Cerebral organization in a right-handed trilingual patient with right-hemisphere speech: a positron emission tomography study.

Using the method of positron emission tomography, combined with word-generation tasks, we had the opportunity to examine the cerebral representation of multiple languages in the brain in a right-handed patient, RA, with known right-hemisphere speech representation as determined by intracarotid sodium amobarbital testing. Similar patterns of cerebral blood flow were observed across all three languages (French, Spanish and English), when synonym generation was compared with a silent resting baseline. In particular, several regions in the right inferior frontal cortex were activated. These foci are in locations corresponding to those observed in the left hemisphere in normal right-handed volunteers with presumed left-hemisphere dominance, and in patients known to be left-hemisphere dominant for speech. The lack of anatomical separation of the three languages within the same individual, who acquired two languages early and one language later in life, suggests that at least at this single-word level of analysis, age of acquisition was not a significant factor in the determining of functional organization in the brain.