1. Language Organization Classic model
Sensory perception--comprehension (WA)--Broca’s
(formulation, motor plan)--motor cortex (final common pathway)

2. Language Organization Classic model
Sensory perception--comprehension (WA)--Broca’s
(formulation, motor plan)--motor cortex (final common pathway)

3. Classical conception of aphasia. Paul Broca (1824-1880).
Communication a la Societe d’Anthropologie (1865)” Je vous ai communique…….dix observations d’aphemie dans lesquelles on a trouve a l’autopsie des lesions diverses de la 3me circonvolution frontale…..Je persiste a penser que l’aphemie verbale, c’est a dire la perte de la parole sans paralysie des organes de l’articulation et sans destruction de l’intelligence est liee aux lesions de la 3me circonvolution frontale. Ma communication est relative a la singuliere predilection de l’aphemie pour l’hemisphere gauche du cerveau”
Mr.Leborgne =Tan-Tan died 4/17/1861

4. Mr. Leborgne died am
at the age of 51.
MRI of Leborgne

5. Voxel-based Lesion-Symptom Mapping (VLSM): sample maps
Fluency
Comprehension
Bates, Wilson, Saygin, Dick, Sereno, Knight & Dronkers, 2002

6. Disruption model of language function
“Broca’s Area”: PIFG
“Wernicke’s area”: PT/IP
Reading Area: Angular Gyrus
Basal Temporal Language Area

7. Frontal regions
44 inf
44/6
9/6 Exners area 46 45 47
6 medial
Temporal regions
41/42 22
21/20 37
Parietal:

8. 1 1 2 2 5 4 8 6 6 3 3 3 7 7 6 9 9 10 10 8

9. Basal Temporal Language Area
Mills Naming Center; Nielson’s language formulation center
Involved in object naming
Lesion: Pure anomic aphasia
Category specificity in more anterior areas
Believe pathways project ant/sup through insula 1 1

11. BTLA is difficult to image:
Major artifacts; need to indicate where you haven’t signal- false negative risk
Object naming area: verb generation is NOT a good activator of this region

12. Wernicke’s area(s)
Inferior portion: middle temporal gyrus/superior temporal sulcus
Often bilateral activation
Superior portion: superior temporal gyrus/supramarginal gyrus
Posterior/adjacent to TTG 2 2 3 3

15. Wernicke’s area(s)
Critical for auditory language comprehension; word recognition, sequencing phonemes
Lesions: grammatic speech; multiple paraphasias;
Superior lesions: phoneme selection deficits, sequencing deficits; reading problems
Activations often quite deep in sulci
Output travels posterior and superior in arcuate fasciculus
Lesions of white matter tracts into and out of the region can lead to serious deficits;These can be quite distal to the cortical processing areas
Object naming, word generation --poor activators

16. Arcuate fasciculus http://da.biostr.washington.edu/da.html

17. Frontal language areas5 4 8 6 6 6 9 9 10 10

18. Bookheimer 2003 Annual Rev. Neurosci.
In a review we did a few years ago, already out of date, suggested a dissociation within IFG based roughly on these “content characteristics”; more studies of phonological processing showing posteior IFG especially this IFS activity; sentence level studies and those looking at other aspects of syntax showed this nive v in area 45; semantic retrieval and other semantic studies showing 47 activity. Suggest a much higher level of modularity the disruption data would suggest, though in retrospect we should notn wonder why. Ojemann found that phoneme monitoring was disrupted in posterior IFG areas. Will show semantic dsiruption as well. In general when we do corticography we are extremely limited in what we can do. Time is spent doing object naming. Robust test; pass the ON test, musnt be important for language.
Bookheimer 2003 Annual Rev. Neurosci.

19. Orbital frontal cortex: 47/45
Arguments about its job: semantics; verbal selection; selection generally
Integration of (semantic) information
Lesion/electrical stimulation: semantic integration deficits: normal object naming, grammatic speech; impaired auditory responsive naming 4

20. “Broca’s” area: 44 and 45
Superior to IFS/PCS border, inferior to sylvian
Focal region; variable in precise location; some language specificity
Must exist!
Lesions: grammatic output; naming; generation; phoneme monitoring; syntax comprehension; effortful speech; arrest or anomia with stimulation 6

23. A B

24. Phonology in IFG
Gelfand and Bookheimer, Neuron 2002

25. reverse
delete
match

27. Exner’s Area 6/8 in MFG/PMC Associated with pure agraphia
Appears in many tasks 7 8

28. Longcamp et al NeuroImage 2003

29. Phoneme to grapheme task; saccades
Exner’s area vs FEF
Phoneme to grapheme task; saccades
Matsuo et al Neurosci Lett 2003
Exner’s
FEF

31. Stimulated region
Tumor
Stimulated region

32. Angular Gyrus Critical for reading
Integrates auditory and visual information
Pathways from IT to AG, oCC-AG, AG-SMG, all vulnerable 7
Reading phrases

34. Supplementary Speech Area (Pre-SMA, Speech SMA)
Important in initiating a motor speech plan
When removed, get a complete arrest of speech; lesions may reduce initiation or lead to a “dwindling aphasia”; comprehension is normal
Easily reorganizes to intact RH when the callosum is intact- 1-3 weeks 10

35. Anterior Insula Very often bilaterally symmetric
When lesioned bilaterally (and selectively): pure apraxia of speech
Lesions of area (nearby white matter, IFG, striatum) lead to profound expressive aphasia
Do not use to establish laterality; don’t recommend to remove it either 5

36. Dorsolateral Pre-frontal Cortex
Not a language area
Will show activation, sometimes unilateral, especially on generation tasks
Lesions show reduced fluency; stimulation often produces perseverations
Don’t use for laterality; often removed in surgery 8

37. Language 2 Reading system and reading disorders
Right hemisphere contributions to language
Prosody
context

38. Reading System Major issue in reading: 1 or 2 pathways
Call this the Dual Route model
Was controversial before functional imaging- now its pretty well accepted
Based on differences in acquired alexia errors

39. Types of Alexia Phonologica, literal or Surface
Patients read in a letter-by-letter fashion
They sound out each word
Errors: they can read pronounceable nonsense words “migbus”; cannot read irregular words like “yacht”
Damage likely to the visual recognition system in the LH: cant recognize whole words

40. Alexia cont. Alexia type 2: visual, semantic alexia
Can read whole words
Can read irregulars like yacht and pharoah
Cannot read nonsense words
Strong frequency effect- more likely to read common than uncommon words; better at concrete nouns
Make visual or regularization errors: lit = light; groal=goal, etc.
Apparently have damage to phonological to orthographic conversion system or to phonological system

41. Rarer alexias
Global alexia: affects all reading. AG lesions or WM exiting visual cortex in LH
Deep dyslexia: associated with large LH lesions- characterized by global dyslexia with:
Visual errors: gird=“girl”
Derivational errors: architecture= architect
Semantic errors: orchestra=symphony
Superior at reading concrete nouns
Suggested to represent some primitive RH whole word recognition capabilities

42. Rarer alexias, cont. Alexia without agraphia or occipital alexia:
Most other acquired alexics have impaired writing similar to reading
Alexia without agraphia associated with 2 lesions: one in the left occipital cortex and one in the posterior callosum
Disruption of visual information into the LH reading system. Usually accompanied by a field or quadrant cut
Can write, but cant read what they write

43. Developmental dyslexia
Most are similar to the surface alexic
Difficulty with auditory processing
Poor at grapheme to phoneme conversion
Lousy at reading nonwords
Slow readers; often learn by whole-word approach
Rarer, there are visual types and often some with general language difficulties

44. Anatomy of Reading Inferior Frontal Gyrus Supramarginal Gyrus (40)
Angular Gyrus (39)
Superior Temporal
Gyrus (posterior)42,41;22
Temporal/Occipital
Junction 21/20/37

45. Dual Routes Inferior Route: Superior Route Interaction through AG
Occipital V1-V2-V3-IT-insula/44/47
Superior Route
V1-V2- AG-ST- IFG 44/6
Interaction through AG
Writing: includes SMG and Exner’s area (46/6 anterior to M1 hand)

46. Focus on the top. Silent reading involves more of the inferior circuit- IT, Fus, and 47; oral reading involves little IT, more ST and M1. Note the lack of language or semantic areas in oral reading.
Other evidence in imaging studies for dual route: lexical descision (Rumsey study_ shows more activity in ventral areas; reading aloud shows more of trhe superior route.

47. Right hemisphere contributions to language
Some evidence that early right brain lesions can be more detrimental to language development than LH lesions
LH may process more rapid information. RH may maintain a context and provide emotional cues to global meaning
Some evidence that the ear itself is tuned for more rapid auditory information in LH or infants (Sininger 2004 Science).

48. Prosody Paradigm Selective attention/stimulus matched paradigm
For the 2 prosody conditions:
“Do the sentences sound alike” regardless of literal meaning
For the SC condition:
“Do the sentences mean the same thing” regardless of the sound

49. Affective prosody vs. others

50. Linguistic vs. Affective

51. Linguistic Prosody- Left
Affective Prosody- Right

52. Making Sense of Conversation (R. Caplan and M. Dapretto, 2003)
Logical Reasoning
Q: Do you like having fun?
A: Yes, because it makes me happy.
Illogical
Q: Do you like having fun?
A: No, because it makes me happy.
On-topic
Q: Do you believe in angels?
A: Yeh, I have my own special angel
Off-topic (LA)
A: Yeh, I like to go to camp

53. Reasoning vs Topic
Normal Adults

54. Topic vs Reasoning in Normal Adults

55. Reorganized language in early lesions
Can see individual patterns using fMRI
Appears to follow a principle of minimal energetics: only move what is essential to move

56. Initiates speech on the right; language is on the left

57. Auditory Naming Task
Patient: LH tumor; R handed, R Brain Speech, Wada confirmed

58. Rasmussen’s Disease, age 12
Right
Left

59. Six months post left hemispherectomy

60. Right hemisphere contributions to language
Sentence level: Topic maintenance vs logical reasoning
Understanding metaphor, purpose or intent of speaker

62. 1 1 2 2 5 4 8 6 6 3 3 3 7 7 6 9 9 10 10 8