Brain lesions are known to elicit reorganization of function in representational cortex. Using linguistic function as an example, we show that (a) injury-related reorganization may also be observed in language-related cortex and (b) this reorganization not only appears in cortical space but also in the dynamic flow of activity. The present study investigated cortical reorganization in a group of 10 nonfluent aphasics who demonstrated partial recovery of linguistic functions. Compared with controls, linguistic functions were organized in an atypical manner, both in terms of spatial structures involved and in the time course of the linguistic processes, from word reading to late stages of word encoding in working memory. For this purpose, event-related potentials were recorded in a two-stimulus design comprising phonological and semantic tasks. Subjects were asked to judge whether two words, separated by a 2-s interval, rhymed (phonological task) or were semantically associated. During word reading of the phonological task, controls showed negativity/activation over occipital sites, whereas patients displayed negativity at left-medial orbitofrontal locations anterior to the common sites of lesion. During the subsequent 2-s interval associated with word encoding, the two groups showed a reversed pattern: significant left-right anterior asymmetry prevailed in controls, whereas lateralization was absent in patients. Aphasics displayed maximum positivity/inhibition over the left frontal regions, at the typical site of lesion. Compared with controls, patients exhibited significant disinhibition (decreased positivity) of right frontal areas and greater activation of left temporal sites. These results suggest that the concept of language plasticity should include, in addition to spatial aspects of linguistic reorganization, the reorganized temporal dynamics associated with recovery of impaired functions.

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We report a case of labio-glosso-pharyngo-laryngeal paralysis with some peculiar features. CT and MRI yielded the diagnosis of acute pseudobulbar syndrome by demonstrating the existence of two lesions of the corticobulbar tract: one subcortical (recent) and the other opercular cortical (old) on the opposite side.