affective-prosodic deficits, functional-anatomic evidence is presented in patients with focal ischemic strokes to support the concepts that (1) affective prosody is a dominant and lateralized function of the right hemisphere, (2) the intrahemispheric organization of affective prosody in the right hemisphere, with the partial exception of Repetition, is analogous to the organization of propositional language in the left hemisphere and (3) the aprosodic syndromes are cortically based as part of evolutionary adaptations underlying human language and communication.     

Effects of right and left hemisphere damage on performance of the "Right Hemisphere Communication Battery"

A Hebrew adaptation of Gardner and Brownell's (1986) "Right Hemisphere Communication Battery" (HRHCB) was administered to 27 right brain-damaged (RBD) patients, 31 left brain-damaged (LBD) patients, and 21 age-matched normal controls. Both patient groups showed deficits relative to controls and overall there was no difference between the two patient groups. A factor analysis of patients' scores on the HRHCB yielded two interpretable factors, a verbal and a nonverbal one. These factors were not lateralized. Performance of patients on the HRHCB correlated significantly and positively with performance on most tests of basic language functions, measured with a Hebrew adaptation of the "Western Aphasia Battery" (HWAB) and with other cognitive functions measured with standardized neuropsychological tests. There were stronger correlations of HRHCB with subtests of the HWAB in LBD patients and with nonlanguage cognitive tests in RBD patients. In the LBD group, HRHCB subtests' scores correlated negatively with lesion extent in frontal and temporal perisylvian regions. Such localization was not observed in RBD patients. The results argue against selective right hemisphere (RH) involvement in the RHCB, alleged to measure pragmatic aspects of language use, and show, instead, bilateral involvement. The results also argue against a modular organization of these functions of language use, especially in the RH.     

Early language development after peri-natal stroke

Early unilateral brain damage has different implications for language development than does similar damage in adults, given the plasticity of the developing brain. The goal of this study was to examine early markers of language and gesture at 12 and 24 months in children who had peri-natal right hemisphere (RH) or left hemisphere (LH) stroke (n = 71), compared with typically developing controls (n = 126). Parents completed the MacArthur-Bates Communicative Development Inventory (CDI): Words & Gestures (12 month data point), or the CDI: Words & Sentences (24 month data point). Statistical analyses were performed on percentile scores using analysis of variance techniques. At 12 months, there were no differences among groups for Words Understood, Phrases Understood or Words Produced. At 24 months, both lesion groups scored significantly lower than controls on Word Production, Irregular Words, and Mean Length of Sentences, but lesion groups did not differ from each other. In a longitudinal subset of participants, expressive vocabulary failed to progress as expected from 12 to 24 months in the stroke group, with no differences based on lesion side. Gesture and word production were dissociated in the left hemisphere subjects. Findings suggest that early language development after peri-natal stroke takes a different course from that of typical language development, perhaps reflecting brain reorganization secondary to plasticity in the developing brain.     

Neural systems behind word and concept retrieval

Using both the lesion method and functional imaging (positron emission tomography) in large cohorts of subjects investigated with the same experimental tasks, we tested the following hypotheses: (A) that the retrieval of words which denote concrete entities belonging to distinct conceptual categories depends upon partially segregated regions in higher-order cortices of the left temporal lobe; and (B) that the retrieval of conceptual knowledge pertaining to the same concrete entities also depends on partially segregated regions; however, those regions will be different from those postulated in hypothesis A, and located predominantly in the right hemisphere (the second hypothesis tested only with the lesion method). The analyses provide support for hypothesis A in that several regions outside the classical Broca and Wernicke language areas are involved in name retrieval of concrete entities, and that there is a partial segregation in the temporal lobe with respect to the conceptual category to which the entities belong, and partial support for hypothesis B in that retrieval of conceptual knowledge is partially segregated from name retrieval in the lesion study. Those regions identified here are seen as parts of flexible, multi-component systems serving concept and word retrieval for concrete entities belonging to different conceptual categories. By comparing different approaches the article also addresses a number of method issues that have surfaced in recent studies in this field.     

Early gray-matter and white-matter concentration in infancy predict later language skills: A whole brain voxel-based morphometry study

Magnetic Resonance Imaging (MRI) brain scans were obtained from 19 infants at 7 months. Expressive and receptive language performance was assessed at 12 months. Voxel-based morphometry (VBM) identified brain regions where gray-matter and white-matter concentrations at 7 months correlated significantly with children’s language scores at 12 months. Early gray-matter concentration in the right cerebellum, early white-matter concentration in the right cerebellum, and early white-matter concentration in the left posterior limb of the internal capsule (PLIC)/cerebral peduncle were positively and strongly associated with infants’ receptive language ability at 12 months. Early gray-matter concentration in the right hippocampus was positively and strongly correlated with infants’ expressive language ability at 12 months. Our results suggest that the cerebellum, PLIC/cerebral peduncle, and the hippocampus may be associated with early language development. Potential links between these structural predictors and infants’ linguistic functions are discussed.     

Language performance on visual processing tasks in right hemisphere lesion cases

Seven language tests were constructed or adapted to assess the performance of three groups of 10 right-handed adult subjects: a right hemisphere lesion (RHL) group, a left hemisphere lesion (LHL) group, and a neurologically normal (NN) control group. Both the LHL and RHL groups produced poorer scores than the NN group on six of the seven tests. On two of the six significant tests, the RHL performed more poorly than the NN group. Analyses of words uttered during an oral story telling test indicated that the RHL group told significantly fewer complete stories using significantly more nouns, adjectives, and conjunctions than the NN group. On a 7-point scale, three judges rated the overall communication abilities of the RHL group as having “mild problems,” a significantly different rating than the ratings of the LHL and NN groups. The findings suggest that underlying visual spatial and perceptual deficits may be accompanied by clearly recognizable language differences in certain subjects.     

The cognitive neuroscience of signed language

The present article is an assessment of the current state of knowledge in the field of cognitive neuroscience of signed language. Reviewed lesion data show that the left hemisphere is dominant for perception and production of signed language in aphasics, in a fashion similar to spoken language aphasia. Several neuropsychological dissociations support this claim: Non-linguistic visuospatial functions can be dissociated from spatial functions and general motor deficits can be dissociated from execution of signs. Reviewed imaging data corroborate the lesion data in that the importance of the left hemisphere is re-confirmed. The data also establish the role of the right hemisphere in signed language processing. Alternative hypotheses regarding what aspects of signed language processing are handled by the right hemisphere are currently tested. The second section of the paper starts by addressing the role that early acquisition of signed and spoken language play for the neurofunctional activation patterns in the brain. Compensatory cognitive and communicative enhancements have also been documented as a function of early sign language use, suggesting an interesting interaction between language and cognition. Recent behavioural data on sign processing in working memory--a cognitive system important for language perception and production suggest e.g. phonological loop effects analogous to those obtained for speech processing. Neuroimaging studies will have to address this potential communality.     

比喻性语言加工的脑机制

早期观点认为比喻性语言加工主要依赖右脑, 随着研究的深入, 右脑假说受到许多研究结果的挑战, 左脑参与比喻性语言的加工。同时, 左右脑语言区发挥各自不同的作用, 新的研究证实, 前额前部皮层同样参与比喻性语言的加工。比喻性语言的理解需要左右半球及前额皮层的共同激活, 同时对其加工还依赖左右半球的联合作用, 比喻性语言理解神经网络的建立需要新证据。     

Neural circuitry of the bilingual mental lexicon: Effect of age of second language acquisition

Numerous studies have proposed that changes of the human language faculty caused by neural maturation can explain the substantial differences in ultimate attainment of grammatical competences between first language (L1) acquirers and second language (L2) learners. However, little evidence on the effect of neural maturation on the attainment of lexical knowledge in L2 is available. The present functional magnetic resonance study addresses this question via a cross-linguistic neural adaptation paradigm. Age of acquisition (AoA) of L2 was systematically manipulated. Concrete nouns were repeated across language (e.g., French–German, valise^suitcase–Koffer^suitcase). Whereas early bilinguals (AoA of L2 < 3 years) showed larger repetition enhancement (RE) effects in the left superior temporal gyrus, the bilateral superior frontal gyrus and the right posterior insula, late bilinguals (AoA of L2 > 10 years) showed larger RE effects in the middle portion of the left insula and in the right middle frontal gyrus (MFG). We suggest that, as for grammatical knowledge, the attainment of lexical knowledge in L2 is affected by neural maturation. The present findings lend support to neurocognitive models of bilingual word recognition postulating that, for both early and late bilinguals, the two languages are interconnected at the conceptual level.