Localization Of Aphasia Research Articles

64-Year-Old Woman With Aphasia and Troponin Elevation

64-Year-Old Woman With Aphasia and Troponin Elevation

Aphasia localization: was Pierre Marie right?

Language and its associated disorders have puzzled humanity since the dawn of civilization. The first descriptions of aphasia go back to classical antiquity. The Egyptians and Babylonians believed speech was a divine gift to mortals, and their descriptions of aphasia attributed these events to their Gods' anger and disfavour. The Edwin Smith Surgical Papyrus and the Hippocratic Corpus report several aphasia cases, relating this phenomenology to apoplexy, epilepsy, and other illnesses.

Localization of Language Function in the Twentieth Century

In the twentieth century the method of identifying pathology in patients with aphasia has fluctuated between localizing and holistic theories. The practical localization of sensation and voluntary movement became a clinical commonplace in the beginning of the century, but the mental component of aphasia made its localization controversial. In Paris before the war, Pierre Marie made the localization of aphasia the centerpiece of his personal feud with Jules Dejerine. After the war Konstantin von Monakow used the phenomenon of recovery from aphasia to support his holistic views of localization. Henry Head, in a 1926 study that remains influential today, took a neo-Jacksonian approach to localization and the physiology of language. Kurt Goldstein led the postwar anti-localizationists, asserting that physicians must look after the whole person and that brain function was inherently unified. Norman Geschwind reflected 1960s physiological thought in analyzing aphasia as a type of disconnection of distinct functional areas. In the twenty-first century the localization of aphasia remains dependent on theory, with competition between holistic and localizing ideas.

Neurology of cognition and language in the publications of Kálmán Sántha and today

Based on histopathological investigation of the brain of exceptionally talented persons Sántha found increased volume of parietal association areas with abundance of cells. He supposed that the angular gyrus may be a "memory field". In his publication Genius and inheritance he expressed that: "Talent is a child of the present, but the genius is born for eternity." He discussed the localization of sensory and motor amnestic aphasia analysing the signs of patient with brain tumor and called attention to concomitant psychological symptoms. He found crossed aphasia in twice as many lefthanded than righthanded persons. This may explain the recent observations that the restitution of aphasia is predetermined; speech ability of ambidexterous or latent lefthanded persons improve better. He analysed the topography of emotional and voluntary facial palsy. The currently accepted hierarchical concept of mental and speech ability can be derived from the ouevre of Sántha and his predecessors. Sántha can be honoured as a forerunner of the modern theories of aphasia localization.

Tc-99m HMPAO Brain Perfusion SPECT in Acute Aphasia Correlation With Clinical and Structural Findings

Tc-99m hexamethylpropylene amineoxime (HMPAO) brain perfusion SPECT was correlated with CT, MRI, and clinical findings in 17 patients with acute and subacute aphasia to determine its diagnostic potential in the early phases of stroke-associated language dysfunction. SPECT was performed using a dedicated brain imaging system after intravenous injection of 20 mCi (740 MBq) of Tc-99m HMPAO. Transaxial and three-dimensional surface rendered images were evaluated visually, and perfusion defects were correlated with CT, MRI, and a standard battery of clinical tests for aphasia. Clinical examination was insufficient for anatomic localization of aphasia in more than 40% of patients. CT exams were normal in 5 patients, although SPECT demonstrated perfusion defects in all 17. Nonfluent aphasia was present in only 6 of 10 patients with perfusion defects in Broca's area and fluent aphasia was present in only 5 of 10 patients with lesions in Wernicke's area. Auditory comprehension defect was associated with perfusion defects in the inferior parietal region in 9 of 12 patients (P = 0.05); reading and writing abnormalities were associated with perfusion defects in the posterior frontal, superior and inferior parietal cortex, and superior temporal gyri, and repetition deficit was associated with defects involving the inferior parietal cortex, the supramarginal and angular gyri, and the ipsilateral thalamus in 8 of 11 patients (P < 0.05). Brain perfusion SPECT should be included in the initial evaluation of aphasic patients, because clinical tests of aphasia and morphological imaging have limited value for accurately determining the extent and location of functional deficits.

Type, Evolution and Localization of Aphasia Following Neuro-Surgical Relief in a 60 Year Old Scientist, Affected by Paralysis agitans

Type, Evolution and Localization of Aphasia Following Neuro-Surgical Relief in a 60 Year Old Scientist, Affected by Paralysis agitans