Contribution to the evaluation of language disturbances in subcortical lesions: a piloty study

Abstract

-Subcortical structures are in a strategic functional position within the cognitive networks and their lesion can interfere with a great number of functions. In this study, we describe fourteen subjects with exclusively subcortical vascular lesions (eight in the basal ganglia and six in the thalamus) and the interrelation between their language alterations and other cognitive abilities, as attention, memory and frontal executive functions. All patients were evaluated through the following batteries: Boston Diagnostic Aphasia Examination, Boston Naming Test, Token Test, Benton Visual Retention Test, Trail Making, Wisconsin Card Sorting Test and a frontal scripts task. All patients underwent MRI and twelve underwent SPECT. Results show that these patients present impairment in several cognitive domains, especially attention and executive functions. These alterations affect language abilities, and this fact must be considered in the rehabilitation efforts.KEY WORDS: thalamus, basal ganglia, language, frontal dysfunction. Contribuição à avaliação dos distúrbios de linguagem em lesões subcorticais: estudo pilotoRESUMO -As estruturas subcorticais ocupam posição funcional estratégica nas redes cognitivas e sua lesão pode interferir com um grande número de funções. Neste estudo, descrevemos 14 indivíduos com lesões vasculares exclusivamente subcorticais (oito em núcleos da base e seis no tálamo) e a interrelação entre suas alterações de linguagem e de outras funções cognitivas, como atenção, memória e funções executivas. Todos os pacientes foram avaliados através dos seguintes testes: Teste de Boston para Diagnóstico da Afasia, Teste de Nomeação Boston, Teste Token, Teste Benton de Retenção Visual, Trail Making, Wisconsin Card Sorting Test e uma tarefa de scripts frontais. Todos os pacientes realizaram RM de crânio e doze realizaram SPECT. Os resultados mostram que estes pacientes apresentam prejuízo nas várias funções cognitivas, especialmente atenção e funções executivas. Estas alterações afetam as habilidades lingüísticas e devem ser levadas em consideração nos esforços de reabilitação. PALAVRAS-CHAVE: tálamo, núcleos da base, linguagem, alteração frontal.

Language disorders and brain lesion topography in aphasics after stroke

“…Other studies by Benke et al 15 and Radanovic et al 16 described aphasic conditions references secondary to lesions in the putamen, white matter, basal ganglia, and globus pallidus. The results from the present study corroborate the findings from previous reports in the literature [14][15][16][17][18][19][20] . These reports described patients with lesions in a range of different regions, such as the putamen, cerebellum, thalamus, lentiform nucleus, internal capsule, cerebellar peduncle and the frontal, parietal and temporal areas of both hemispheres, which were associated with compromised language comprehension and expression.…”

“…Radanovic et al 14 reported on a series of 14 patients with lesions exclusively in the subcortical regions (to basal ganglia and thalamus), of whom 10 were diagnosed with aphasia and presented compromised repetition, low verbal fluency, and impaired comprehension. Other studies by Benke et al 15 and Radanovic et al 16 described aphasic conditions references secondary to lesions in the putamen, white matter, basal ganglia, and globus pallidus.…”

Persistent developmental stuttering as a cortical-subcortical dysfunction: evidence from muscle activation

“…The cingulum gyrus and the supplementary motor area are important to motivated behavior. The anterior cingulum circuit receives information of other limbic structures, projects itself to the ventral striatum, entering the cortico-subcortical loop along with other basal ganglia [24][25][26] .…”

Language recovery and evidence of residual deficits after nonthalamic subcortical stroke: A 1 year follow-up study

“…In addition, fluent aphasia, comprehension difficulties and phonemic paraphasias may follow large putamenal hemorrhages (D'Esposito & Alexander, 1995). Language disturbances after left striatiocapsular lesions often involve fluent speech disturbances (Radanovic, Mansur, Azambuja, Porto, & Scaff, 2004) and impairment in repetition and in naming with paraphasic errors (Nadeau & Crosson, 1997). It has been also suggested that striatocapsular and white matter periventricular lesions are more strongly associated with phonetic than semantic impairment (Kuljic-Obradovic, 2003).…”