The anatomy of aphasia revisited

Kreisler, A.; Godefroy, Olivier; Delmaire, Christine; Debachy, Brigitte; Leclercq, M.; Pruvo, J. P.; Leys, Didier

doi:10.1212/wnl.54.5.1117

Cited by 197 publications

(132 citation statements)

References 27 publications

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“…As an alternative to FLDA, classification trees analysis is a non-parametric technique that makes no distributional assumptions and is not affected by outliers, colinearities, or distributional error structures (Breiman et al, 1984). Thus, the classification trees method is especially suitable for detecting neural bases of brain disorders (Feldesman, 2002;Godefroy et al, 1998;Kreisler et al, 2000;Ripley, 2002;Zimmerman-Moreno et al, 2008).…”

Section: Classification Analysismentioning

confidence: 99%

The neural substrates for atypical planning and execution of word production in stuttering

Chen

Ning

et al. 2010

Experimental Neurology

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a b s t r a c t a r t i c l e i n f oUsing an fMRI-based classification approach and the structural equation modeling (SEM) method, this study examined the neural bases of atypical planning and execution processes involved in stuttering. Twelve stuttering speakers and 12 controls were asked to name pictures under different conditions (single-syllable, multi-syllable, or repeated-syllable) in the scanner. The contrasts between conditions provided information about planning and execution processes. The classification analysis showed that, as compared to nonstuttering controls, stuttering speakers' atypical planning of speech was evident in their neural activities in the bilateral inferior frontal gyrus (IFG) and right putamen and their atypical execution of speech was evident in their activations in the right cerebellum and insula, left premotor area (PMA), and angular gyrus (AG). SEM results further revealed two parallel neural circuits-the basal ganglia-IFG/PMA circuit and the cerebellum-PMA circuit-that were involved in atypical planning and execution processes of stuttering, respectively. The AG appeared to be involved in the interface of atypical planning and execution in stuttering. These results are discussed in terms of their implications to the theories about stuttering and to clinical applications.

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Section: Classification Analysismentioning

confidence: 99%

The neural substrates for atypical planning and execution of word production in stuttering

Chen

Ning

et al. 2010

Experimental Neurology

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“…On the other hand, all cases of lone cortical dysarthria were associated to lesions in the left capsule-nuclear or right MCA territory, leaving unaffected the performance on language tests. The presence of mutism in 9 of the 11 patients with global aphasia may be explained by lesions in the frontalputaminal part of the MCA territory 1 .…”

Section: Discussionmentioning

confidence: 94%

“…Four of the eight patients who did not survive had a cardioembolic stroke, while cardioembolism was the most frequent etiology for patients with global (5) Spontaneous speech* -5 5 14 2 0.0001 (6) Counting from 1 to 20* -4 2 11 1 0.0120 (6) Mentioning the 7 weekdays* -3 3 10 0 0.0046 (6) Singing* -3 4 12 0 0.0001 (6) Phono-articulatory function* -0 4 4 7 0.0043 (6) Constructional praxis (4 matches)* -3 2 14 4 0.0021 (6) Constructional praxis (9 matches)* -2 4 14 6 0.0105 (6) Ideomotor praxis (mean±SD) 5 2.8±1.6 2.4±1.5 1.6±2.0 4.7±0.5 0.0012 (7) SD: standard deviation; MCA: middle cerebral artery. *Number of subjects with difficulties and/or errors; (1) ANOVA; (2) ANOVA followed by Tukey's test (differences between the following groups: capsule-nuclear and whole middle cerebral artery territory; capsule-nuclear and temporal-parietal; capsulenuclear and frontal); (3) ANOVA followed by Tukey's test (differences between the following groups: frontal and temporal-parietal; frontal and whole middle cerebral artery territory; capsule-nuclear and temporal-parietal; capsule-nuclear and whole middle cerebral artery territory); (4) ANOVA followed by Tukey's test (differences between the capsule-nuclear group and the whole middle cerebral artery territory group); (5) ANOVA followed by Tukey's test (differences between the following groups: capsule-nuclear and whole middle cerebral artery territory; capsule-nuclear and frontal); (6) Fisher's exact test; (7) ANOVA followed by Tukey's test (differences between the following groups: capsule-nuclear and temporal-parietal; capsule-nuclear and whole middle cerebral artery territory).…”

Section: Discussionmentioning

confidence: 99%

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A topographic study on the evaluation of speech and language in the acute phase of a first stroke

Oliveira

Damasceno

2011

Arq. Neuro-Psiquiatr.

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Evaluation of speech and language may help in localization of site and extension of brain lesions, particularly in the absence of other neurological signs or radiologically defined injuries. Objective: To verify what language tasks are best correlated to which brain regions, in order to develop a test for neurologists in emergency settings. Method: Thirty-seven adult first-stroke patients were submitted to cognitive and language tests, and then paired with thirty-seven healthy controls. Patients underwent CT and/or MRI for topographic correlation with test results (p<0.05). Results: All tests were able to distinguish patients from controls, but only word/sentence repetition, naming, ideomotor praxis and, non-significantly, comprehension and counting 1-20 predicted left hemisphere lesions. Repetition was related to perisylvian structures, comprehension to the posterior portion of the middle cerebral artery territory, and fluency to frontal lesions, while naming was accurate only for lesion side. Conclusion: Language and cognitive tasks can help in the localization of acute stroke lesions. Key words: linguistics, aphasia, apraxias, stroke, brain infarction, language, speech, disability evaluation.Um estudo topográfico da avaliação de fala e linguagem na fase aguda de um primeiro infarto cerebral RESUMO Avaliação de fala e linguagem pode ajudar na localização do sítio e da extensão de lesões cerebrais, especialmente quando ausentes outros sinais neurológicos ou radiológicos. Objetivo: Verificar quais tarefas linguísticas se correlacionam melhor com quais regiões cerebrais, a fim de desenvolver um teste para uso pelos neurologistas em emergências. Método: 37 pacientes e 37 controles pareados passaram por avaliação linguístico-cognitiva. Pacientes foram submetidos a TC e/ou RM para correlação topográfica com os resultados da avaliação (p<0,05). Resultados: Todos os testes diferenciaram pacientes de controles, mas apenas os de repetição de palavras/sentenças, nomeação, praxia ideomotora e, de forma não-significativa, compreensão e contagem 1-20 puderam predizer lesões no hemisfério esquerdo. Os testes de repetição estavam relacionados com estruturas perisylvianas, compreensão com a porção posterior do território da artéria cerebral média, e fluência com regiões frontais, enquanto os de nomeação localizavam apenas o lado das lesões. Conclusão: Testes linguístico-cognitivos podem ajudar a localizar infartos cerebrais agudos. Palavras-Chave: linguística, afasia, apraxias, acidente cerebral vascular, infarto encefálico, linguagem, fala, avaliação da deficiência.

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“…Classic clinical-anatomic correlations 2,25 were met pertaining stroke topography in relation to the aphasic syndrome presented in almost 95% of studied subjects. The two patients who did not correspond to the expected brain lesion site could have some individual variation in the cytoarchitecture of language networks and, with specific regard to the patient with Wernicke's aphasia, the language disturbance could be attributed to a temporary hypoperfusion of the left temporal cortex in the acute phase, or to a case of crossed aphasia with predominant impairment in comprehension due to dysfunctional neural tissue surrounding the original lesion.…”

Section: Resultsmentioning

confidence: 99%

Global aphasia as a predictor of mortality in the acute phase of a first stroke

Oliveira

Damasceno

2011

Arq. Neuro-Psiquiatr.

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Objective: To establish whether vascular aphasic syndromes can predict stroke outcomes. Method: Thirty-seven adults were evaluated for speech and language within 72 hours after a single first-ever ischemic brain lesion, in blind association to CT and/or MR. Results: Speech or language disabilities were found in seven (87.5%) of the eight deceased patients and twenty-six (89.7%) of the twenty-nine survivors. Global aphasia was identified in eleven patients, all with left hemisphere lesions (nine mute; five deceased), consisting on a risk factor for death in the acute stroke phase (ρ=0.022). Age (z=1.65; ρ>0.09), thrombolysis (ρ=0.591), infarct size (ρ=0.076) and side (ρ=0.649) did not significantly influence survival. Absence of aphasia did not predict a better evolution, regardless of the affected hemisphere. Prevalence of cardiovascular risk factors was similar for all patient groups. Conclusion: Global aphasia in acute stroke can adversely affect prognosis, translated into impairment of dominant perisylvian vascular territories, with mutism as an important semiological element. Key words: linguistics, aphasia, stroke, brain infarction, language, speech, disability evaluation, prognosis.Afasia global prediz mortalidade na fase aguda de um primeiro acidente vascular cerebral isquêmico RESUMO Objetivo: Determinar se síndromes afásicas na fase aguda do infarto cerebral influenciam o prognóstico. Método: Avaliação para fala e linguagem de 37 adultos dentro de 72 horas após um primeiro infarto cerebral, em associação topográfica cega com TC e/ou RM. Resultados: Detectaram-se afasias ou disartria em 7 (87,5%) dos 8 pacientes falecidos, e em 26 (89,7%) dos 29 sobreviventes. Afasia global foi identificada em 11 pacientes, todos com lesões no hemisfério esquerdo (cinco óbitos; mutismo em nove), consistindo em fator de risco para mortalidade na fase aguda do acidente vascular cerebral isquêmico (ρ=0,022). Idade (z=1,65; ρ>0,09), trombólise (ρ=0,591), dimensões da lesão (ρ=0,076) e lado (ρ=0,649) não afetaram significativamente a sobrevivência. Ausência de afasia não prenunciou melhor evolução. Fatores de risco cardiovascular tiveram similar prevalência para todos os grupos de pacientes. Conclusão: Afasia global na fase aguda do infarto cerebral pode aumentar mortalidade, demonstrando envolvimento de território vascular perisylviano dominante, tomando-se mutismo como importante elemento semiológico. Palavras-chave: linguística, afasia, acidente cerebral vascular, infarto encefálico, linguagem, fala, avaliação da deficiência, prognóstico.

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The anatomy of aphasia revisited

Abstract: Lesion location is the main determinant of aphasic disorders at the acute stage. Most clinical-radiologic correlations supported the classic anatomy of aphasia.

Cited by 197 publications

References 27 publications

The neural substrates for atypical planning and execution of word production in stuttering

The neural substrates for atypical planning and execution of word production in stuttering

A topographic study on the evaluation of speech and language in the acute phase of a first stroke

Global aphasia as a predictor of mortality in the acute phase of a first stroke

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