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Higher Cortical Functions
Cerebral Asymmetry Cerebral Dominance Fall 2012
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Association Fibers
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Corpus Callosum
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Lateral Fissure Asymmetries
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Planum Temporale Larger Left hemisphere = 65% Right hemisphere = 11%
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Cerebral Dominance Dominant Non-dominant Language/Speech Math skills
Problem solving Processing sign language Non-dominant Spatial relationships Music and poetry Artistic ability Emotion
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Cerebral Dominance 90-95% right handed people = left hemisphere dominance 65-75% left handed people = left hemisphere dominance True ambidextrous people 60% left dominance 30% right dominance 10% equal dominance Handedness is not a 100% accurate assessment of cerebral dominance Wada testing
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Language Areas Central Sulcus Precentral Gyrus Postcentral Gyrus
Arcuate Fasciculus Angular Gyrus Broca’s Area 44 & 45 Wernicke’s Area 22 Lateral Fissure Superior Temporal Gyrus
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Broca’s Aphasia NON-FLUENT, MOTOR OR EXPRESSIVE APHASIA
SPONTANEOUS SPEECH Non-fluent, telegraphic, often dysarthric Greatly reduced - 10 wpm COMPREHENSION Intact, mild difficulty with complex grammatical phrases REPETITION Impaired
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Broca’s Aphasia NAMING READING WRITING
Impaired Prompting helps significantly READING Often impaired WRITING Impaired, dysmorphic, dysgrammatic
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Broca’s Aphasia Anterior distribution of left middle cerebral artery
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Wernicke’s Aphasia FLUENT, SENSORY OR RECEPTIVE APHASIA
SPONTANEOUS SPEECH Fluent, often increased, paraphasias common, usually not dysarthric Often meaningless - Neologisms COMPREHENSION Impaired REPETITION
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Wernicke’s Aphasia NAMING READING WRITING Impaired
Impaired for both comprehension and reading out loud WRITING Well-formed letters in meaningless combinations
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Wernicke’s Aphasia Posterior distribution of left middle cerebral artery
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Conduction Aphasia SPONTANEOUS SPEECH COMPREHENSION REPETITION
Fluent, some hesitancy May be paraphasic - meaningless COMPREHENSION Intact REPETITION Severely impaired Lesion involves arcuate fasciculus in dominant hemisphere
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Conduction Aphasia NAMING May be moderately impaired READING
Reading out loud severely impaired Reading comprehension usually good WRITING Variable deficits
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Aphasia Square Good Comprehension Poor Comprehension Fluent Speech
Wernicke’s Aphasia Fluent Speech Conduction Aphasia Transcortical Sensory Aphasia Broca’s Aphasia Mixed Transcortical Aphasia Non-Fluent Speech Transcortical Motor Aphasia POOR REPETITION GOOD
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Anomic Aphasia (Anomia)
SPONTANEOUS SPEECH Fluent, some pauses, circumlocution COMPREHENSION Intact REPETITION NAMING Impaired, but prompting helps READING WRITING Intact, except for anomia
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