Activation of language cortex with automatic speech tasks
Activation of language cortex with automatic speech tasks
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DOI：
10.1212/wnl.55.8.1151
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发表时间：
2000-10-24
期刊：
影响因子：
9.9
通讯作者：
Theodore, WH
中科院分区：
文献类型：
--
作者：
Bookheimer, SY;Zeffiro, TA;Theodore, WH
目的：使用 PET 识别能够可靠证明皮质布罗卡区和韦尼克区局部脑血流量 (rCBF) 增加的自动语音任务。背景：通过直接皮层刺激映射来定位语言需要患者在涉及口才皮层的测试中具有稳定的基线。对于语言障碍患者或年幼的儿童，通常使用计数等自动语音任务来代替更复杂的语言测试。来自病变和神经影像学研究的证据表明，这些任务可能无法充分调动语言皮层。在这项研究中，我们检查了不同复杂程度的自动口运动和言语任务中的 rCBF，以确定那些引起布罗卡区和韦尼克区 CBF 增加的因素。方法：8 名正常志愿者在休息、舌头运动和三个自动言语任务中接受 PET：重复音素序列、重复一年中的月份和背诵记忆的散文段落。对受试者之间的图像进行平均，并在区域定位和偏侧性任务之间进行比较。结果：虽然所有激活任务都会在与发音和听觉处理相关的大脑区域中产生相对 CBF 增加，但只有使用真实单词（相对于音素）的两项任务显示后上颞叶（韦尼克区）的左偏 rCBF 增加，并且只有散文重复任务在布罗卡区产生左偏活动。结论：虽然自动语音通常不会涉及语言皮层，但重复记忆的散文段落在布罗卡区和韦尼克区都显示出明确的激活。这些结果警告不要使用常见的自动语音任务来映射雄辩皮层，并为那些语言能力较差或获得性言语障碍且无法可靠地执行标准化语言测试的人建议替代任务。
Objective: To identify automatic speech tasks that reliably demonstrate increased regional cerebral blood flow (rCBF) in Broca's and Wernicke's areas of the cortex using PET. Background: Localizing language with direct cortical stimulation mapping requires that patients have a stable baseline on tests that engage eloquent cortex. For dysphasic patients or younger children, automatic speech tasks such as counting are often used in lieu of more complex language tests. Evidence from both lesion and neuroimaging studies suggests that these tasks may not adequately engage language cortices. In this study, we examined rCBF during automatic oromotor and speech tasks of varying complexity to identify those eliciting increased CBF in Broca's and Wernicke's areas. Methods: Eight normal volunteers underwent PET during rest, tongue movements, and three automatic speech tasks: repeating a phoneme sequence, repeating the months of the year, and reciting a memorized prose passage. Images were averaged across subjects and compared across tasks for regional localization and laterality. Results: Whereas all activation tasks produced increased relative CBF in brain regions that correlated with articulation and auditory processing, only the two tasks that used real words (versus phonemes) showed left-lateralized rCBF increases in posterior superior temporal lobe (Wernicke's area), and only the prose repetition task produced left lateralized activity in Broca's area. Conclusions: Whereas automatic speech typically does not engage language cortex, repeating a memorized prose passage showed unambiguous activation in both Broca's and Wernicke's areas. These results caution against the use of common automatic speech tasks for mapping eloquent cortex and suggest an alternative task for those with poor language abilities or acquired dysphasia who cannot perform standardized language tests reliably.