• Neuropsychologia · Dec 2008

    Cortico-subcortical organization of language networks in the right hemisphere: an electrostimulation study in left-handers.

    • Hugues Duffau, Marianne Leroy, and Peggy Gatignol.
    • Department of Neurosurgery, Hôpital Gui de Chauliac, INSERM U678 and CNRS UMR 8189, CHU de Montpellier, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France. h-duffau@chu-montpellier.fr
    • Neuropsychologia. 2008 Dec 1;46(14):3197-209.

    AbstractWe have studied the configuration of the cortico-subcortical language networks within the right hemisphere (RH) in nine left-handers, being operated on while awake for a cerebral glioma. Intraoperatively, language was mapped using cortico-subcortical electrostimulation, to avoid permanent deficit. In frontal regions, cortical stimulation elicited articulatory disorders (ventral premotor cortex), anomia (dorsal premotor cortex), speech arrest (pars opercularis), and semantic paraphasia (dorsolateral prefrontal cortex). Insular stimulation generated dysarthria, parietal stimulation phonemic paraphasias, and temporal stimulation semantic paraphasias. Subcortically, the superior longitudinal fasciculus (inducing phonological disturbances when stimulated), inferior occipito-frontal fasciculus (eliciting semantic disturbances during stimulation), subcallosal fasciculus (generating control disturbances when stimulated), and common final pathway (inducing articulatory disorders during stimulation) were identified. These cortical and subcortical structures were preserved, avoiding permanent aphasia, despite a transient immediate postoperative language worsening. Both intraoperative results and postsurgical transitory dysphasia support the major role of the RH in language in left-handers, and provide new insights into the anatomo-functional cortico-subcortical organization of the language networks in the RH-suggesting a "mirror" configuration in comparison to the left hemisphere.

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