Temporal lobe stimulation reveals anatomic distinction between auditory naming processes
Temporal lobe stimulation reveals anatomic distinction between auditory naming processes
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DOI：
10.1212/01.wnl.0000061489.25675.3e
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发表时间：
2003-05-13
期刊：
影响因子：
9.9
通讯作者：
McKhann, GM
中科院分区：
文献类型：
--
作者：
Hamberger, MJ;Seidel, WT;McKhann, GM
背景：皮质刺激引起的语言错误可以深入了解受刺激区域支持的功能。作者观察到，在听觉描述命名过程中，一些刺激引起的错误以舌尖反应或错位错误为特征，表明表达困难，而其他错误则性质不同，表明接受困难。他们假设这两种反应类型反映了听觉语言处理不同阶段的中断，并且这些“子过程”可能由解剖学上不同的皮层区域支持。目的：探讨听觉语言处理中错误类型的地形分布。方法：21 名需要左颞叶手术的患者使用直接皮质刺激进行了术前语言映射。在从前尖到顶叶盖 1 厘米的颞部位置测试听觉命名。错误被分为“表达性”或“接受性”。探索了错误类型的地形分布。结果：与两种错误类型相关的位点在地形上彼此不同。大多数接受位点位于颞上回（STG）的中部，而大多数表达位点位于该区域之外，分布在颞侧和颞顶皮层。结论：结果提出了关于在颞叶癫痫手术中纳入 STG 的临床问题，并表明更详细的皮质绘图可能能够更好地预测术后语言衰退。从理论角度来看，结果对于理解听觉语言处理的颞叶中介的结构功能关系具有重要意义。
Background: Language errors induced by cortical stimulation can provide insight into function(s) supported by the area stimulated. The authors observed that some stimulation-induced errors during auditory description naming were characterized by tip-of-the-tongue responses or paraphasic errors, suggesting expressive difficulty, whereas others were qualitatively different, suggesting receptive difficulty. They hypothesized that these two response types reflected disruption at different stages of auditory verbal processing and that these "subprocesses" might be supported by anatomically distinct cortical areas. Objective: To explore the topographic distribution of error types in auditory verbal processing. Methods: Twenty-one patients requiring left temporal lobe surgery underwent preresection language mapping using direct cortical stimulation. Auditory naming was tested at temporal sites extending from 1 cm from the anterior tip to the parietal operculum. Errors were dichotomized as either "expressive" or "receptive." The topographic distribution of error types was explored. Results: Sites associated with the two error types were topographically distinct from one another. Most receptive sites were located in the middle portion of the superior temporal gyrus (STG), whereas most expressive sites fell outside this region, scattered along lateral temporal and temporoparietal cortex. Conclusions: Results raise clinical questions regarding the inclusion of the STG in temporal lobe epilepsy surgery and suggest that more detailed cortical mapping might enable better prediction of postoperative language decline. From a theoretical perspective, results carry implications regarding the understanding of structure-function relations underlying temporal lobe mediation of auditory language processing.