Tippett Donna C, Niparko John K, Hillis Argye E
Department of Neurology, Johns Hopkins University School of Medicine, USA.
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, USA.
J Neurol Transl Neurosci. 2014 Jan;2(1):1042.
Recent advances in neuroimaging contribute to a new insights regarding brain-behavior relationships and expand understanding of the functional neuroanatomy of language. Modern concepts of the functional neuroanatomy of language invoke rich and complex models of language comprehension and expression, such as dual stream networks. Increasingly, aphasia is seen as a disruption of cognitive processes underlying language. Rehabilitation of aphasia incorporates evidence based and person-centered approaches. Novel techniques, such as methods of delivering cortical brain stimulation to modulate cortical excitability, such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation, are just beginning to be explored. In this review, we discuss the historical context of the foundations of neuroscientific approaches to language. We sample the emergent theoretical models of the neural substrates of language and cognitive processes underlying aphasia that contribute to more refined and nuanced concepts of language. Current concepts of aphasia rehabilitation are reviewed, including the promising role of cortical stimulation as an adjunct to behavioral therapy and changes in therapeutic approaches based on principles of neuroplasticity and evidence-based/person-centered practice to optimize functional outcomes.
神经影像学的最新进展为脑-行为关系带来了新的见解,并拓展了对语言功能神经解剖学的理解。现代语言功能神经解剖学概念引入了丰富而复杂的语言理解和表达模型,如双流网络。失语症越来越被视为语言背后认知过程的紊乱。失语症康复采用基于证据和以人为本的方法。诸如重复经颅磁刺激和经颅直流电刺激等通过传递皮层脑刺激来调节皮层兴奋性的新技术才刚刚开始被探索。在这篇综述中,我们讨论了语言神经科学方法基础的历史背景。我们列举了语言神经基质以及失语症背后认知过程的新兴理论模型,这些模型有助于形成更精确、更细微的语言概念。本文回顾了当前失语症康复的概念,包括皮层刺激作为行为疗法辅助手段的潜在作用,以及基于神经可塑性原则和循证/以人为本实践改变治疗方法以优化功能结果。