J Korean Med Sci.  2013 Oct;28(10):1529-1533. 10.3346/jkms.2013.28.10.1529.

Neural Substrate Responsible for Crossed Aphasia

• Kim WJ
• Yang EJ
• Paik NJ

• KMID: 1777693
• DOI: http://doi.org/10.3346/jkms.2013.28.10.1529

Abstract

Crossed aphasia (CA) refers to language impairment secondary to right hemisphere lesion. Imaging analysis on the lesion location of CA has not yet been reported in the literature. This study was proposed to analyze the most prevalent lesion site related to CA. Brain MRI of 7 stroke patients satisfying the criteria for CA were used to define Region of interest (ROIs) before overlaying the images to visualize the most overlapped area. Talairach coordinates for the most overlapped areas were converted to corresponding anatomical regions. Anatomical lesions where more than 3 patients' images were overlapped were considered significant. The overlayed ROIs of 7 patients revealed the lentiform nucleus as the most frequently involved area, overlapping in 6 patients. Our study first demonstrates the areas involved in CA by lesion mapping using brain MRI, and lentiform nucleus is the responsible neural substrate for crossed aphasia.

Keyword

Aphasia; Stroke; Lentiform Nucleus; Crossed Aphasia

MeSH Terms

Aged
Aged, 80 and over
Aphasia/complications/*diagnosis
Brain/anatomy & histology/radiography
Brain Mapping
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neurons/physiology
Retrospective Studies
Stroke/complications

Figure

• 

  Fig. 1 FLAIR MR images of axial brain slices of 7 patients showing distribution of all patients lesion area on a brain template. Color-coding reflects number of patients with local lesion overlap (red = 7, yellow = 6, lime = 5, green = 4, blue = 3, navy = 2, purple = 1). Red empty circles indicate the most overlapped anatomical regions. The sagittal sections (lower, right) indicate each level of analysis.

Reference

1. Croquelois A, Bogousslavsky J. Stroke aphasia: 1,500 consecutive cases. Cerebrovasc Dis. 2011; 31:392–399.

2. Bakar M, Kirshner HS, Wertz RT. Crossed aphasia: functional brain imaging with PET or SPECT. Arch Neurol. 1996; 53:1026–1032.

3. Ishizaki M, Ueyama H, Nishida Y, Imamura S, Hirano T, Uchino M. Crossed aphasia following an infarction in the right corpus callosum. Clin Neurol Neurosurg. 2012; 114:161–165.

4. Castro-Caldas A, Confraria A. Age and type of crossed aphasia in dextrals due to stroke. Brain Lang. 1984; 23:126–133.

5. Dewarrat GM, Annoni JM, Fornari E, Carota A, Bogousslavsky J, Maeder P. Acute aphasia after right hemisphere stroke. J Neurol. 2009; 256:1461–1467.

6. Kim H, Na DL. Normative data on the Korean version of the Western Aphasia Battery. J Clin Exp Neuropsychol. 2004; 26:1011–1020.

7. Marchina S, Zhu LL, Norton A, Zipse L, Wan CY, Schlaug G. Impairment of speech production predicted by lesion load of the left arcuate fasciculus. Stroke. 2011; 42:2251–2256.

8. Van Oers CA, Vink M, van Zandvoort MJ, van der Worp HB, de Haan EH, Kappelle LJ, Ramsey NF, Dijkhuizen RM. Contribution of the left and right inferior frontal gyrus in recovery from aphasia: a functional MRI study in stroke patients with preserved hemodynamic responsiveness. Neuroimage. 2010; 49:885–893.

9. Oldfield RC. The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia. 1971; 9:97–113.

10. Russmann H, Vingerhoets F, Ghika J, Maeder P, Bogousslavsky J. Acute infarction limited to the lenticular nucleus: clinical, etiologic, and topographic features. Arch Neurol. 2003; 60:351–355.

11. De Boissezon X, Marie N, Castel-Lacanal E, Marque P, Bezy C, Gros H, Lotterie JA, Cardebat D, Puel M, Demonet JF. Good recovery from aphasia is also supported by right basal ganglia: a longitudinal controlled PET study: EJPRM-ESPRM 2008 award winner. Eur J Phys Rehabil Med. 2009; 45:547–558.

12. Habib M, Joanette Y, Ali-Cherif A, Poncet M. Crossed aphasia in dextrals: a case report with special reference to site of lesion. Neuropsychologia. 1983; 21:413–418.

13. Giroud M, Lemesle M, Madinier G, Billiar T, Dumas R. Unilateral lenticular infarcts: radiological and clinical syndromes, aetiology, and prognosis. J Neurol Neurosurg Psychiatry. 1997; 63:611–615.

14. Castro-Caldas A, Confraria A, Paiva T, Trindade A. Contrecoup injury in the misdiagnosis of crossed aphasia. J Clin Exp Neuropsychol. 1986; 8:697–701.

15. Cappa SF, Perani D, Bressi S, Paulesu E, Franceschi M, Fazio F. Crossed aphasia: a PET follow up study of two cases. J Neurol Neurosurg Psychiatry. 1993; 56:665–671.

16. Gomez-Tortosa E, Martin EM, Sychra JJ, Dujovny M. Language-activated single-photon emission tomography imaging in the evaluation of language lateralization: evidence from a case of crossed aphasia: case report. Neurosurgery. 1994; 35:515–519.

17. Dyukova GM, Glozman ZM, Titova EY, Kriushev ES, Gamaleya AA. Speech disorders in right-hemisphere stroke. Neurosci Behav Physiol. 2010; 40:593–602.

18. Carr MS, Jacobson T, Boller F. Crossed aphasia: analysis of four cases. Brain Lang. 1981; 14:190–202.

19. Basso A, Capitani E, Laiacona M, Zanobio ME. Crossed aphasia: one or more syndromes? Cortex. 1985; 21:25–45.

20. Mariën P, Paghera B, De Deyn PP, Vignolo LA. Adult crossed aphasia in dextrals revisited. Cortex. 2004; 40:41–74.

21. Sheehy LM, Haines ME. Crossed Wernicke's aphasia: a case report. Brain Lang. 2004; 89:203–206.