Seghier M, Lazeyras F, Momjian S, Annoni J M, de Tribolet N, Khateb A
Department of Radiology, Geneva University Hospital, 24, rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland.
Neuroreport. 2001 Sep 17;12(13):2785-90. doi: 10.1097/00001756-200109170-00007.
Studies have suggested that congenital left hemispheric (LH) frontal arteriovenous malformations (AVMs) are associated with an early transfer of language to right hemisphere (RH) frontal regions. The question remains whether such anatomofunctional reorganisation is due to RH compensatory abilities or to a general principle of lateral shift. In this study, we used fMRI language paradigms to investigate the case of a patient presenting aphasic symptoms following an haemorrhage due to a right frontal AVM. Prior to surgery, fMRI showed that language processing was confined to the RH, suggesting that language had not shifted during childhood from this congenitally dominant RH to the LH. After surgery, the patient presented severe aphasia that recovered to presurgical level within 70 days. At this time, fMRI showed that language tasks were still not associated with activations in the LH. These results suggest that the principles of early cerebral reorganisation after congenital lesions may differ in the RH and the LH. In addition, they support the idea that efficient restoration of language is achieved if a sufficiently large neuronal network is preserved around the lesion.
研究表明，先天性左半球（LH）额叶动静脉畸形（AVM）与语言早期转移至右半球（RH）额叶区域有关。问题仍然存在，即这种解剖功能重组是由于右半球的代偿能力还是由于侧向转移的一般原则。在本研究中，我们使用功能磁共振成像（fMRI）语言范式来研究一名因右侧额叶AVM出血后出现失语症状的患者。手术前，功能磁共振成像显示语言处理局限于右半球，这表明在儿童期语言并未从这个先天性占优势的右半球转移至左半球。手术后，患者出现严重失语，并在70天内恢复到术前水平。此时，功能磁共振成像显示语言任务仍与左半球的激活无关。这些结果表明，先天性病变后早期脑重组的原则在右半球和左半球可能有所不同。此外，它们支持这样一种观点，即如果在病变周围保留足够大的神经元网络，就能实现语言的有效恢复。
