Damage to ventral and dorsal language pathways in acute aphasia.
Damage to ventral and dorsal language pathways in acute aphasia.
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DOI：
10.1093/brain/aws354
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发表时间：
2013-02
期刊：
影响因子：
--
通讯作者：
Saur D
中科院分区：
文献类型：
--
作者：
Kümmerer D;Hartwigsen G;Kellmeyer P;Glauche V;Mader I;Klöppel S;Suchan J;Karnath HO;Weiller C;Saur D
来自神经影像学研究和计算模型的证据表明，语言在背腹双脑网络中进行组织：背侧流通过上纵束和弓状束将颞顶叶与额叶前运动区连接起来，并整合感觉运动处理，例如在言语的重复中。腹侧流通过末端胶囊连接颞叶和前额叶区域并介导意义，例如在听觉理解方面。我们研究的目的是在 100 名失语性中风患者的大样本中测试重复和理解的急性损伤与背侧或腹侧流损伤的相关性。在我们之前对健康受试者的研究中，我们将体素病变行为映射与通过概率纤维跟踪确定的背侧和腹侧白质纤维束结合起来。我们发现，重复障碍主要与位于后颞顶区域的病变相关，在背侧上纵束和弓状束的投影中，脑室周围白质的统计病变最大。相比之下，与理解缺陷相关的病变在颞前额叶区域更多地位于腹前侧，在腹侧极端囊的投影中，岛叶皮质和壳核之间的统计病变最大。单个病变与背侧纤维束的重叠与重复表现呈显着负相关，而与腹侧纤维束的病变重叠与理解表现呈显着负相关。总而言之，我们对急性中风病变患者的研究结果支持这样的说法：语言是沿着两条分离的背腹流组织的。特别是，这是第一个损伤研究，表明听觉理解测量的任务表现需要颞叶和前额叶大脑区域通过腹侧极端胶囊通路之间的相互作用。
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.
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