Department of Neurology, University Medical Centre Freiburg, Breisacher Strasse 64, 79106 Freiburg, Germany.
Brain. 2013 Feb;136(Pt 2):619-29. doi: 10.1093/brain/aws354. Epub 2013 Jan 31.
Converging evidence from neuroimaging studies and computational modelling suggests an organization of language in a dual dorsal-ventral brain network: a dorsal stream connects temporoparietal with frontal premotor regions through the superior longitudinal and arcuate fasciculus and integrates sensorimotor processing, e.g. in repetition of speech. A ventral stream connects temporal and prefrontal regions via the extreme capsule and mediates meaning, e.g. in auditory comprehension. The aim of our study was to test, in a large sample of 100 aphasic stroke patients, how well acute impairments of repetition and comprehension correlate with lesions of either the dorsal or ventral stream. We combined voxelwise lesion-behaviour mapping with the dorsal and ventral white matter fibre tracts determined by probabilistic fibre tracking in our previous study in healthy subjects. We found that repetition impairments were mainly associated with lesions located in the posterior temporoparietal region with a statistical lesion maximum in the periventricular white matter in projection of the dorsal superior longitudinal and arcuate fasciculus. In contrast, lesions associated with comprehension deficits were found more ventral-anterior in the temporoprefrontal region with a statistical lesion maximum between the insular cortex and the putamen in projection of the ventral extreme capsule. Individual lesion overlap with the dorsal fibre tract showed a significant negative correlation with repetition performance, whereas lesion overlap with the ventral fibre tract revealed a significant negative correlation with comprehension performance. To summarize, our results from patients with acute stroke lesions support the claim that language is organized along two segregated dorsal-ventral streams. Particularly, this is the first lesion study demonstrating that task performance on auditory comprehension measures requires an interaction between temporal and prefrontal brain regions via the ventral extreme capsule pathway.
来自神经影像学研究和计算模型的综合证据表明,语言组织在一个双重背-腹脑网络中:一个背侧流通过上纵束和弓状束将颞顶叶与额前运动区连接起来,并整合感觉运动处理,例如在言语重复中。一个腹侧流通过极囊将颞叶和前额叶区域连接起来,并介导意义,例如在听觉理解中。我们的研究目的是在 100 名失语症中风患者的大样本中测试,急性重复和理解损伤与背侧或腹侧流的损伤有多好相关。我们将体素病变行为映射与我们之前在健康受试者中进行的背侧和腹侧白质纤维束的概率纤维追踪相结合。我们发现,重复障碍主要与位于后颞顶叶的病变有关,在背侧上纵束和弓状束投射的脑室周围白质中有统计学上的病变最大值。相比之下,与理解缺陷相关的病变在前颞叶更为腹侧-前部,在岛叶皮质和壳核之间的投影中有统计学上的病变最大值,在腹侧极囊中。个体病变与背侧纤维束的重叠与重复表现呈显著负相关,而与腹侧纤维束的重叠与理解表现呈显著负相关。总之,我们从急性中风患者的研究结果支持语言沿着两个分离的背-腹流组织的观点。特别是,这是第一项证明听觉理解测量任务表现需要通过腹侧极囊通路在颞叶和前额叶大脑区域之间相互作用的病变研究。