Right anterior superior temporal activation predicts auditory sentence comprehension following aphasic stroke
Right anterior superior temporal activation predicts auditory sentence comprehension following aphasic stroke
复制标题
DOI：
10.1093/brain/awh659
复制
发表时间：
2005-12-01
期刊：
影响因子：
14.5
通讯作者：
Price, CJ
中科院分区：
文献类型：
--
作者：
Crinion, J;Price, CJ
先前的研究表明，左脑梗塞后语言理解能力的恢复可能依赖于右脑的一种机制。然而，左半球中风后不同的右半球区域在言语理解中所起的作用还没有确定。在这里，我们使用功能磁共振成像(FMRI)研究了18名神经学正常受试者和17名有失语病史的左半球中风患者的叙述性言语激活。在正常受试者和每个患者中，都发现了听有意义的故事而不是无意义的颠倒言语的激活。然后使用第二水平的分析来研究故事激活如何随着患者的听觉句子理解技能和意外故事识别记忆测试的扫描后的变化而变化。无论病变部位如何，听觉句子理解测验成绩与初级听觉皮质前方右侧颞上区的激活呈正相关。此外，当中风没有影响左侧颞叶皮质时，在听觉句子理解测试中的良好表现也与左侧后上颞叶皮质(韦尼克区)相关。与此形成鲜明对比的是，良好的故事再认记忆可以预测左侧额叶下部和右侧小脑的激活。在听觉句子理解和故事识别记忆的影响中，这种双重分离的含义是，左额叶和左额叶激活是可以分离的。我们的发现有力地支持了右颞叶在处理叙述性言语，特别是在左半球失语症中风后的听觉句子理解中的作用。此外，他们强调了右侧前上颞叶皮质的重要性，在那里，反应与左侧后颞叶的反应是分离的。
Previous studies have suggested that recovery of speech comprehension after left hemisphere infarction may depend on a mechanism in the right hemisphere. However, the role that distinct right hemisphere regions play in speech comprehension following left hemisphere stroke has not been established. Here, we used functional magnetic resonance imaging (fMRI) to investigate narrative speech activation in 18 neurologically normal subjects and 17 patients with left hemisphere stroke and a history of aphasia. Activation for listening to meaningful stories relative to meaningless reversed speech was identified in the normal subjects and in each patient. Second level analyses were then used to investigate how story activation changed with the patients' auditory sentence comprehension skills and surprise story recognition memory tests post-scanning. Irrespective of lesion site, performance on tests of auditory sentence comprehension was positively correlated with activation in the right lateral superior temporal region, anterior to primary auditory cortex. In addition, when the stroke spared the left temporal cortex, good performance on tests of auditory sentence comprehension was also correlated with the left posterior superior temporal cortex (Wernicke's area). In distinct contrast to this, good story recognition memory predicted left inferior frontal and right cerebellar activation. The implication of this double dissociation in the effects of auditory sentence comprehension and story recognition memory is that left frontal and left temporal activations are dissociable. Our findings strongly support the role of the right temporal lobe in processing narrative speech and, in particular, auditory sentence comprehension following left hemisphere aphasic stroke. In addition, they highlight the importance of the right anterior superior temporal cortex where the response was dissociated from that in the left posterior temporal lobe.