A Weak Shadow of Early Life Language Processing Persists in the Right Hemisphere of the Mature Brain

Precision fMRI reveals that the language network exhibits adult-like left-hemispheric lateralization by 4 years of age

Left hemisphere damage in adulthood often leads to linguistic deficits, but many cases of early damage leave linguistic processing preserved, and a functional language system can develop in the right hemisphere. To explain this early apparent equipotentiality of the two hemispheres for language, some have proposed that the language system is bilateral during early development and only becomes left-lateralized with age. We examined language lateralization using functional magnetic resonance imaging with two large pediatric cohorts (total n=273 children ages 4-16; n=107 adults). Strong, adult-level left-hemispheric lateralization (in activation volume and response magnitude) was evident by age 4. Thus, although the right hemisphere can take over language function in some cases of early brain damage, and although some features of the language system do show protracted development (magnitude of language response and strength of inter-regional correlations in the language network), the left-hemisphere bias for language is robustly present by 4 years of age. These results call for alternative accounts of early equipotentiality of the two hemispheres for language.

Significance Statement

Language is the most canonical function that shows a strong hemispheric asymmetry in adult brains. However, whether the language system is already lateralized to the left hemisphere early in development has long been debated, given that early left-hemisphere damage often leaves language processing unimpaired. We examined the developmental trajectory of language lateralization in two large-scale pediatric datasets using robust individual-subject fMRI approaches. We found that the language system exhibits adult-like left-hemispheric lateralization by age 4, although other aspects of the neural infrastructure for language show a clear change between age 4 and late childhood. These findings challengethe claim that the language system is bilateral during early development and call for alternative accounts of early hemispheric equipotentiality for language.

Distributed Sensitivity to Syntax and Semantics throughout the Language Network

Human language is expressive because it is compositional: The meaning of a sentence (semantics) can be inferred from its structure (syntax). It is commonly believed that language syntax and semantics are processed by distinct brain regions. Here, we revisit this claim using precision fMRI methods to capture separation or overlap of function in the brains of individual participants. Contrary to prior claims, we find distributed sensitivity to both syntax and semantics throughout a broad frontotemporal brain network. Our results join a growing body of evidence for an integrated network for language in the human brain within which internal specialization is primarily a matter of degree rather than kind, in contrast with influential proposals that advocate distinct specialization of different brain areas for different types of linguistic functions.

The language network as a natural kind within the broader landscape of the human brain

Language behaviour is complex, but neuroscientific evidence disentangles it into distinct components supported by dedicated brain areas or networks. In this Review, we describe the 'core' language network, which includes left-hemisphere frontal and temporal areas, and show that it is strongly interconnected, independent of input and output modalities, causally important for language and language-selective. We discuss evidence that this language network plausibly stores language knowledge and supports core linguistic computations related to accessing words and constructions from memory and combining them to interpret (decode) or generate (encode) linguistic messages. We emphasize that the language network works closely with, but is distinct from, both lower-level - perceptual and motor - mechanisms and higher-level systems of knowledge and reasoning. The perceptual and motor mechanisms process linguistic signals, but, in contrast to the language network, are sensitive only to these signals' surface properties, not their meanings; the systems of knowledge and reasoning (such as the system that supports social reasoning) are sometimes engaged during language use but are not language-selective. This Review lays a foundation both for in-depth investigations of these different components of the language processing pipeline and for probing inter-component interactions.

Visual word processing engages a hierarchical, distributed, and bilateral cortical network

Although the Visual Word Form Area (VWFA) in left temporal cortex is considered the pre-eminent region in visual word processing, other regions are also implicated. We examined the entire text-selective circuit, using functional MRI. Ten regions of interest (ROIs) per hemisphere were defined, which, based on clustering, grouped into early vision, high-level vision, and language clusters. We analyzed the responses of the ROIs and clusters to words, inverted words, and consonant strings using univariate, multivariate, and functional connectivity measures. Bilateral modulation by stimulus condition was evident, with a stronger effect in left hemisphere regions. Last, using graph theory, we observed that the VWFA was equivalently connected with early visual and language clusters in both hemispheres, reflecting its role as a mediator in the circuit. Although the individual ROIs and clusters bilaterally were flexibly altered by the nature of the input, stability held at the level of global circuit connectivity, reflecting the complex hierarchical distributed system serving visual text perception.

Morphometrics of the preserved post-surgical hemisphere in pediatric drug-resistant epilepsy

Importance

Structural integrity of cortex following cortical resection for epilepsy management has been previously characterized, but only in adult patients.

Objective

This study sought to determine whether morphometrics of the preserved hemisphere in pediatric cortical resection patients differ from non-neurological controls.

Design

This was a case-control study, from 2013-2022.

Setting

This was a single-site study.

Participants

32 patients with childhood epilepsy surgery and 51 age- and gender-matched controls participated.

Main Measures

We quantified morphometrics of the preserved hemisphere at the level of gross anatomy (lateral ventricle size, volume of gray and white matter). Additionally, cortical thickness, volume, and surface area were measured for 34 cortical regions segmented with the Desikan-Killiany atlas, and, last, volumes of nine subcortical regions were also quantified.

Results

13 patients with left hemisphere (LH) surgery and a preserved right hemisphere (RH) (median age/median absolute deviation of age: 15.7/1.7 yr; 6 females, 7 males) and 19 patients with RH surgery and a preserved LH (15.4/3.7 yr; 11 females, 8 males) were compared to 51 controls (14.8/4.9 yr; 24 females, 27 males). Patient groups had larger ventricles and reduced total white matter volume relative to controls, and only patients with a preserved RH, but not patients with a preserved LH, had reduced total gray matter volume relative to controls. Furthermore, patients with a preserved RH had lower cortical thickness and volume and greater surface area of several cortical regions, relative to controls. Patients with a preserved LH had no differences in thickness, volume, or area, of any of the 34 cortical regions, relative to controls. Moreover, both LH and RH patients showed reduced volumes in select subcortical structures, relative to controls.

Conclusions and Relevance

That left-sided, but not right-sided, resection is associated with more pronounced reduction in cortical thickness and volume and increased cortical surface area relative to typically developing, age-matched controls suggests that the preserved RH undergoes structural plasticity to an extent not observed in cases of right-sided pediatric resection. Future work probing the association of the current findings with neuropsychological outcomes will be necessary to understand the implications of these structural findings for clinical practice.

One right can make a left: sentence processing in the right hemisphere after perinatal stroke

When brain regions that are critical for a cognitive function in adulthood are irreversibly damaged at birth, what patterns of plasticity support the successful development of that function in an alternative location? Here we investigate the consistency of language organization in the right hemisphere (RH) after a left hemisphere (LH) perinatal stroke. We analyzed fMRI data collected during an auditory sentence comprehension task on 14 people with large cortical LH perinatal arterial ischemic strokes (left hemisphere perinatal stroke (LHPS) participants) and 11 healthy sibling controls using a "top voxel" approach that allowed us to compare the same number of active voxels across each participant and in each hemisphere for controls. We found (1) LHPS participants consistently recruited the same RH areas that were a mirror-image of typical LH areas, and (2) the RH areas recruited in LHPS participants aligned better with the strongly activated LH areas of the typically developed brains of control participants (when flipped images were compared) than the weakly activated RH areas. Our findings suggest that the successful development of language processing in the RH after a LH perinatal stroke may in part depend on recruiting an arrangement of frontotemporal areas reflective of the typical dominant LH.

No evidence of theory of mind reasoning in the human language network

Language comprehension and the ability to infer others' thoughts (theory of mind [ToM]) are interrelated during development and language use. However, neural evidence that bears on the relationship between language and ToM mechanisms is mixed. Although robust dissociations have been reported in brain disorders, brain activations for contrasts that target language and ToM bear similarities, and some have reported overlap. We take another look at the language-ToM relationship by evaluating the response of the language network, as measured with fMRI, to verbal and nonverbal ToM across 151 participants. Individual-participant analyses reveal that all core language regions respond more strongly when participants read vignettes about false beliefs compared to the control vignettes. However, we show that these differences are largely due to linguistic confounds, and no such effects appear in a nonverbal ToM task. These results argue against cognitive and neural overlap between language processing and ToM. In exploratory analyses, we find responses to social processing in the "periphery" of the language network-right-hemisphere homotopes of core language areas and areas in bilateral angular gyri-but these responses are not selectively ToM-related and may reflect general visual semantic processing.

Time course of right-hemisphere recruitment during word production following left-hemisphere damage: A single case of young stroke

Our understanding of post-stroke language function is largely based on older age groups, who show increasing age-related brain pathology and neural reorganisation. To illustrate language outcomes in the young-adult brain, we present the case of J., a 23-year-old woman with chronic aphasia from a left-hemisphere stroke affecting the temporal lobe. Diffusion MRI-based tractography indicated that J.'s language-relevant white-matter structures were severely damaged. Employing magnetoencephalography (MEG), we explored J.'s conceptual preparation and word planning abilities using context-driven and bare picture-naming tasks. These revealed naming deficits, manifesting as word-finding difficulties and semantic paraphasias about half of the time. Naming was however facilitated by semantically constraining lead-in sentences. Altogether, this pattern indicates disrupted lexical-semantic and phonological retrieval abilities. MEG revealed that J.'s conceptual and naming-related neural responses were supported by the right hemisphere, compared to the typical left-lateralised brain response of a matched control. Differential recruitment of right-hemisphere structures (330-440 ms post-picture onset) was found concurrently during successful naming (right mid-to-posterior temporal lobe) and word-finding attempts (right inferior frontal gyrus). Disconnection of the temporal lobes via corpus callosum was not critical for recruitment of the right hemisphere in visually guided naming, possibly due to neural activity right lateralising from the outset. Although J.'s right hemisphere responded in a timely manner during word planning, its lexical and phonological retrieval abilities remained modest.