Tracy Joseph I, Waldron Brigid, Glosser David, Sharan Ashwini, Mintzer Scott, Zangaladze Andro, Skidmore Christopher, Siddiqui Imran, Caris Elizabeth, Sperling Michael R
Department of Neurology, Thomas Jefferson University, Jefferson Medical College, Philadelphia, PA 19107, United States.
Cortex. 2009 Nov-Dec;45(10):1178-89. doi: 10.1016/j.cortex.2009.01.007. Epub 2009 Feb 13.
Patients with an early onset of temporal lobe epilepsy (TLE) are at an increased risk for language reorganization. It is unknown whether this reorganization involves a full shift of all language skills to the contralateral hemisphere, or whether it can be partial and involve only a subset of language skills. In this study we report dominance concordance patterns for five separate language skills measured during the Intracarotid Amobarbital Procedure (IAP) for 124 TLE patients. We examined whether the language skills show similar or independent lateralization patterns. We compare these patterns in early versus late seizure onset groups with either a left or right temporal lobe seizure focus. The data showed that the rates of atypical representation ranged from 25.8% for reading to 14.5% of the sample for speech. A majority of patients (60%) showing atypical language representation do so on more than one skill. While multiple atypicalities were common, the proportion of patients showing atypical representation on all five skills was strikingly low (5.6% of the total sample). Our data suggest that language systems are not independent and do not shift and reorganize in isolation, and no pairs of skills seem more likely to reorganize than others. There was also evidence that language is not monolithic with all language skills reorganizing together. The latter suggests that the pressures compelling atypical representation may not work equally on all language skills.
早发性颞叶癫痫（TLE）患者发生语言重组的风险增加。目前尚不清楚这种重组是否涉及所有语言技能完全转移至对侧半球，还是可能只是部分转移，仅涉及一部分语言技能。在本研究中，我们报告了124例TLE患者在颈内动脉阿米妥试验（IAP）期间所测量的五种不同语言技能的优势一致性模式。我们研究了这些语言技能是否表现出相似或独立的偏侧化模式。我们比较了早期发作与晚期发作组（癫痫病灶位于左侧或右侧颞叶）的这些模式。数据显示，非典型表征的发生率从阅读的25.8%到言语的14.5%不等。大多数（60%）表现出非典型语言表征的患者在不止一项技能上如此。虽然多种非典型情况很常见，但在所有五项技能上均表现出非典型表征的患者比例极低（占总样本的5.6%）。我们的数据表明，语言系统并非相互独立，不会孤立地转移和重组，而且没有哪两项技能似乎比其他技能更易重组。也有证据表明，语言并非整体统一，所有语言技能不会一起重组。后者表明，促使非典型表征出现的压力可能并非对所有语言技能都产生同等作用。
