Crossed Aphasias Can Be Mirror Image or Anomalous

Alexander, Michael P.; Fischette, Maria R.; Fischer, Richard S.

doi:10.1093/brain/112.4.953

Cited by 109 publications

(56 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Alexander et al (1989) reported a similar figure (i. e., 11 %). In contrast, from Table 2 it emerges that the crossed right hemisphere syndrome is more homogeneous.…”

Section: Discussionsupporting

confidence: 59%

Crossed right hemisphere syndrome following left thalamic stroke

2005

View full text Add to dashboard Cite

In most right-handed people, language and motor functions are more reliant on systems of the left hemisphere while several non-linguistic visuo-spatial and attentional processes depend more on the right hemisphere. The rare exceptions to these rules provide important clues as to what functions co-lateralise, and are thus crucial for models of cerebral specialization. Here we report on the case of a patient, who, after a lesion restricted to the left thalamic region, showed signs normally associated with right hemispheric injury including motor impersistence, visuo-spatial dysfunction and poor comprehension of facial expression. Language abilities were spared and no signs of apraxia were present, in spite of his right hand, foot and eye preference, a pattern normally associated with conventional cerebral dominance. In spite of his other right hemispheric signs, the patient showed no signs of hemi-spatial neglect. The patient's pattern of spared and impaired abilities is compared and contrasted with other rare cases of crossed right hemisphere syndrome.

show abstract

“…Alexander et al (1989) reported a similar figure (i. e., 11 %). In contrast, from Table 2 it emerges that the crossed right hemisphere syndrome is more homogeneous.…”

Section: Discussionsupporting

confidence: 59%

Crossed right hemisphere syndrome following left thalamic stroke

2005

View full text Add to dashboard Cite

show abstract

“…Right hemisphere stroke is only responsible for approximately 4% of poststroke aphasia and occurs in right- or left-handed or ambidextrous patients with their language representation in the right hemisphere [1,46,47]. For right-handers, the term ‘crossed aphasia' is used, but right hemisphere stroke aphasia is more often seen in left-handers.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Brain Stimulation for Treatment of Right- and Left-Handed Poststroke Aphasics

Heiss

Hartmann²,

Rubi-Fessen³

et al. 2013

Cerebrovasc Dis

View full text Add to dashboard Cite

Background: Accumulating evidence from single case studies, small case series and randomized controlled trials seems to suggest that inhibitory noninvasive brain stimulation (NIBS) over the contralesional inferior frontal gyrus (IFG) of right-handers in conjunction with speech and language therapy (SLT) improves recovery from poststroke aphasia. Application of inhibitory NIBS to improve recovery in left-handed patients has not yet been reported. Methods: A total of 29 right-handed subacute poststroke aphasics were randomized to receive either 10 sessions of SLT following 20 min of inhibitory repetitive transcranial magnetic stimulation (rTMS) over the contralesional IFG or 10 sessions of SLT following sham stimulation; 2 left-handers were treated according to the same protocol with real rTMS. Language activation patterns were assessed with positron emission tomography prior to and after the treatment; 95% confidence intervals for changes in language performance scores and the activated brain volumes in both hemispheres were derived from TMS- and sham-treated right-handed patients and compared to the same parameters in left-handers. Results: Right-handed patients treated with rTMS showed better recovery of language function in global aphasia test scores (t test, p < 0.002) as well as in picture-naming performance (ANOVA, p = 0.03) than sham-treated right-handers. In treated right-handers, a shift of activation to the ipsilesional hemisphere was observed, while sham-treated patients consolidated network activity in the contralesional hemisphere (repeated-measures ANOVA, p = 0.009). Both left-handed patients also improved, with 1 patient within the confidence limits of TMS-treated right-handers (23 points, 15.9-28.9) and the other patient within the limits of sham-treated subjects (8 points, 2.8-14.5). Both patients exhibited only a very small interhemispheric shift, much less than expected in TMS-treated right-handers, and more or less consolidated initially active networks in both hemispheres. Conclusion: Inhibitory rTMS over the nondominant IFG appears to be a safe and effective treatment for right-handed poststroke aphasics. In the 2 cases of left-handed aphasics no deterioration of language performance was observed with this protocol. However, therapeutic efficiency is less obvious and seems to be more related to the dominance pattern prior to the stroke than to the TMS intervention.

show abstract

“…Some authors [24] have suggested that repetition in transcortical aphasia is carried out by either the non-dominant (usually the right) hemisphere, or by joint activity of non-involved left hemisphere structures and the intact right hemisphere [25]. Kezuka et al [26] pointed out that the literature contains case reports [25, 27,28] which provide indirect support for the importance of the contralateral (spared) hemisphere in language repetition, and that despite significant damage to the central language zone, the patients described in these papers exhibited a relative preservation of repetition. In fact, some cases of transcortical mixed aphasia were noted to be associated with extensive reductions in blood flow and metabolism in the cerebral hemisphere including the perisylvian speech area.…”

Section: Discussionmentioning

confidence: 99%

Transcortical mixed aphasia due to cerebral infarction in left inferior frontal lobe and temporo-parietal lobe

et al. 2002

View full text Add to dashboard Cite

We present a case of transcortical mixed aphasia caused by a cerebral embolism. A 77-year-old right-handed man was admitted to our hospital with speech disturbance and a right hemianopia. His spontaneous speech was remarkably reduced, and object naming, word fluency, comprehension, reading and writing were all severely disturbed. However, repetition of phonemes and sentences and reading aloud were fully preserved. Although magnetic resonance imaging (MRI) showed cerebral infarcts in the left frontal and parieto-occipital lobe which included the inferior frontal gyrus and angular gyrus, single photon emission CT revealed a wider area of low perfusion over the entire left hemisphere except for part of the left perisylvian language areas. The amytal (Wada) test, which was performed via the left internal carotid artery, revealed that the left hemisphere was dominant for language. Hence, it appears that transcortical mixed aphasia may be caused by the isolation of perisylvian speech areas, even if there is a lesion in the inferior frontal gyrus, due to disconnection from surrounding areas.

show abstract

Crossed Aphasias Can Be Mirror Image or Anomalous

Cited by 109 publications

References 0 publications

Crossed right hemisphere syndrome following left thalamic stroke

Crossed right hemisphere syndrome following left thalamic stroke

Noninvasive Brain Stimulation for Treatment of Right- and Left-Handed Poststroke Aphasics

Transcortical mixed aphasia due to cerebral infarction in left inferior frontal lobe and temporo-parietal lobe

Contact Info

Product

Resources

About