To what extent can aphasic syndromes be localized?

Modern views on the representation of function in the cortex make it difficult to maintain the notion that specific subtypes of aphasia are associated with specific centres within the language area. We have conducted a retrospective study on 221 aphasic patients with one contiguous vascular lesion in the territory of the middle cerebral artery. The localization of CT lesions was established within a standardized grid model. Aphasiological data were based on one or more examinations with the Aachen Aphasia Test. Both sets of data were processed in a data- and methodbase system. No unequivocal association between type of aphasia and localization of lesion was found. In a smaller study, participation of basal ganglia and in particular of the head of the caudate nucleus in lesions producing aphasia was not confirmed. Concepts of the localization of a lesion in aphasia must account for changes in patterns of aphasic symptoms in the presence of a stable lesion and for the impact of the neurological condition that has produced the lesion.