Annoni J M, Michel C M, Landis T, Khateb A
Clinique de Neurologie, Hôpitaux Universitaires de Genève, Switzerland.
Rev Neurol (Paris). 2002 Mar;158(3):317-31.
After stroke, the interhemispheric reorganisation of the neural network implicated in language is hypothesized to be a function not only of the site of lesion but also of the residual impairment. With a multiple case approach, we tested this hypothesis in three chronic aphasic patients. Two patients, GE (capsulo-lenticular stroke) and JHN (fronto-temporal stroke) showed formal residual semantic difficulties, while the third patient (EG, large sylvian lesion) did not. Brain electric activity was analysed during a categorisation task of tachistoscopically presented words in the left and the right visual field. The temporal analysis of brain activity showed that both patients with semantic residual difficulties activated the right hemisphere (RH) during some steps of word processing. In the third patient, without semantic impairment, the RH was activated only during a short time period. Further more, RH activation was shown to be dependent on the visual field of word presentation. Phonological impairment was not predictive of RH activation. These results suggest that RH activation, particularly anterior regions, can occur during semantic processing of words as a function of semantic residual impairment.
中风后,参与语言功能的神经网络半球间重组被认为不仅是损伤部位的函数,也是残余损伤的函数。采用多病例研究方法,我们在三名慢性失语症患者中验证了这一假设。两名患者,GE(豆状核-内囊中风)和JHN(额颞叶中风)表现出形式上的残余语义困难,而第三名患者(EG,大脑外侧裂大损伤)则没有。在对快速呈现于左、右视野的单词进行分类任务期间,分析了脑电活动。对脑活动的时间分析表明,两名有语义残余困难的患者在单词处理的某些步骤中激活了右半球(RH)。在第三名没有语义损伤的患者中,右半球仅在短时间内被激活。此外,右半球激活显示依赖于单词呈现的视野。语音损伤不能预测右半球激活。这些结果表明,作为语义残余损伤的函数,右半球激活,特别是前部区域的激活,可发生在单词的语义处理过程中。