Dronkers Nina F, Wilkins David P, Van Valin Robert D, Redfern Brenda B, Jaeger Jeri J
VA Northern California Health Care System, Martinez, CA 94553, USA.
Cognition. 2004 May-Jun;92(1-2):145-77. doi: 10.1016/j.cognition.2003.11.002.
The cortical regions of the brain traditionally associated with the comprehension of language are Wernicke's area and Broca's area. However, recent evidence suggests that other brain regions might also be involved in this complex process. This paper describes the opportunity to evaluate a large number of brain-injured patients to determine which lesioned brain areas might affect language comprehension. Sixty-four chronic left hemisphere stroke patients were evaluated on 11 subtests of the Curtiss-Yamada Comprehensive Language Evaluation - Receptive (CYCLE-R; Curtiss, S., & Yamada, J. (1988). Curtiss-Yamada Comprehensive Language Evaluation. Unpublished test, UCLA). Eight right hemisphere stroke patients and 15 neurologically normal older controls also participated. Patients were required to select a single line drawing from an array of three or four choices that best depicted the content of an auditorily-presented sentence. Patients' lesions obtained from structural neuroimaging were reconstructed onto templates and entered into a voxel-based lesion-symptom mapping (VLSM; Bates, E., Wilson, S., Saygin, A. P., Dick, F., Sereno, M., Knight, R. T., & Dronkers, N. F. (2003). Voxel-based lesion-symptom mapping. Nature Neuroscience, 6(5), 448-450.) analysis along with the behavioral data. VLSM is a brain-behavior mapping technique that evaluates the relationships between areas of injury and behavioral performance in all patients on a voxel-by-voxel basis, similar to the analysis of functional neuroimaging data. Results indicated that lesions to five left hemisphere brain regions affected performance on the CYCLE-R, including the posterior middle temporal gyrus and underlying white matter, the anterior superior temporal gyrus, the superior temporal sulcus and angular gyrus, mid-frontal cortex in Brodmann's area 46, and Brodmann's area 47 of the inferior frontal gyrus. Lesions to Broca's and Wernicke's areas were not found to significantly alter language comprehension on this particular measure. Further analysis suggested that the middle temporal gyrus may be more important for comprehension at the word level, while the other regions may play a greater role at the level of the sentence. These results are consistent with those seen in recent functional neuroimaging studies and offer complementary data in the effort to understand the brain areas underlying language comprehension.
大脑中传统上与语言理解相关的皮质区域是韦尼克区和布洛卡区。然而，最近的证据表明，其他脑区可能也参与了这一复杂过程。本文描述了评估大量脑损伤患者以确定哪些受损脑区可能影响语言理解的机会。对64名慢性左半球中风患者进行了柯蒂斯 - 山田综合语言评估 - 接受性（CYCLE - R；柯蒂斯，S.，& 山田，J.（1988年）。柯蒂斯 - 山田综合语言评估。未发表的测试，加州大学洛杉矶分校）的11个分测验评估。8名右半球中风患者和15名神经功能正常的老年对照者也参与了研究。患者需要从三到四个选项的一组线条图中选择最能描绘听觉呈现句子内容的单个线条图。从结构神经成像获得的患者病变被重建到模板上，并与行为数据一起进行基于体素的病变 - 症状映射（VLSM；贝茨，E.，威尔逊，S.，赛金，A.P.，迪克，F.，塞雷诺，M.，奈特，R.T.，& 德龙克斯，N.F.（2003年）。基于体素的病变 - 症状映射。《自然神经科学》，6(5)，448 - 450）分析。VLSM是一种脑 - 行为映射技术，它在逐个体素的基础上评估所有患者损伤区域与行为表现之间的关系，类似于对功能神经成像数据的分析。结果表明，左半球五个脑区的病变影响了CYCLE - R的表现，包括颞中回后部及深层白质、颞上回前部、颞上沟和角回、布罗德曼46区的额中皮质以及额下回的布罗德曼47区。在这一特定测量中，未发现布洛卡区和韦尼克区的病变会显著改变语言理解。进一步分析表明，颞中回在单词层面的理解可能更重要，而其他区域在句子层面可能发挥更大作用。这些结果与最近的功能神经成像研究结果一致，并为理解语言理解背后的脑区提供了补充数据。
