Age of language acquisition and cortical language organization in multilingual patients undergoing awake brain mapping
Age of language acquisition and cortical language organization in multilingual patients undergoing awake brain mapping
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DOI：
10.3171/2016.5.jns152791
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发表时间：
2017-06-01
影响因子：
4.1
通讯作者：
Gabarros, Andreu
中科院分区：
文献类型：
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作者：
Fernandez-Coello, Alejandro;Havas, Viktoria;Gabarros, Andreu
目的 大多数关于多语言的解剖结构的知识都是基于失语学。功能成像研究。然而，结果仍需通过金标准方法验证，即清醒神经外科手术期间的电刺激映射（ESM）。在这项 ESM 研究中，作者描述了由 13 名多语言个体组成的高度特定的群体的语言表征，重点关注习得年龄如何影响语言的皮层组织。 方法 13 名具有多种语言熟练程度且在优势左半球内存在病变的患者在清醒条件下接受了 ESM 手术。记录人口统计和语言数据，涉及语言习得年龄（母语以及早期和晚期习得语言）、神经心理学术前和术后语言测试、语言位点的数量和位置以及语言习得时间的重叠分布。还记录了病变生长模式和组织病理学特征、位置和大小。根据习得年龄和重叠情况分析语言位点的分布。结果功能性语言相关位点分布在额叶（55%）、颞叶（29%）和顶叶（16%）。母语位点总数为 47 个。早期习得语言（包括母语）有 97 个位点（55 个重叠），晚习得语言有 70 个位点（45 个重叠）。重叠分布为早-早20%，早-晚71%，晚-晚9%。平均病变尺寸（最大直径）为3.3厘米。有5个快速生长的病变和7个缓慢生长的病变。结论多语言患者的皮层语言分布不均匀，并且受获得年龄的影响。早期获得的语言比后来获得的语言具有更大的皮质表征。流行的母语和早期获得的语言主要集中在左半球左半球的额顶颞叶区域，而不太流行的晚期获得的语言则大多与它们重叠。
OBJECTIVE Most knowledge regarding the anatomical organization of multilingualism is based on aphasiology and. functional imaging studies. However, the results have still to be validated by the gold standard approach, namely electrical stimulation mapping (ESM) during awake neurosurgical procedures. In this ESM study the authors describe language representation in a highly specific group of 13 multilingual individuals, focusing on how age of acquisition may influence the cortical organization of language.METHODS Thirteen patients who had a high degree of proficiency in multiple languages and were harboring lesions within the dominant, left hemisphere underwent ESM while being operated on under awake conditions. Demographic and language data were recorded in relation to age of language acquisition (for native languages and early- and late acquired languages), neuropsychological pre- and postoperative language testing, the number and location of language sites, and overlapping distribution in terms of language acquisition time. Lesion growth patterns and histopathological characteristics, location, and size were also recorded. The distribution of language sites was analyzed with respect to age of acquisition and overlap.RESULTS The functional language-related, sites were distributed in the frontal (55%), temporal (29%), and parietal lobes (16%). The total number of native language sites was 47. Early-acquired languages (including native languages) were represented in 97 sites (55 overlapped) and late-acquired languages in 70 sites (45 overlapped). The overlapping distribution was 20% for early-early, 71% for early-late, and 9% for late-late. The average lesion size (maximum diameter) was 3.3 cm. There were 5 fast-growing and 7 slow-growing lesions.CONCLUSIONS Cortical language distribution in multilingual patients is not homogeneous, and it is influenced by age of acquisition. Early-acquired languages have a greater cortical representation than languages acquired later. The prevalent native and early-acquired languages are largely represented within the perisylvian left hemisphere frontoparietotemporal areas, and the less prevalent late-acquired languages are mostly overlapped with them.