Schäffler L, Lüders H O, Beck G J
Department of Neurology, Cleveland Clinic Foundation, Ohio 44195, USA.
Epilepsia. 1996 May;37(5):463-75. doi: 10.1111/j.1528-1157.1996.tb00593.x.
Subdural electrodes were implanted over the language-dominant left lateral convexity in 45 patients undergoing evaluation for epilepsy surgery. In 29 patients, additional electrodes were placed over the left basal temporal cortex. We identified language areas by using intermittent electrical stimuli applied while patients read aloud. Aphasia was classified as expressive or receptive based on additional testing performed when electrical stimulation elicited reading arrest in the absence of direct excitatory or inhibitory motor effects. Using correlated logistic regression, we noted no statistically significant differences among Broca's, and Wernicke's areas and the basal temporal language area (BTLA) regarding the frequency with which electrical stimulation interfered with language. Speech production deficits, however, occurred significantly more frequently in Broca's than in Wernicke's area (p = 0.012). In contrast, language comprehension deficits occurred with equal frequency when Broca's and Wernicke's areas were stimulated. These results suggest that both Broca's and Wernicke's areas play important roles in language comprehension and that the primarily expressive aphasia of patients with lesions of Broca's area results mainly from the predominant participation of Broca's area in language production.
45例接受癫痫手术评估的患者在语言优势半球左侧外侧凸面植入硬膜下电极。其中29例患者在左侧颞叶基底皮质上方额外放置了电极。我们通过在患者大声朗读时施加间歇性电刺激来识别语言区域。根据在电刺激引起朗读停顿且无直接兴奋或抑制运动效应时进行的额外测试，将失语症分为表达性或接受性失语。使用相关逻辑回归分析，我们发现布罗卡区、韦尼克区和颞叶基底语言区（BTLA）在电刺激干扰语言的频率方面没有统计学上的显著差异。然而，布罗卡区出现言语产生缺陷的频率明显高于韦尼克区（p = 0.012）。相比之下，刺激布罗卡区和韦尼克区时，语言理解缺陷出现的频率相同。这些结果表明，布罗卡区和韦尼克区在语言理解中都起着重要作用，并且布罗卡区病变患者主要的表达性失语主要是由于布罗卡区在语言产生中的主要参与。
