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Ocklenburg S, Mundorf A, Gerrits R, Karlsson EM, Papadatou-Pastou M, Vingerhoets G. Clinical implications of brain asymmetries. Nat Rev Neurol 2024; 20:383-394. [PMID: 38783057 DOI: 10.1038/s41582-024-00974-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
No two human brains are alike, and with the rise of precision medicine in neurology, we are seeing an increased emphasis on understanding the individual variability in brain structure and function that renders every brain unique. Functional and structural brain asymmetries are a fundamental principle of brain organization, and recent research suggests substantial individual variability in these asymmetries that needs to be considered in clinical practice. In this Review, we provide an overview of brain asymmetries, variations in such asymmetries and their relevance in the clinical context. We review recent findings on brain asymmetries in neuropsychiatric and neurodevelopmental disorders, as well as in specific learning disabilities, with an emphasis on large-scale database studies and meta-analyses. We also highlight the relevance of asymmetries for disease symptom onset in neurodegenerative diseases and their implications for lateralized treatments, including brain stimulation. We conclude that alterations in brain asymmetry are not sufficiently specific to act as diagnostic biomarkers but can serve as meaningful symptom or treatment response biomarkers in certain contexts. On the basis of these insights, we provide several recommendations for neurological clinical practice.
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Affiliation(s)
- Sebastian Ocklenburg
- Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany.
- ICAN Institute for Cognitive and Affective Neuroscience, MSH Medical School Hamburg, Hamburg, Germany.
- Biopsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany.
| | - Annakarina Mundorf
- ISM Institute for Systems Medicine and Department of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
- Division of Cognitive Neuroscience, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robin Gerrits
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Emma M Karlsson
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Marietta Papadatou-Pastou
- National and Kapodistrian University of Athens, Athens, Greece
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Guy Vingerhoets
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
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Takahashi N, Kawamura M, Sato M, Kobayashi Y. A Case of Mirror-Image Crossed Thalamic Aphasia With Jargon Agraphia. Cureus 2024; 16:e60637. [PMID: 38903355 PMCID: PMC11187460 DOI: 10.7759/cureus.60637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2024] [Indexed: 06/22/2024] Open
Abstract
In right-handed individuals, aphasia resulting from right hemisphere damage is termed crossed aphasia and has a very low occurrence rate. Additionally, aphasia due to thalamic lesions often involves hemorrhage, with infarction cases less frequently reported. We present the case of an 81-year-old right-handed female who developed aphasia due to a right thalamic infarction. She exhibited characteristics typical of thalamic aphasia observed in left thalamic lesions. Furthermore, jargon agraphia manifested during writing tasks. This may suggest disinhibition of the left hemisphere writing motor memory by the right hemisphere language function.
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Affiliation(s)
- Nobuhiro Takahashi
- Department of Rehabilitation, Fukui Health Science University, Fukui, JPN
| | - Mimpei Kawamura
- Department of Medical Welfare, Kyoto Koka Women's University, Kyoto, JPN
| | - Mamiko Sato
- Department of Rehabilitation, Fukui Health Science University, Fukui, JPN
| | - Yasutaka Kobayashi
- Department of Rehabilitation, Fukui Health Science University, Fukui, JPN
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Ishihara K, Kakurai M, Endoh K, Kobayashi K, Asahi T. [A case of crossed aphasia following infarction in the right anterior cerebral artery territory]. Rinsho Shinkeigaku 2023:cn-001763. [PMID: 37394492 DOI: 10.5692/clinicalneurol.cn-001763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
We report a patient presenting with crossed aphasia following infarction in the territory of the right anterior cerebral artery (ACA). A right-handed 68-year-old woman without a history of correction had acute disturbance of consciousness, left hemiparesis predominant in the lower extremity, speech disorder and left unilateral spatial neglect during the admission due to hypertensive emergency. No other family member was left-handed. MRI of the head revealed acute phase infarction in the territory of the right ACA: mesial frontal lobe including the supplementary motor area, anterior cingulate gyrus, and the corpus callosum. Language symptoms in the subacute phase included difficulty in initiation, slow speech rate, loss of intonation and phonetic paraphasia, and accompanying errors in comprehension, repetition, reading, and writing letters. These symptoms suggested "anomalous" type crossed aphasia. No limb apraxia, construction disorder or left unilateral spatial neglect was observed in this period. Only a few cases of crossed aphasia due to infarction in the territory of the ACA have been reported so far. However, language and concomitant symptoms differs, depending on each case, suggesting a difference in individual cerebral lateralization.
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Affiliation(s)
- Kenji Ishihara
- Department of Neurology, Asahi Hospital of Neurology and Rehabilitation
| | - Misa Kakurai
- Department of Rehabilitation, Asahi Hospital of Neurology and Rehabilitation
| | - Keiko Endoh
- Department of Rehabilitation, Tohoku University Hospital
| | - Kazuhiko Kobayashi
- Department of Psychiatry, Asahi Hospital of Neurology and Rehabilitation
| | - Toshiomi Asahi
- Department of Neurology, Asahi Hospital of Neurology and Rehabilitation
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Bakhtiar M, Wong MN, Lam MW, McNeil MR. Reading and listening comprehension in Cantonese-speaking people with right hemisphere versus left hemisphere brain damage. CLINICAL LINGUISTICS & PHONETICS 2023; 37:567-582. [PMID: 36779905 DOI: 10.1080/02699206.2023.2176787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/28/2022] [Accepted: 01/26/2023] [Indexed: 05/20/2023]
Abstract
The problem in language comprehension in people with right hemisphere damage (RHD) is more equivocal than people with left hemisphere damage. This study explores the reading and listening comprehension of Cantonese-speaking individuals with RHD, left hemisphere damage, and neurotypical healthy controls using the Cantonese Computerized Revised Token Test (CRTT-Cantonese) adapted from the English CRTT. Eighteen native Cantonese-speaking individuals with RHD, 32 individuals with left hemisphere damage and aphasia (PWA), and 42 healthy controls participated in this study. All the participants completed the Cantonese Aphasia Battery, Hong Kong Oxford Cognitive Screen, the listening comprehension version of CRTT-Cantonese (CRTT-L-Cantonese), and the reading comprehension version of CRTT-Cantonese (CRTT-R-WF-Cantonese) across different sessions. Linear mixed-effect analysis revealed significant differences among the groups in CRTT-Cantonese tests. However, there were no significant difference between CRTT-L-Cantonese and CRTT-R-WF-Cantonese within the PWA, RHD and healthy control groups. Tukey post-hoc pairwise comparisons showed that PWA scored significantly lower than RHD and healthy control groups (p < 0.0001) in both CRTT-L-Cantonese and CRTT-R-WF-Cantonese, and the RHD group scored significantly lower than healthy control group only on the CRTT-R-WF-Cantonese. The results demonstrate that the CRTT-L-Cantonese and CRTT-R-WF-Cantonese differentiate language comprehension abilities among PWA, RHD and healthy control groups. Although the current findings did not show any diversion between reading and listening comprehension in RHD group, this group showed poorer performance in reading comprehension when compared to healthy controls. The latter findings may support the view that the right hemisphere contributes to reading comprehension in Chinese.
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Affiliation(s)
- Mehdi Bakhtiar
- Unit of Human Communication, Development and Information Sciences, The University of Hong Kong, Pokfulam, Hong Kong
| | - Min Ney Wong
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Research Centre for Language, Cognition, and Neuroscience, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Ming Wai Lam
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Malcolm R McNeil
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, USA
- Geriatric Research Education Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
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Buklina SB, Kaftanov AN, Melikyan AG, Kopachev DN, Batalov AI. [Crossed aphasia in neurosurgical practice: case report and literature review]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2022; 86:103-111. [PMID: 35170283 DOI: 10.17116/neiro202286011103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Crossed aphasia in dexstral (CAD) is an extremely rare disorder. To date, about 200 cases have been described in the literature. MATERIAL AND METHODS The authors report 4 cases of CAD. Luria's neuropsychological examination was carried out. Functional asymmetry in the arm was analyzed using the Annett questionnaire. MRI and intraoperative findings confirmed localization of lesion in the right hemisphere in all patients. RESULTS A 59-year-old right-handed man developed frontotemporal aphasia after previous resection of right-sided glioblastoma of fronto-insular-temporal region. In a 31-year-old right-handed man, crossed aphasia occurred after extensive hemorrhage from arteriovenous malformation into the right frontotemporoparietal region. A 39-year-old right-handed man developed severe combined aphasia after resection of diffuse glioma of the right insular-temporal region. A 10-year-old right-handed boy developed aphasia with word forgetting after resection of a large tumor of the right temporal lobe. All patients had impaired dynamic praxis. Other cognitive functions were intact. CONCLUSION The authors discuss possible combinations of functions in one hemisphere for both right-handers and left-handers and emphasize diverse types of functional asymmetries described in the literature. Different localizations of functions in right-handers and left-handers indicate that local zones with different methods of information processing (successive or simultaneous) can coexist in one hemisphere. Therefore, the functions requiring different processing of information (for example, speech with praxis or spatial functions) can develop in one hemisphere. Cognitive impairment depends not only on the type of functional asymmetry, but also on localization of lesion. Crossed aphasia in right-handers indicates the rarest normal type of functional brain asymmetry with localization of speech functions in the right hemisphere. Possible aphasia in right-handers following damage to homologues of speech zones in the right hemisphere can require additional examination of these patients.
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Affiliation(s)
- S B Buklina
- Burdenko Neurosurgical Center, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | | | | | | | - A I Batalov
- Burdenko Neurosurgical Center, Moscow, Russia
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Bonkhoff AK, Lim JS, Bae HJ, Weaver NA, Kuijf HJ, Biesbroek JM, Rost NS, Bzdok D. Generative lesion pattern decomposition of cognitive impairment after stroke. Brain Commun 2021; 3:fcab110. [PMID: 34189457 PMCID: PMC8233115 DOI: 10.1093/braincomms/fcab110] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/21/2021] [Accepted: 05/20/2021] [Indexed: 01/28/2023] Open
Abstract
Cognitive impairment is a frequent and disabling sequela of stroke. There is however incomplete understanding of how lesion topographies in the left and right cerebral hemisphere brain interact to cause distinct cognitive deficits. We integrated machine learning and Bayesian hierarchical modelling to enable a hemisphere-aware analysis of 1080 acute ischaemic stroke patients with deep profiling ∼3 months after stroke. We show the relevance of the left hemisphere in the prediction of language and memory assessments and relevance of the right hemisphere in the prediction of visuospatial functioning. Global cognitive impairments were equally well predicted by lesion topographies from both sides. Damage to the hippocampal and occipital regions on the left was particularly informative about lost naming and memory functions, while damage to these regions on the right was linked to lost visuospatial functioning. Global cognitive impairment was predominantly linked to lesioned tissue in the supramarginal and angular gyrus, the post-central gyrus as well as the lateral occipital and opercular cortices of the left hemisphere. Hence, our analysis strategy uncovered that lesion patterns with unique hemispheric distributions are characteristic of how cognitive capacity is lost due to ischaemic brain tissue damage.
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Affiliation(s)
- Anna K Bonkhoff
- Department of Neurology, J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, MA, Boston, USA
| | - Jae-Sung Lim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Hee-Joon Bae
- Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Nick A Weaver
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands
| | - J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Natalia S Rost
- Department of Neurology, J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, MA, Boston, USA
| | - Danilo Bzdok
- Department of Biomedical Engineering, McConnell Brain Imaging Centre, Montreal Neurological Institute, Faculty of Medicine, School of Computer Science, McGill University, Montreal, Canada.,Mila-Quebec Artificial Intelligence Institute, Montreal, Canada
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Abstract
While paying attention to the recommendations of Ocklenburg, Berretz, Packheiser, and Friedrich (2020) in the target article, researchers in the field of laterality should attempt to: (1) solve the long-standing puzzle of the relationship between handedness and language lateralization; (2) further explore the genetic bases of manual and cerebral asymmetry and of their associations with psychiatric and neurodevelopmental conditions; (3) explore the adaptive significance of laterality for humans and non-humans and elucidate the relationships of asymmetry across species; and (4) embrace developing technologies to investigate the interaction between the hemispheres during the performance of everyday tasks.
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Affiliation(s)
- Alan A Beaton
- Department of Psychology, School of Human & Health Sciences, Swansea University, Swansea, UK.,Department of Psychology, Aberystwyth University, Aberystwyth, UK
| | - Gareth Richards
- School of Psychology, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Labache L, Mazoyer B, Joliot M, Crivello F, Hesling I, Tzourio-Mazoyer N. Typical and atypical language brain organization based on intrinsic connectivity and multitask functional asymmetries. eLife 2020; 9:e58722. [PMID: 33064079 PMCID: PMC7605859 DOI: 10.7554/elife.58722] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/16/2020] [Indexed: 01/23/2023] Open
Abstract
Based on the joint investigation in 287 healthy volunteers (150 left-Handers (LH)) of language task-induced asymmetries and intrinsic connectivity strength of the sentence-processing supramodal network, we show that individuals with atypical rightward language lateralization (N = 30, 25 LH) do not rely on an organization that simply mirrors that of typical leftward lateralized individuals. Actually, the resting-state organization in the atypicals showed that their sentence processing was underpinned by left and right networks both wired for language processing and highly interacting by strong interhemispheric intrinsic connectivity and larger corpus callosum volume. Such a loose hemispheric specialization for language permits the hosting of language in either the left and/or right hemisphere as assessed by a very high incidence of dissociations across various language task-induced asymmetries in this group.
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Affiliation(s)
- Loïc Labache
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CNRS, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CEA, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- Université de Bordeaux, Institut de Mathématiques de Bordeaux, UMR 5251BordeauxFrance
- Bordeaux INP, Institut de Mathématiques de Bordeaux, UMR 5251BordeauxFrance
- INRIA Bordeaux Sud-Ouest, Institut de Mathématiques de Bordeaux, UMR 5251, Contrôle de Qualité et Fiabilité DynamiqueTalenceFrance
| | - Bernard Mazoyer
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CNRS, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CEA, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- Centre Hospitalier Universitaire de BordeauxBordeauxFrance
| | - Marc Joliot
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CNRS, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CEA, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
| | - Fabrice Crivello
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CNRS, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CEA, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
| | - Isabelle Hesling
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CNRS, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CEA, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
| | - Nathalie Tzourio-Mazoyer
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CNRS, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
- CEA, Institut des Maladies Neurodégéneratives, UMR 5293, Groupe d’Imagerie NeurofonctionnelleBordeauxFrance
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Torrisi M, Pollicino P, Corallo F, Vermiglio G, Logiudice AL, Mantarro C, Calabrò C, Bramanti P, Calabrò RS, Morabito R, Marino S. A case report on crossed aphasia in dextrals: Consideration about clinical features and neural network. Medicine (Baltimore) 2019; 98:e17660. [PMID: 31651891 PMCID: PMC6824653 DOI: 10.1097/md.0000000000017660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE The term crossed aphasia in dextrals (CAD) describes aphasia following a right hemisphere lesion in right-handed subjects. The diagnostic criteria for CAD, defined on the basis of clinical cases observed over the years, are aphasia; lesion in right hemisphere; strong preference for right hand use without familial history of left handedness; structural integrity of left hemisphere; and absence of brain damage in childhood. The studies of CAD have mainly been focused on the neurobiological mechanisms underlying the functional neurocognitive lateralization and organization of the brain, such as a dissociation between language and handedness, language and praxis, or other cognitive functions.Patient concerns: We described a case of a patient affected by an aphasic syndrome following cerebral hemorrhage located in right hemisphere. DIAGNOSIS Considering the correlation between clinical data and instrumental investigations such as magnetic resonance imaging, we diagnose the patient with non-fluent aphasia. Specifically, the patient came to our attention showing a trans-cortical mixed aphasia that, later, developed in a trans-cortical motor aphasia. Contrary to most cases of CAD, our patient does not show apraxia and visuo-spatial neglect. Interventions language and visual attention when latter functions are related to right hemisphere. INTERVENTIONS The rehabilitation program consisted in exercises stimulating verbal fluency, comprehension, reading, and writing. OUTCOMES After 5 months of rehabilitation patient showed significant improvement in comprehension and absence of echolalia. LESSONS At present there is no agreement about pathogenesis of CAD and neural mechanism is still unclear. Considering the clinical symptomatology, we can argue that we observed a non-fluent aphasia. However, a more large sample should be studied to asses the role of brain circuits.
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Gajardo-Vidal A, Lorca-Puls DL, Hope TMH, Parker Jones O, Seghier ML, Prejawa S, Crinion JT, Leff AP, Green DW, Price CJ. How right hemisphere damage after stroke can impair speech comprehension. Brain 2019; 141:3389-3404. [PMID: 30418586 PMCID: PMC6262220 DOI: 10.1093/brain/awy270] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 09/12/2018] [Indexed: 12/17/2022] Open
Abstract
Acquired language disorders after stroke are strongly associated with left hemisphere damage. When language difficulties are observed in the context of right hemisphere strokes, patients are usually considered to have atypical functional anatomy. By systematically integrating behavioural and lesion data from brain damaged patients with functional MRI data from neurologically normal participants, we investigated when and why right hemisphere strokes cause language disorders. Experiment 1 studied right-handed patients with unilateral strokes that damaged the right (n = 109) or left (n = 369) hemispheres. The most frequently impaired language task was: auditory sentence-to-picture matching after right hemisphere strokes; and spoken picture description after left hemisphere strokes. For those with auditory sentence-to-picture matching impairments after right hemisphere strokes, the majority (n = 9) had normal performance on tests of perceptual (visual or auditory) and linguistic (semantic, phonological or syntactic) processing. Experiment 2 found that these nine patients had significantly more damage to dorsal parts of the superior longitudinal fasciculus and the right inferior frontal sulcus compared to 75 other patients who also had right hemisphere strokes but were not impaired on the auditory sentence-to-picture matching task. Damage to these right hemisphere regions caused long-term speech comprehension difficulties in 67% of patients. Experiments 3 and 4 used functional MRI in two groups of 25 neurologically normal individuals to show that within the regions identified by Experiment 2, the right inferior frontal sulcus was normally activated by (i) auditory sentence-to-picture matching; and (ii) one-back matching when the demands on linguistic and non-linguistic working memory were high. Together, these experiments demonstrate that the right inferior frontal cortex contributes to linguistic and non-linguistic working memory capacity (executive function) that is needed for normal speech comprehension. Our results link previously unrelated literatures on the role of the right inferior frontal cortex in executive processing and the role of executive processing in sentence comprehension; which in turn helps to explain why right inferior frontal activity has previously been reported to increase during recovery of language function after left hemisphere stroke. The clinical relevance of our findings is that the detrimental effect of right hemisphere strokes on language is (i) much greater than expected; (ii) frequently observed after damage to the right inferior frontal sulcus; (iii) task dependent; (iv) different to the type of impairments observed after left hemisphere strokes; and (v) can result in long-lasting deficits that are (vi) not the consequence of atypical language lateralization.
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Affiliation(s)
- Andrea Gajardo-Vidal
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK.,Faculty of Health Sciences, Universidad del Desarrollo, Concepcion, Chile
| | - Diego L Lorca-Puls
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Thomas M H Hope
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | | | - Mohamed L Seghier
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK.,Cognitive Neuroimaging Unit, Emirates College for Advanced Education, Abu Dhabi, UAE
| | - Susan Prejawa
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Jennifer T Crinion
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Alex P Leff
- Institute of Cognitive Neuroscience, University College London, London, UK.,Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - David W Green
- Experimental Psychology, Faculty of Brain Sciences, University College London, London, UK
| | - Cathy J Price
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
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Kim J, Park J, Kang HH, Bang OY. Atypical clinical presentations in right hemispheric infarcts: complex stories beyond neurological examination and diffusion-weighted magnetic resonance imaging. PRECISION AND FUTURE MEDICINE 2018. [DOI: 10.23838/pfm.2018.00093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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13
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Crossed aphasia following cerebral infarction in a right-handed patient with atypical cerebral language dominance. J Neurol 2018; 265:1671-1675. [PMID: 29777360 DOI: 10.1007/s00415-018-8901-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 04/25/2018] [Accepted: 05/05/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVE Crossed aphasia (CA), usually referred to as an acquired language disturbance, is caused by a lesion in the cerebral hemisphere ipsilateral to the dominant hand, and the exact mechanism is not clear. The development of handedness is influenced by education and training and the impact of habitualization, while language is more susceptible to the impact of speech habits, and it is not absolutely accurate to judge cerebral language dominance by the degree of hand preference. METHODS We describe a case of CA after right hemispheric stroke in a right-handed patient with atypical language dominance and attempt to analyze the mechanism of CA based on functional imaging methods, including arterial spin labeling (ASL) and positron emission tomography/magnetic resonance imaging (PET-MRI). RESULTS Brain MRI at 24 h after admission showed a large cerebral infarction in the right cerebral hemisphere, including the posteroinferior part of Broca's area in the right frontal lobe, the right temporal lobe, and the right occipital lobe. The patient exhibited a non-fluent aphasia on a standard language test (the Aphasia Battery of Chinese [ABC]) performed on the 7th day after onset. Thus, atypical language dominance was suspected. One week after admission, ASL imaging showed high perfusion in the infarct core zone and low perfusion in the left cerebellar hemisphere. Two months later, PET/MRI demonstrated low metabolism in the posterior frontal lobe, temporal lobe, temporal occipital junction area, and the right basal ganglia. CONCLUSION The findings suggest that the patient has right-sided cerebral language dominance, or that both hemispheres have linguistic functions. Not all patients show linguistic capabilities on the side opposite hand preference. The language dominance should be predicted by a combination of clinical manifestations and functional imaging techniques.
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Kasselimis D, Potagas C, Simos P, Evdokimidis I, Whitaker H. Mixed language dominance: insights from a case of unexpected fluent aphasia with semantic jargon resulting from massive left perisylvian lesion. Neurocase 2018; 24:10-15. [PMID: 29277135 DOI: 10.1080/13554794.2017.1420805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We report a right-handed patient with a massive lesion in left perisylvian language cortex, who unexpectedly presented with fluent aphasia with semantic jargon. Language deficits were assessed with a comprehensive battery of language tests. Comprehension, naming, reading, and writing were severely impaired, and verbal expression was moderately fluent with semantic jargon. Although the patient's lesion included brain areas typically essential for motor speech coordination, he was neither nonfluent nor apraxic. He exhibited strikingly unexpected aphasia with semantic jargon and prominent comprehension deficits, suggesting that this is a case of mixed dominance: the right hemisphere likely controls motor speech and basic syntactic skills, while the severely damaged left hemisphere controls semantic processing, predictably severely impaired.
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Affiliation(s)
- Dimitrios Kasselimis
- a Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece.,b Department of Psychiatry, School of Medicine , University of Crete , Crete , Greece
| | - Constantin Potagas
- a Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Panagiotis Simos
- b Department of Psychiatry, School of Medicine , University of Crete , Crete , Greece.,c Institute of Computer Science, Computational Biomedicine Laboratory , Foundation for Research and Technology , Heraklion , Greece
| | - Ioannis Evdokimidis
- a Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Harry Whitaker
- d Department of Psychology , Northern Michigan University , Marquette , MI , USA
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Pseudoneglect in line bisection judgement is associated with a modulation of right hemispheric spatial attention dominance in right-handers. Neuropsychologia 2017; 94:75-83. [DOI: 10.1016/j.neuropsychologia.2016.11.024] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 02/05/2023]
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Abstract
Aphasia is a rare sign of multiple sclerosis (MS). Several different forms of aphasia have been reported in MS. We report, to our knowledge, the first case of a MS patient with crossed aphasia during an attack.
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Affiliation(s)
- M Demirkiran
- Department of Neurology, School of Medicine, Cukurova University, Adana, Turkey.
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17
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Lee B, Moon HI, Lim SH, Cho H, Choi H, Pyun SB. Recovery of language function in Korean-Japanese crossed bilingual aphasia following right basal ganglia hemorrhage. Neurocase 2016; 22:300-5. [PMID: 26853846 DOI: 10.1080/13554794.2016.1141966] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Few studies have investigated language recovery patterns and the mechanisms of crossed bilingual aphasia following a subcortical stroke. In particular, Korean-Japanese crossed bilingual aphasia has not been reported. A 47-year-old, right-handed man was diagnosed with an extensive right basal ganglia hemorrhage. He was bilingual, fluent in both Korean and Japanese. After his stroke, the patient presented with crossed aphasia. We investigated changes in the Korean (L1) and Japanese (L2) language recovery patterns. Both Korean and Japanese versions of the Western Aphasia Battery (WAB) were completed one month after the stroke, and functional magnetic resonance imaging (fMRI) was performed using picture-naming tasks. The WAB showed a paradoxical pattern of bilingual aphasia, with an aphasia quotient (AQ) of 32 for Korean and 50.6 for Japanese, with Broca's aphasia. The patient scored better in the Japanese version of all domains of the tests. The fMRI study showed left lateralized activation in both language tasks, especially in the inferior frontal gyrus. After six months of language therapy targeting L1, the Korean-WAB score improved significantly, while the Japanese-WAB score showed slight improvement. In this case, the subcortical lesion contributed to crossed bilingual aphasia more highly affecting L1 due to loss of the cortico-subcortical control mechanism in the dominant hemisphere. The paradoxical pattern of bilingual aphasia disappeared after lengthy language therapy targeting L1, and the therapy effect did not transfer to L2. Language recovery in L1 might have been accomplished by reintegrating language networks, including the contralesional language homologue area in the left hemisphere.
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Affiliation(s)
- Boram Lee
- a Department of Physical Medicine and Rehabilitation , Korea University College of Medicine , Seoul , Korea
| | - Hyun Im Moon
- a Department of Physical Medicine and Rehabilitation , Korea University College of Medicine , Seoul , Korea
| | - Sung Hee Lim
- a Department of Physical Medicine and Rehabilitation , Korea University College of Medicine , Seoul , Korea
| | - Hyesuk Cho
- b Wisdom Science Center , Korea University , Seoul , South Korea
| | - Hyunjoo Choi
- c Department of Communication Disorders , Korea Nazarene University , Cheonan , Korea
| | - Sung-Bom Pyun
- a Department of Physical Medicine and Rehabilitation , Korea University College of Medicine , Seoul , Korea.,d Brain Convergence Research Center , Korea University Hospital , Seoul , Korea
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18
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Spinelli EG, Caso F, Agosta F, Gambina G, Magnani G, Canu E, Blasi V, Perani D, Comi G, Falini A, Gorno-Tempini ML, Filippi M. A multimodal neuroimaging study of a case of crossed nonfluent/agrammatic primary progressive aphasia. J Neurol 2015; 262:2336-45. [PMID: 26194195 DOI: 10.1007/s00415-015-7845-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/30/2015] [Accepted: 07/01/2015] [Indexed: 11/21/2022]
Abstract
Crossed aphasia has been reported mainly as post-stroke aphasia resulting from brain damage ipsilateral to the dominant right hand. Here, we described a case of a crossed nonfluent/agrammatic primary progressive aphasia (nfvPPA), who developed a corticobasal syndrome (CBS). We collected clinical, cognitive, and neuroimaging data for four consecutive years from a 55-year-old right-handed lady (JV) presenting with speech disturbances. 18-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) and DaT-scan with (123)I-Ioflupane were obtained. Functional MRI (fMRI) during a verb naming task was acquired to characterize patterns of language lateralization. Diffusion tensor MRI was used to evaluate white matter damage within the language network. At onset, JV presented with prominent speech output impairment and right frontal atrophy. After 3 years, language deficits worsened, with the occurrence of a mild agrammatism. The patient also developed a left-sided mild extrapyramidal bradykinetic-rigid syndrome. The clinical picture was suggestive of nfvPPA with mild left-sided extrapyramidal syndrome. At this time, voxel-wise SPM analyses of (18)F-FDG PET and structural MRI showed right greater than left frontal hypometabolism and damage, which included the Broca's area. DaT-scan showed a reduced uptake in the right striatum. FMRI during naming task demonstrated bilateral language activations, and tractography showed right superior longitudinal fasciculus (SLF) involvement. Over the following year, JV became mute and developed frank left-sided motor signs and symptoms, evolving into a CBS clinical picture. Brain atrophy worsened in frontal areas bilaterally, and extended to temporo-parietal regions, still with a right-sided asymmetry. Tractography showed an extension of damage to the left SLF and right inferior longitudinal fasciculus. We report a case of crossed nfvPPA followed longitudinally and studied with advanced neuroimaging techniques. The results highlight a complex interaction between individual premorbid developmental differences and the clinical phenotype.
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Affiliation(s)
- Edoardo G Spinelli
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesca Caso
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy
| | - Giuseppe Gambina
- SSO Centro Alzheimer e Disturbi Cognitivi, DAI di Neuroscienze, UOC di Neurologia d.O., Azienda Ospedaliera Integrata Verona, Verona, Italy
| | - Giuseppe Magnani
- Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy
| | - Valeria Blasi
- Department of Neuroradiology and CERMAC, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Daniela Perani
- Nuclear Medicine Unit, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Falini
- Department of Neuroradiology and CERMAC, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy. .,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
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Matute E, Ardila A, Rosselli M, Molina Del Rio J, López Elizalde R, López M, Ontiveros A. Crossed-brain representation of verbal and nonverbal functions. Case Rep Neurol Med 2015; 2015:301297. [PMID: 25802778 PMCID: PMC4329825 DOI: 10.1155/2015/301297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 01/12/2015] [Indexed: 11/17/2022] Open
Abstract
A 74-year-old, left-handed man presented with a rapidly evolving loss of strength in his right leg associated with difficulty in walking. MR images disclosed an extensive left hemisphere tumor. A neuropsychological examination revealed that language was broadly normal but that the patient presented with severe nonlinguistic abnormalities, including hemineglect (both somatic and spatial), constructional defects, and general spatial disturbances; symptoms were usually associated with right hemisphere pathologies. No ideomotor apraxia was found. The implications of crossed-brain representations of verbal and nonverbal functions are analyzed.
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Affiliation(s)
| | | | | | | | | | - Manuel López
- Hospital Civil de Guadalajara Juan I. Menchaca, Guadalajara, JAL, Mexico
| | - Angel Ontiveros
- Hospital Civil de Guadalajara Juan I. Menchaca, Guadalajara, JAL, Mexico
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20
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Carey DP, Johnstone LT. Quantifying cerebral asymmetries for language in dextrals and adextrals with random-effects meta analysis. Front Psychol 2014; 5:1128. [PMID: 25408673 PMCID: PMC4219560 DOI: 10.3389/fpsyg.2014.01128] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 09/16/2014] [Indexed: 12/31/2022] Open
Abstract
Speech and language-related functions tend to depend on the left hemisphere more than the right in most right-handed (dextral) participants. This relationship is less clear in non-right handed (adextral) people, resulting in surprisingly polarized opinion on whether or not they are as lateralized as right handers. The present analysis investigates this issue by largely ignoring methodological differences between the different neuroscientific approaches to language lateralization, as well as discrepancies in how dextral and adextral participants were recruited or defined. Here we evaluate the tendency for dextrals to be more left hemisphere dominant than adextrals, using random effects meta analyses. In spite of several limitations, including sample size (in the adextrals in particular), missing details on proportions of groups who show directional effects in many experiments, and so on, the different paradigms all point to proportionally increased left hemispheric dominance in the dextrals. These results are analyzed in light of the theoretical importance of these subtle differences for understanding the cognitive neuroscience of language, as well as the unusual asymmetry in most adextrals.
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Affiliation(s)
- David P Carey
- Perception, Action and Memory Research Group, School of Psychology, Bangor University Bangor, UK
| | - Leah T Johnstone
- Perception, Action and Memory Research Group, School of Psychology, Bangor University Bangor, UK
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Jeong EH, Lee YJ, Kwon M, Kim JS, Na DL, Lee JH. Agrammatic primary progressive aphasia in two dextral patients with right hemispheric involvement. Neurocase 2014; 20:46-52. [PMID: 23058062 DOI: 10.1080/13554794.2012.732084] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Agrammatic primary progressive aphasia (PPA-G) has been known to be associated with focal brain atrophy involving the left posterior frontal and anterior insular regions. However, aphasia can also rarely result from right hemispheric lesions in right-handed patients, so-called crossed aphasia in dextrals (CAD). We report two right-handed patients with PPA-G whose 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) showed hypometabolism predominantly in the right hemisphere, implicating "crossed PPA-G."
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Affiliation(s)
- Eun Hye Jeong
- a Department of Neurology , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Republic of Korea
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23
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Múnera CP, Lomlomdjian C, Solis P, Medel N, Seoane E, Kochen S. Crossed aphasia after right anterior temporal lobectomy. A case report. Epilepsy Behav 2012; 25:125-8. [PMID: 22819142 DOI: 10.1016/j.yebeh.2012.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 05/12/2012] [Accepted: 05/15/2012] [Indexed: 10/28/2022]
Abstract
The occurrence of crossed aphasia as a complication after temporal lobe epilepsy surgery is extremely rare. We report the case of a 47-year-old right-handed patient with drug-resistant mesial temporal lobe epilepsy (MTLE) who developed a transitory aphasic syndrome after a right temporal anterior lobectomy. This syndrome was characterized by anomia, poor verbal fluency, verbal perseveration, and verbal comprehension difficulties. He also showed writing difficulties, reading substitutions, and calculation task errors. The patient was regularly assessed with language tasks, and showed a spontaneous and progressive recovery of his symptoms, with remaining naming difficulties. We discuss the role that epileptogenic zone could play in cortical reorganization of the language systems.
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Affiliation(s)
- C P Múnera
- Epilepsy Centre, Neurology Div., Ramos Mejía Hospital, Buenos Aires, Argentina.
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24
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Drane DL, Roraback-Carson J, Hebb AO, Hersonskey T, Lucas T, Ojemann GA, Lettich E, Silbergeld DL, Miller JW, Ojemann JG. Cortical stimulation mapping and Wada results demonstrate a normal variant of right hemisphere language organization. Epilepsia 2012; 53:1790-8. [PMID: 22780099 DOI: 10.1111/j.1528-1167.2012.03573.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Exclusive right hemisphere language lateralization is rarely observed in the Wada angiography results of epilepsy surgery patients. Cortical stimulation mapping (CSM) is infrequently performed in such patients, as most undergo nondominant left hemisphere resections, which are presumed not to pose any risk to language. Early language reorganization is typically assumed in such individuals, taking left hemisphere epileptiform activity as confirmation of change resulting from a pathologic process. We present data from CSM and Wada studies demonstrating that right hemisphere language occurs in the absence of left hemisphere pathology, suggesting it can exist as a normal, but rare variant, in some individuals. Furthermore, these data confirm the Wada test findings of atypical dominance. METHODS Cortical stimulation mapping data were examined for all right hemisphere surgical patients with right hemisphere speech at our center between 1974 and 2006. Of 1,209 interpretable Wada procedures, 89 patients (7.4%) had exclusive right hemisphere speech, and 21 (1.7%) of these patients underwent surgery involving the right hemisphere. Language site location was determined by examining intraoperative photographs, and site distribution was statistically compared to published findings from left hemisphere language dominant patients. KEY FINDINGS Language cortex was identified in the right hemisphere during CSM for all patients with available data. All sites could be classified in superior or middle temporal gyri, inferior parietal lobe, or inferior frontal gyrus, all of which were common zones where language was identified in the left hemisphere dominant comparison sample. SIGNIFICANCE Results suggest that the Wada procedure is a valid measure for identifying right hemisphere language processing without any false lateralization found in the patients mapped with CSM (i.e., a positive Wada is 100% sensitive for finding right hemisphere language sites), and that the distribution of language sites is consistent across right hemisphere and left hemisphere language dominant patients, supporting the theory that right hemisphere language can occur as a normal variant of language lateralization.
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Affiliation(s)
- Daniel L Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.
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25
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Abstract
PURPOSE The lateralization of cognitive functions in crossed aphasia in dextrals (CAD) has been explored and compared mainly with cases of aphasia with left hemisphere damage. However, comparing the neuropsychological aspects of CAD and aphasia after right brain damage in left-handers (ARL) could potentially provide more insights into the effect of a shift in the laterality of handedness or language on other cognitive organization. Thus, this case study compared two cases of CAD and one case of ARL. MATERIALS AND METHODS The following neuropsychological measures were obtained from three aphasic patients with right brain damage (two cases of CAD and one case of ARL); language, oral and limb praxis, and nonverbal cognitive functions (visuospatial neglect and visuospatial construction). RESULTS All three patients showed impaired visuoconstructional abilities, whereas each patient showed a different level of performances for oral and limb praxis, and visuospatial neglect. CONCLUSION Based on the analysis of these three aphasic patients' performances, we highlighted the lateralization of language, handedness, oral and limb praxis, visuospatial neglect and visuospatial constructive ability in aphasic patients with right brain damage.
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Affiliation(s)
- Ji-Wan Ha
- Department of Speech Pathology, Daegu University, Gyeongsan, Korea
- The Geriatric Health Clinic and Research Institute (GHCRI), Korea University, Seoul, Korea
| | - Sung-Bom Pyun
- Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Seoul, Korea
| | - Yu Mi Hwang
- Department of English Language, Interpretation & Translation, Dongguk University, Seoul, Korea
| | - Hyunsub Sim
- Department of Communication Disorders, Ewha Womans University, Seoul, Korea
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Roby-Brami A, Hermsdörfer J, Roy AC, Jacobs S. A neuropsychological perspective on the link between language and praxis in modern humans. Philos Trans R Soc Lond B Biol Sci 2012; 367:144-60. [PMID: 22106433 DOI: 10.1098/rstb.2011.0122] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Hypotheses about the emergence of human cognitive abilities postulate strong evolutionary links between language and praxis, including the possibility that language was originally gestural. The present review considers functional and neuroanatomical links between language and praxis in brain-damaged patients with aphasia and/or apraxia. The neural systems supporting these functions are predominantly located in the left hemisphere. There are many parallels between action and language for recognition, imitation and gestural communication suggesting that they rely partially on large, common networks, differentially recruited depending on the nature of the task. However, this relationship is not unequivocal and the production and understanding of gestural communication are dependent on the context in apraxic patients and remains to be clarified in aphasic patients. The phonological, semantic and syntactic levels of language seem to share some common cognitive resources with the praxic system. In conclusion, neuropsychological observations do not allow support or rejection of the hypothesis that gestural communication may have constituted an evolutionary link between tool use and language. Rather they suggest that the complexity of human behaviour is based on large interconnected networks and on the evolution of specific properties within strategic areas of the left cerebral hemisphere.
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Affiliation(s)
- Agnes Roby-Brami
- Laboratory of Neurophysics and Physiology, University Paris Descartes, CNRS UMR 8119, 45 rue des Saints Pères, 75006 Paris, France.
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27
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Kim KK, Karunanayaka P, Privitera MD, Holland SK, Szaflarski JP. Semantic association investigated with functional MRI and independent component analysis. Epilepsy Behav 2011; 20:613-22. [PMID: 21296027 PMCID: PMC3078943 DOI: 10.1016/j.yebeh.2010.11.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 11/14/2010] [Accepted: 11/15/2010] [Indexed: 11/29/2022]
Abstract
Semantic association, an essential element of human language, enables discourse and inference. Neuroimaging studies have revealed localization and lateralization of semantic circuitry, making substantial contributions to cognitive neuroscience. However, because of methodological limitations, these investigations have only identified individual functional components rather than capturing the behavior of the entire network. To overcome these limitations, we have implemented group independent component analysis (ICA) to investigate the cognitive modules used by healthy adults performing the fMRI semantic decision task. When compared with the results of a standard general linear modeling (GLM) analysis, ICA detected several additional brain regions subserving semantic decision. Eight task-related group ICA maps were identified, including left inferior frontal gyrus (BA44/45), middle posterior temporal gyrus (BA39/22), angular gyrus/inferior parietal lobule (BA39/40), posterior cingulate (BA30), bilateral lingual gyrus (BA18/23), inferior frontal gyrus (L>R, BA47), hippocampus with parahippocampal gyrus (L>R, BA35/36), and anterior cingulate (BA32/24). Although most of the components were represented bilaterally, we found a single, highly left-lateralized component that included the inferior frontal gyrus and the medial and superior temporal gyri, the angular and supramarginal gyri, and the inferior parietal cortex. The presence of these spatially independent ICA components implies functional connectivity and can be equated with their modularity. These results are analyzed and presented in the framework of a biologically plausible theoretical model in preparation for similar analyses in patients with right- or left-hemispheric epilepsies.
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Affiliation(s)
- Kwang Ki Kim
- Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
| | - Prasanna Karunanayaka
- Pediatric Neuroimaging Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Michael D. Privitera
- Cincinnati Epilepsy Center, University of Cincinnati, Cincinnati, OH, USA
- Center for Imaging Research, University of Cincinnati, Cincinnati, OH, USA
| | - Scott K. Holland
- Pediatric Neuroimaging Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Radiology, Cincinnati Children#x02019;s Hospital Medical Center, Cincinnati, OH, USA
| | - Jerzy P. Szaflarski
- Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
- Pediatric Neuroimaging Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Cincinnati Epilepsy Center, University of Cincinnati, Cincinnati, OH, USA
- Center for Imaging Research, University of Cincinnati, Cincinnati, OH, USA
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Kim HS, Shin JB, Kim JM. Crossed Transcortical Motor Aphasia, Left Spatial Neglect, and Limb and Magnetic Apraxia Due to Right Anterior Cerebral Artery Infarction. Ann Rehabil Med 2011; 35:949-53. [PMID: 22506227 PMCID: PMC3309387 DOI: 10.5535/arm.2011.35.6.949] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Accepted: 04/29/2010] [Indexed: 11/10/2022] Open
Abstract
Crossed aphasia refers to language disturbance due to right-hemisphere lesions in right-handed individuals, while magnetic apraxia is described as 'forced grasping and groping' caused by lesions in the contralateral frontal lobe. This is a case report of a 70-year-old right handed woman who suffered from crossed transcortical motor aphasia and left hand magnetic apraxia due to right anterior cerebral artery infarction. The definite mechanism of this disorder is not yet understood, but neurophysiological observations suggest that affected supplementary motor areas may be responsible for this phenomenon.
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Affiliation(s)
- Hyoung Seop Kim
- Department of Rehabilitation Medicine, National Health Insurance Corporation Ilsan Hospital, Ilsan 410-719, Korea
| | - Jung Bin Shin
- Department of Rehabilitation Medicine, National Health Insurance Corporation Ilsan Hospital, Ilsan 410-719, Korea
| | - Jong Moon Kim
- Department of Rehabilitation Medicine, National Health Insurance Corporation Ilsan Hospital, Ilsan 410-719, Korea
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Vitali P, Dronkers N, Pincherle A, Giovagnoli AR, Marras C, D'Incerti L, Ghielmetti F, Spreafico R, Villani F. Accuracy of pre-surgical fMRI confirmed by subsequent crossed aphasia. Neurol Sci 2010; 32:175-80. [PMID: 21088978 DOI: 10.1007/s10072-010-0426-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 09/08/2010] [Indexed: 11/30/2022]
Abstract
Atypical patterns of language activation in functional MRI (fMRI) are not unusual, particularly in patients with severe epilepsy. Still, the functional significance of these activations is under debate. We describe a case of a right-handed patient affected by drug-refractory right temporal lobe epilepsy in whom pre-surgical fMRI showed bilateral language activations, greater in the right hemisphere (RH). After surgery, a right subdural hematoma caused epileptic status and severe aphasia. This post-surgical complication of a crossed aphasia confirmed the prior fMRI findings of RH language thus stressing the value of pre-surgical fMRI evaluations, even when surgery is planned in the RH of a right-handed patient.
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Affiliation(s)
- Paolo Vitali
- Division of Neuroradiology, Department of Diagnostics and Applied Technology, Foundation IRCCS National Neurological Institute C. Besta, Milan, Italy
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Left hemisphere lateralization for language in right-handers is controlled in part by familial sinistrality, manual preference strength, and head size. J Neurosci 2010; 30:13314-8. [PMID: 20926657 DOI: 10.1523/jneurosci.2593-10.2010] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We investigated the effects of familial sinistrality (FS+; presence of left-handedness in one's close relatives), manual preference strength (MPS), and head size on the hemispheric lateralization of language in right-handers. Functional magnetic resonance imaging was used to map 49 individuals while listening to a story in their mother tongue. We found that individuals who had both the FS+ trait and weak MPS had no left hemisphere dominance for this lexicosyntactic task, whereas others showed a leftward functional asymmetry. In addition, the smaller the brain size, the smaller the leftward asymmetry for language, independent of FS and MPS. None of these effects were observed when the same subjects performed a spatial attention task that elicited right hemispheric functional asymmetry. These results demonstrate that the left hemisphere dominance for language in right-handers is a variable controlled, in part, by a number of specific factors, including FS, MPS, and head size.
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Dyukova GM, Glozman ZM, Titova EY, Kriushev ES, Gamaleya AA. Speech Disorders in Right-Hemisphere Stroke. ACTA ACUST UNITED AC 2010; 40:593-602. [DOI: 10.1007/s11055-010-9301-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ozeki T, Azuma F, Makiura Y, Nokura K, Yamamoto H, Kamiya M. [Pure agraphia with topographical disorientation caused by right hemisphere lesion]. Rinsho Shinkeigaku 2008; 48:505-8. [PMID: 18717186 DOI: 10.5692/clinicalneurol.48.505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 69-year-old, right-handed, Japanese male patient presented with pure agraphia with topographical disorientation after hemorrhage in the right parietal lobe. Upon developing cerebral hemorrhage, he was referred to our hospital for close examination of agraphia. There was no paresis or clumsiness in his extremities. His speech was fluent and well-articulated. Neither aphasia nor reading impairments was found, although there was a clear writing impairment with effort and hesitation. His writing of both kanji and kana letters contained additional, absent or deformed strokes or parts. No hemianopia, prosopagnosia, constructional disturbances and dressing apraxia were found. He could recognize familiar buildings or landscapes, but often lost his way around well-known areas. MR images revealed subcortical lesions of precuneus, superior and inferior parietal lobules in the right hemisphere, around the posterior horn of the lateral ventricle. He revealed pure agraphia and topographical disorientation after the right brain haemorrhage, without dementia or personality change. These findings indicate that the right parietal lobe participates in the kinesthetic movements of writing. Some authers have been documented cases of aphasic agraphia or alexia with agraphia caused by right hemisphere damage in dextrals, but pure agraphia caused by the lesion in the right hemisphere is very rare.
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Affiliation(s)
- Toshihiko Ozeki
- Department of Neurology, Second Teaching Hospital, School of Medicine, Fujita Health University
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Derakhshan I. Bimanual simultaneous movements and hemispheric dominance: Timing of events reveals hard-wired circuitry for action, speech, and imagination. Psychol Res Behav Manag 2008; 1:1-9. [PMID: 22110313 PMCID: PMC3218756 DOI: 10.2147/prbm.s4132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The evidence that speech is the marker of hemisphere of action is overwhelming. Thus, contrary to the commonly accepted belief, the evidence indicates that both sides of the body are under the same command (major hemisphere) and that the nondominant side of the body is a callosum-width farther from the major hemisphere. Substantial controversy exists, however, as to the best method for determining the laterality of motor control in an individual case. According to the new understanding, ie, the one-way callosal traffic circuitry underpinning laterality of motor control, the larger excursions of effectors located opposite (contralateral to) the command center while performing bimanual simultaneous drawing tasks provides the best noninvasive and inexpensive approach for demonstrating the laterality of the major hemisphere of a person (who is able to perform such tasks). Here, it is documented pictorially that bimanual simultaneous drawing of geometrical designs or straight lines, as well as moving the arms simultaneously from side to side (or up and down) while noting the difference of speed of the two arms (represented by the distance between the two index fingers), both provide a reliable indication of the laterality of a person’s major hemisphere. In all these maneuvers the nondominant side of the body (even the diaphragms) lags behind the dominant side by an interval equal to the interhemispheric transfer time (IHTT). This lagging behind of the nondominant side of the body in bimanual simultaneous movements is the footprint of directionality of callosal traffic underpinning the laterality of motor control evidenced by worsening of the delay of the nondominant side following callosotomy (uncoupling). Here, the historical precedence of a novel understanding in motor control together with its neurological implications in daily life as well as in laterality of seizure onset are briefly addressed, pointing out the deleterious effects of Sir Isaac Newton’s influence in neurological research on interhemispheric connectivity by suggesting symmetrical representation of visual sense of space in the human brain.
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Affiliation(s)
- Iraj Derakhshan
- Formerly of Department of Neurology, Case Western Reserve and Cincinnati Universities, Ohio, USA
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Lessa Mansur L, Radanovic M, Santos Penha S, Iracema Zanotto de Mendonça L, Cristina Adda C. Language and visuospatial impairment in a case of crossed aphasia. Laterality 2006; 11:525-39. [PMID: 16966241 DOI: 10.1080/13576500600832030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Crossed aphasia in dextrals (CAD) constitutes an interesting model for understanding the lateralisation and interaction of language with other cognitive functions in the brain. The authors present a study of a right-handed patient with Wernicke's aphasia following a right hemisphere cerebrovascular accident, who also had impairment in visuospatial skills. Although the patient presented a remarkable improvement in language symptoms on longitudinal follow-up, the combination of linguistic, visuospatial, and attentional impairments ultimately resulted in a persisting inability to perform complex tasks. The study of mild residual disturbances can improve our understanding of the interaction of language with other cognitive functions, going some way towards explaining the particular features found in CAD.
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Semenza C, Delazer M, Bertella L, Granà A, Mori I, Conti FM, Pignatti R, Bartha L, Domahs F, Benke T, Mauro A. Is math lateralised on the same side as language? Right hemisphere aphasia and mathematical abilities. Neurosci Lett 2006; 406:285-8. [PMID: 16930841 DOI: 10.1016/j.neulet.2006.07.063] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Revised: 05/16/2006] [Accepted: 07/25/2006] [Indexed: 11/21/2022]
Abstract
The main purpose of the present study was to learn how mathematical abilities are located and develop in the brain with respect to language. Mathematical abilities were assessed in six right-handed patients affected by aphasia following a lesion to their non-dominant hemisphere (crossed aphasia) and in two left-handed aphasics with a right-sided lesion. Acalculia, although in different degrees, was found in all cases. The type of acalculia depended on the type of aphasia, following patterns that have been previously observed in the most common aphasias resulting from left hemisphere lesions. No sign of right hemisphere or spatial acalculia (acalculia in left lateralised right-handed subjects) was detected. These results suggest that, as a rule, language and calculation share the same hemisphere. A primitive computational mechanism capable of recursion may be the precursor of both functions.
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Affiliation(s)
- Carlo Semenza
- Department of Psychology, University of Trieste, Via S Anastasio 12, 34122 Trieste, Italy.
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Hébert S, Racette A, Gagnon L, Peretz I. Revisiting the dissociation between singing and speaking in expressive aphasia. Brain 2003; 126:1838-50. [PMID: 12821526 DOI: 10.1093/brain/awg186] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We investigated the production of sung and spoken utterances in a non-fluent patient, C.C., who had a severe expressive aphasia following a right-hemisphere stroke, but whose language comprehension and memory were relatively preserved. In experiment 1, C.C. repeated familiar song excerpts under four different conditions: spoken lyrics, sung lyrics on original melody, lyrics sung on new but familiar melody and melody sung to a neutral syllable "la". In experiment 2, C.C. repeated novel song excerpts under three different conditions: spoken lyrics, sung lyrics and sung-to-la melody. The mean number of words produced under the spoken and sung conditions did not differ significantly in either experiment. The mean number of notes produced was not different either in the sung-to-la and sung conditions, but was higher than the words produced, hence showing a dissociation between C.C.'s musical and verbal productions. Therefore, our findings do not support the claim that singing helps word production in non-fluent aphasic patients. Rather, they are consistent with the idea that verbal production, be it sung or spoken, result from the operation of same mechanisms.
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Affiliation(s)
- Sylvie Hébert
- Ecole d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal C.P. 6128, succ. Centre-ville Montréal, Québec, Canada H3C 3J7.
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