Lesion localization in aphasia with cranial computed tomography and the Boston Diagnostic Aphasia Exam

Naeser, Margaret A.; Hayward, Robert W.

doi:10.1212/wnl.28.6.545

Cited by 210 publications

(27 citation statements)

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“…Each lesion map was realigned into stereotaxic Montreal Neurological Institute (MNI) space to overlay them on standard brain templates. In order to improve the lesion-mapping method, the following procedures were followed: an experienced examiner mapped all of the lesions, and these lesion maps were reviewed by a 2 nd rater following procedures previously described to generate the final lesion maps (Cola, Daniels, Corey, Lemen, Romero, & Foundas, 2010; Daniels & Foundas, 1999; Foundas, Daniels, Vasterling, 1998; Hanna-Pladdy et al, 2001; Naeser & Hayward, 1978; Damasio & Damasio, 1989). …”

Section: Methodsmentioning

confidence: 99%

Ipsilesional neglect: Behavioral and anatomical correlates.

Sacchetti¹,

Goedert²,

Foundas³

et al. 2015

Neuropsychology

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Objective The sparse existing research on ipsilesional neglect supports an association of this disorder with damage to the right frontal and subcortical brain networks. It is believed that dysfunction in these networks may result in primarily “aiming”, motor-intentional spatial errors. The purpose of this study was to confirm whether frontal-subcortical circuits are indeed commonly affected in ipsilesional neglect and to determine the relative presence of “aiming”, motor-intentional versus “where”, perceptual-attentional spatial errors in these individuals. Methods We identified 12 participants with ipsilesional neglect based on a computerized line bisection task and used the line bisection data to quantify participants' perceptual-attentional and motor-intentional errors. We were able to discriminate between these two biases using the algebraic solutions for two separate equations, one for “aiming” and one for “where” biases. Lesion mapping was conducted for all participants using MRICroN® software; lesion checklist and overlap analysis were created from these images. Results A greater percentage of participants with ipsilesional neglect had frontal/subcortical damage (83%) compared to the expected percentage (27%) observed in published patient samples with contralesional neglect. We observed the greatest area of lesion overlap in frontal lobe white matter pathways. Nevertheless, participants with ipsilesional neglect made primarily “where” rather than “aiming” spatial errors. Conclusion Our data confirms previous research suggesting that ipsilesional neglect may result from lesions to the right frontal-subcortical networks. Furthermore, in our group, ipsilesional neglect was also strongly associated with primarily “where”, perceptual-attentional bias, and less so with “aiming” motor-intentional spatial bias.

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Section: Methodsmentioning

confidence: 99%

Ipsilesional neglect: Behavioral and anatomical correlates.

Sacchetti¹,

Goedert²,

Foundas³

et al. 2015

Neuropsychology

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“…Specifically, several studies have shown that Broca’s aphasia is caused by lesions involving the insula, white matter underlying Broca’s area, surrounding frontal cortex, basal ganglia, and superior temporal lobe, rather than Brodmann’s areas 44 and 45 proper. 10,20,25,26,32 Furthermore, the brains Broca examined himself have been reevaluated with CT and MRI, 10 showing damage extending far beyond the inferior frontal gyrus: in the claustrum, putamen, caudate, globus pallidus, internal and external capsules, superior temporal lobe, the entire insula, and the inferior parietal lobe in Leborgne’s brain, for example.…”

Section: Discussionmentioning

confidence: 99%

“…29,31 But there is a high variability in the location of these speech arrest sites that cannot be definitively predicted by anatomical features. 26 And in many patients (up to 40%), no frontal lobe speech arrest sites can be found. 31 Why some patients have clear speech arrest in Broca’s area and others do not is unknown.…”

Section: Discussionmentioning

confidence: 99%

Frontal operculum gliomas: language outcome following resection

Rolston

Englot

Benet

et al. 2015

JNS

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OBJECT The dominant hemisphere frontal operculum may contain critical speech and language pathways, and due to these properties, patients with tumors of the opercular region may be at higher risk for postoperative speech dysfunction. However, the likelihood of incurring temporary or permanent language dysfunction is unknown. METHODS The authors retrospectively analyzed their cohort of patients with frontal gliomas to identify those tumors that predominantly involved the dominant frontal operculum. Each tumor was classified as involving the pars orbitalis, pars triangularis, pars opercularis, or a combination of some or all of these areas. The authors then identified and compared characteristics between those patients experiencing transient or permanent speech deficits, as opposed to those with no language dysfunction. RESULTS Forty-three patients were identified for inclusion in this analysis. Transient deficits occurred in 12 patients (27.9%), while 4 patients (9.8%) had persistent deficits involving language. Individuals with preoperative language deficits and patients with seizures characterized by speech dysfunction appear to be at the highest risk to develop a deficit (relative risks 3.09 and 1.75, respectively). No patient with a tumor involving the pars orbitalis experienced a persistent deficit. CONCLUSIONS Resection of gliomas is widely recognized as a critical element of improved outcome. Given the low rate of language morbidity reported in this group of patients, resection of gliomas within the dominant frontal operculum is well-tolerated with acceptable morbidity and, in this particular location, should not be a deterrent in the overall management of these tumors.

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“…In some of the earliest applications of this approach to disorders of spoken language understanding, Kertesz, Lesk, and McCabe (1977) and Naeser and Hayward (1978) overlaid the lesions of patients with Wernicke's aphasia. Both studies demonstrated consistent involvement of the left superior temporal gyrus.…”

Section: Historical Backgroundmentioning

confidence: 99%

Lesion-symptom mapping in the study of spoken language understanding

Wilson

2016

Language, Cognition and Neuroscience

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Lesion-symptom mapping studies aim to make inferences about the functional neuroanatomy of spoken language understanding by investigating relationships between damage to different brain regions and the various speech perception and comprehension deficits that result. Voxel-based lesion-symptom mapping (VLSM), voxel-based morphometry (VBM), and studies focused on specific cortical regions of interest or fiber pathways have all yielded insights regarding the localization of different components of spoken language processing. Major challenges include the fact that brain damage rarely impacts just a single brain region or just a single processing component, and that neuroplasticity and recovery can complicate the interpretation of lesion-deficit correlations. Future studies involving large patient cohorts derived from multi-center projects, and multivariate approaches to quantifying patterns of brain damage and patterns of linguistic deficits, will continue to yield new insights into the neural basis of spoken language understanding.

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Lesion localization in aphasia with cranial computed tomography and the Boston Diagnostic Aphasia Exam

Cited by 210 publications

References 0 publications

Ipsilesional neglect: Behavioral and anatomical correlates.

Ipsilesional neglect: Behavioral and anatomical correlates.

Frontal operculum gliomas: language outcome following resection

Lesion-symptom mapping in the study of spoken language understanding

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