Abstract
Communication in humans activates almost every part of the brain. Of course, the use of language predominates, but other cognitive functions such as attention, memory, emotion, and executive processes are also involved. However, in order to explain how our brain “understands,” “speaks,” and “writes,” and in order to rehabilitate aphasic disorders, neuroscience has faced the challenge for years to reveal the responsible neural networks. Broca and Wernicke (and Lichtheim and many others), during the 19th century, when brain research was mainly observational and autopsy driven, offered fundamental knowledge about the brain and language, so the Wernicke-Geschwind model appeared and aphasiology during the 20th century was based on it. This model is still useful for a first approach into the classical categorization of aphasic syndromes, but it is outdated, because it does not adequately describe the neural networks relevant for language, and it offers a modular perspective, focusing mainly on cortical structures. During the last three decades, neuroscience conquered new imaging, recording, and manipulation techniques for brain research, and a new model of the functional neuroanatomy of language was developed, the dual stream model, consisting of two interacting networks (“streams”), one ventral, bilaterally organized, for language comprehension, and one dorsal, left hemisphere dominant, for production. This new model also has its limitations but helps us to understand, among others, why patients with different brain lesions can have similar language impairments. Furthermore, interesting aspects arise from studying language functions in aging brains (and also in young, developing brains) and in cognitively impaired patients and neuromodulation effects on reorganization of brain networks subserving language. In this selective review, we discuss methods for coupling new knowledge regarding the functional reorganization of the brain with sophisticated techniques capable of activating the available supportive networks in order to provide improved neurorehabilitation strategies for people suffering from neurogenic communication disorders.
Highlights
Let us consider two healthy men, without a history of neurological disease, one 20 and one 80 years old, who both participated in a sentence comprehension task and showed the same success at comprehending sentences
From neuroanatomists to neurolinguists, focus their research on specific small particles of language processing. These efforts together contributed deep inside our brains as communication organs and form our current knowledge on language functions and cognitivelinguistic interactions both in health and disease. An example on this is the findings from one of our recent studies, in which we examined verb-noun dissociations in patients with relapsing remitting multiple sclerosis and reported for the first time in the literature a noun superiority over verbs for picture confrontation naming in these patients [24]
Hillis et al [49] recently showed that stroke aphasic patients with damage in the left posterior superior temporal gyrus and/or superior longitudinal fasciculus/arcuate fasciculus (SLF/Articulate fasciculus (AF)) and showed better naming outcome when administered Selective Serotonin Reuptake Inhibitors (SSRIs) for 3 months after their stroke
Summary
Let us consider two healthy men, without a history of neurological disease, one 20 and one 80 years old, who both participated in a sentence comprehension task and showed the same success at comprehending sentences. Behavioural Neurology from healthy and diseased brains, its ability to make communication possible through meaningful symbols, expressions, and comprehension of ideas and concepts [2] This selective review begins with a brief description of the Broca-Wernicke-Lichtheim-Geschwind classical model, from the era of autopsy-driven research. Hickok and Poeppel’s dual stream model of language processing is described, including its limitations (i.e., the role of the cerebellum) It continues with a discussion of the ability to use language to communicate, which relies on the traditionally described core language networks and on other additional, widely distributed, networks, which can be recruited to support linguistic functions when needed. The newly conquered tools for clinical and experimental applications of neuroimaging and neuromodulation, i.e., artificial manipulation of brain activity, assisted neuroscience to establish a new era By utilizing these modern methods, we have advanced our knowledge and subsequently challenged the classical knowledge about the brain and language. We intentionally highlight numerous aspects of brain and language associations that could give rise to ideas on new therapeutic targets for people living with aphasia
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