Hemispheric lateralization in 47,XXY Klinefelter's syndrome boys

Thirty-two boys with a 47,XXY karyotype were compared with chromosomally normal male controls in their performance on six tasks of hemispheric specialization. The results revealed that the 47,XXY subjects had smaller asymmetries on left hemisphere tasks and larger asymmetries on right hemisphere tasks than controls. Analyses of individual right and left side scores revealed that the atypical lateral asymmetries of the 47,XXYs were due to a shift toward greater right hemisphere involvement on four of the six measures. It was postulated that the slower fetal growth rates of the extra X chromosome group might contribute to their atypical hemispheric specialization and the failure of their left hemisphere to gain dominance over their right in language processing.     

Effect of hemispherectomy in infantile hemiplegics

Four patients with infantile hemiplegia who had undergone hemispherectomy were examined. both left (LH) and right (RH) hemidecorticates obtained borderline defective scores on IQ tests. Patients with isolated right hemispheres were found not to be aphasic or apraxic. Visuospatial and constructional capacities were compromised in all patients. Individuals with an isolated right hemisphere smiled and gestured more than did those with an isolated right hemisphere. EEG and CT scan data showed that the remaining hemisphere was not normal in these patients. Therefore, inferences regarding the functional plasticity of the remaining hemisphere must be made with caution.     

Ear asymmetries on a selective attentional task

To ascertain whether there are ear-hemisphere asymmetries of selective attention, signal stimuli (tonal sequences) were presented monaurally with and without complex maskers (music and speech). The right ear-left hemisphere was more disrupted by language maskers; the left ear-right hemisphere was more disrupted by music maskers. These results suggest that there are hemispheric asymmetries of selective attention and that the ear hemisphere that usually processes a class of stimuli has greater difficulty filtering out those stimuli than does the nonspecialized hemisphere.     

Persisting apraxia in two left-handed, aphasic patients with right-hemisphere lesions

Apraxia usually follows a left hemisphere lesion in right-handers with left hemisphere speech representation. Apraxia following a right hemisphere lesion in left-handers is rare, however, and not well documented in the literature. Two left-handed patients are described in whom apraxia and aphasia followed a right hemisphere lesion. Both the apraxic and the aphasic deficits improved but were still demonstrable 6 weeks following the infarct. The data are consistent with those for right-handers with left hemisphere lesions in suggesting some overlap of anatomical structures for the control of speech and praxis.     

Multiple component agraphia in a patient with atypical cerebral dominance: an error analysis

A 52-year-old man with atypical cerebral dominance (left-handed for writing but mixed handedness for other tasks) suffered an extensive right hemisphere stroke, resulting in a combination of deficits that has not been previously reported. There were profound visual constructive and visual perceptual disturbances and a spatial agraphia, which were consistent with a nondominant hemisphere lesion. There was also a severe apraxic agraphia, which is typically associated with a dominant hemisphere lesion, but no other signs of dominant hemisphere dysfunction such as linguistic disturbance or limb-motor apraxia were present. This case serves to highlight the functional and anatomical relationship between handwriting and other forms of praxis; the various sources of error in letter formation; the need to be specific in labeling and describing agraphias ; and the role of a detailed analysis of writing errors in delineating the neuropsychological processes involved in handwriting.     

Bilateral capacity for speech sound processing in auditory comprehension: evidence from Wada procedures

Data from lesion studies suggest that the ability to perceive speech sounds, as measured by auditory comprehension tasks, is supported by temporal lobe systems in both the left and right hemisphere. For example, patients with left temporal lobe damage and auditory comprehension deficits (i.e., Wernicke's aphasics), nonetheless comprehend isolated words better than one would expect if their speech perception system had been largely destroyed (70-80% accuracy). Further, when comprehension fails in such patients their errors are more often semantically-based, than-phonemically based. The question addressed by the present study is whether this ability of the right hemisphere to process speech sounds is a result of plastic reorganization following chronic left hemisphere damage, or whether the ability exists in undamaged language systems. We sought to test these possibilities by studying auditory comprehension in acute left versus right hemisphere deactivation during Wada procedures. A series of 20 patients undergoing clinically indicated Wada procedures were asked to listen to an auditorily presented stimulus word, and then point to its matching picture on a card that contained the target picture, a semantic foil, a phonemic foil, and an unrelated foil. This task was performed under three conditions, baseline, during left carotid injection of sodium amytal, and during right carotid injection of sodium amytal. Overall, left hemisphere injection led to a significantly higher error rate than right hemisphere injection. However, consistent with lesion work, the majority (75%) of these errors were semantic in nature. These findings suggest that auditory comprehension deficits are predominantly semantic in nature, even following acute left hemisphere disruption. This, in turn, supports the hypothesis that the right hemisphere is capable of speech sound processing in the intact brain.     

Linguistic and neuropsychological deficits in crossed conduction aphasia. Report of three cases

This study describes the linguistic and neuropsychological findings in three right-handed patients with crossed conduction aphasia. Despite the location of the lesion in the right hemisphere, all patients displayed a combination of linguistic deficits typically found in conduction aphasia following analogous damage to the left hemisphere. Associated cognitive deficits varied across the three patients. In addition, all cases showed deficits classically attributed to non-dominant hemisphere damage (visuoperceptual deficits and reduced figural memory). As a result, lesion-behaviour relationships in our study sample indicate both dominant and non-dominant qualities of the right hemisphere.     

Alcoholism, aging, and functional cerebral asymmetries

Reviews research concerning the possible relationship between cognitive decline and abnormal hemispheric asymmetries in alcoholic and aging individuals. Because the deteriorative effects of alcoholism on the central nervous system have suggested greater visuospatial than language-related functional impairments, numerous investigators had hypothesized that right-hemisphere integrity may be selectively disrupted (rather than the left hemisphere). Furthermore, performance on diverse perceptual and cognitive tests used to measure right-hemisphere functions in alcoholics had been observed to decline with normal chronological aging as well, thereby raising the possibility that certain neuropsychological deficits associated with alcoholism (presumably related to right-hemispheric decline) are identical to those associated with aging. However, an extensive review of empirical research findings on cerebral asymmetries both in alcoholics and in aging individuals suggested that their patterns of functional laterality are similar to those of normal controls.     

The cost of action miscues: hemispheric asymmetries

Adaptive behaviors require preparation and when necessary inhibition or alteration of actions. The right hemisphere has been posited to be dominant for preparatory motor activation. This experiment was designed to learn if there are hemispheric asymmetries in the control of altered plans of actions. Cues, both valid and invalid, which indicate the hand most likely to be called onto respond, as well as the imperative stimuli that indicate the actual response hand, were presented to either the right or left visual fields of 14 normal right handed participants. The delay after a miscue is dependent on the time taken to inhibit the premotor and motor systems of the incorrectly activated hemisphere, as well as to activate the motor systems of the opposite hemisphere, which might have been interhemispherically inhibited by this miscue. Analyses of reaction times revealed that miscues presented in left hemispace (right hemisphere) cost more time than those miscues presented in right hemispace (left hemisphere), suggesting that activation of the preparatory systems controlled by the right hemisphere may take longer to reverse than those controlled by the left hemisphere. This asymmetry may be related to asymmetries in the strength of hemispheric activation with contralateral inhibition.     

Name and face matching in one or two visual fields: a test of models of hemispheric specialization

In two experiments a name and a face (each male or female) were simultaneously flashed to either the same or opposite visual fields (left or right), for matching congruent (same sex) or incongruent (opposite sex), to test the predictions of various models of hemispheric specialization. While overall best performance occurred with a face in the left visual field (LVF) and a name in the right visual field (RVF), and worst with the opposite configuration, the general pattern of results was incompatible with either a direct access model or an activational/attentional account. The results were, however, most compatible with the predictions of a semispecialized hemispheres account, whereby cerebral asymmetries are seen as relative rather than absolute, either hemisphere being capable of processing either kind of material (verbal or visuospatial), but to different levels of efficiency. However, despite the fact that the stimulus materials had previously been shown to produce stable and consistent lateral asymmetries in the predicted directions when presented in isolation, in the composite, integrative matching task the position of the name seemed to be the major determinant of the resultant asymmetries. It would seem therefore that when such stimuli are to be cross matched, either left hemisphere (language) processes somehow dominate right hemisphere (visuospatial) processing (though not in the way that would be predicted by a simple activational/attentional account) or the left hemisphere's greater capacity predominates.     

Lateralized interhemispheric transfer of color cues: evidence for dynamic coding principles of visual lateralization in pigeons

Visual feature discrimination tasks in pigeons reveal a right eye/left hemisphere dominance at the population level. Anatomical studies and lesion data show this visual lateralization to be related to asymmetries of the tectofugal system, which ascends from the tectum over the n. rotundus to the forebrain. Anatomically, this system is characterized by numerous morphological and connectional asymmetries which result in a bilateral visual representation in the dominant left hemisphere and a mostly contralateral representation in the subdominant right hemisphere. Ontogenetically, visual lateralization starts with an asymmetrical embryonic position within the egg, which leads to asymmetries of light stimulation. Differences in exposure to light stimulation between the eyes result in activity differences between the ascending tectofugal pathways of the left and the right hemisphere, which are transcribed during a critical time span into morphological asymmetries. The asymmetries established after this transient period finally start to determine the lateralized processes of the visual system for the entire life span of the individual. We now can show that these anatomical lateralizations are accompanied by asymmetries of interocular transfer, which enable a faster shift of learned color cues from the dominant right to the left eye than vice versa. In summary, our data provide evidence that cerebral asymmetries are based both on "static" anatomical and on "dynamic" process-dependent principles.     

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.     

Limb apraxia and motor performance

This study was desinged to determine if motor deficits in limb apraxia are task specific. Non-brain-damaged patients and apraxic and nonapraxic patients with left hemisphere damage performed language and limb apraxia tests and six motor tasks with the left hand. Contrary to previous data, no significant group differences occurred on a finger tapping task. Although task complexity or sequencing requirements affected group differences, greatest apraxic impairment was noted on a task of precise steadiness, but only when its response inhibition requirements were increased. This pattern of deficits appears to be associated with greater involvement of the premotor area in the apraxic group.     

Auditory evoked potentials and sex-related differences in brain development

Auditory evoked potentials (AEPs) were obtained to probe tones which were delivered during the presentation of complex verbal and nonverbal auditory stimulation to 3-month-old infants. Significant sex-dependent AEP amplitude asymmetries were found. Females produced higher-amplitude responses from the left hemisphere and males produced higher-amplitude responses from the right hemisphere during both the verbal and nonverbal presentations. No significant AEP asymmetries were obtained in an independent group of infants that received only the probe tones. These findings are consistent with theories and behavioral data suggesting differences between males and females in the development of language and spatial functions.     

卒中部位及局部脑血流量对智力的影响

用长谷川智力测定量表法测定了１８９例卒中患者的智力,分析了病变部位、脑萎缩及局部脑血流量（ｒＣＢＦ）对智力的影响．其中６９例患者长谷川分数低于２１．５分．当病变位于左半球时,属痴呆或可疑痴呆者达４２．９％;而病变位于右半球时,仅２３．１％属痴呆及可疑痴呆．ｒＣＢＦ与长谷川分数之间的相关分析显示：左额、右颞及左顶叶的ｒＣＢＦ与长谷川分数呈极显著正相关．提示左半球在智力活动中起主导作用．脑萎缩亦是影响智力的因素．     

Psychic tonus, body schema and the parietal lobes: a multiple lesion case analysis

The psychic tonus model (Braun and colleagues, 1999, 2002, 2003, 2006) states that the left hemisphere is a "booster" of internal experience and behavior in general, and that the right hemisphere is a "dampener". Twenty-five patients with a "positive" extreme disturbance of body schema (somatoparaphrenia) and 37 patients with a "negative" disturbance of body schema (autotopagnosia or Gerstmann's syndrome), all following a unilateral parietal lesion, were found in the literature and were analyzed to test predictions from Braun's "psychic tonus" model. As expected, patients with a positive syndrome had a right hemisphere lesion significantly more frequently, and those with a negative syndrome had a left hemisphere lesion significantly more frequently. Thus the psychic tonus model of hemispheric specialization, previously supported with regard to psychomotor baseline, libido, talkativeness, memory, auditory and visual perceptual tonus, now incorporates the tonus of representation of the body (body schema) in the parietal lobes.     

The role of the right hemisphere in the control of speech prosody in propositional and affective contexts

Sixteen right-handed adult males with localized insult to either the right or left hemisphere and five control subjects without brain damage read aloud target sentences embedded in paragraphs, while intoning their voices in either a declarative, interrogative, happy, or sad mode. Acoustical analysis of the speech wave was performed. Right-anterior (pre-Rolandic) and right-central (pre- and post-Rolandic) brain-damaged patients spoke with less pitch variation and restricted intonational range across emotional and nonemotional domains, while patients with right posterior (post-Rolandic) damage had exaggerated pitch variation and intonational range across both domains. No such deficits were found in patients with left posterior damage, whose prosody was similar to that of normal control subjects. It is suggested that damage to the right hemisphere alone may result in a primary disturbance of speech prosody that may be independent of the disturbances in affect often noted in right-brain-damaged populations.     

LATERALIZATION FOR FACIAL EMOTIONAL BEHAVIOR: A METHODOLOGICAL PERSPECTIVE*

Recent attention has focused upon the neuropsychological mechanisms underlying facial emotional expression. The greater intensity of expression and more extensive muscular involvement of the left hemiface have suggested right hemisphere dominance in the expression of emotion. This interpretation is based on the fact that the lower portion of the face is predominantly innervated by the contralateral cerebral hemisphere. The current paper reviews a series of studies on (a) facial asymmetry in normal subjects, (b) facial emotional expression in brain-damaged subjects with unilateral lesions, and (c) peripheral factors mediating facial expression findings. Neuropsychological mechanisms underlying emotional processing are also discussed. Our finding of left-sided facial asymmetries in normals is underscored by our finding that right brain-damaged patients are impaired in the expression of facial emotion. Finally, our studies have demonstrated that the asymmetries in normals and the deficits in patient populations are not artifacts of hemiface size and mobility or facial paralysis and apraxia. Taken together, these studies provide evidence that the right hemisphere is specialized for the expression of facial emotion.     

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.