title: A re-examination of neural basis of language processing: proposal of a dynamic hodotopical model from data provided by brain stimulation mapping during picture naming.
abstract: From recent findings provided by brain stimulation mapping during picture naming, we re-examine the neural basis of language. We studied structural-functional relationships by correlating the types of language disturbances generated by stimulation in awake patients, mimicking a transient virtual lesion both at cortical and subcortical levels (white matter and deep grey nuclei), with the anatomical location of the stimulation probe. We propose a hodotopical (delocalized) and dynamic model of language processing, which challenges the traditional modular and serial view. According to this model, following the visual input, the language network is organized in parallel, segregated (even if interconnected) large-scale cortico-subcortical sub-networks underlying semantic, phonological and syntactic processing. Our model offers several advantages (i) it explains double dissociations during stimulation (comprehension versus naming disorders, semantic versus phonemic paraphasias, syntactic versus naming disturbances, plurimodal judgment versus naming disorders); (ii) it takes into account the cortical and subcortical anatomic constraints; (iii) it explains the possible recovery of aphasia following a lesion within the "classical" language areas; (iv) it establishes links with a model executive functions.
authors.affiliation: Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 Avenue Augustin Fliche, 34295 Montpellier, France; Institut of Neuroscience of Montpellier, INSERM U1051, Team "Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors", Hôpital Saint Eloi, CHU Montpellier, 80 Avenue Augustin Fliche, 34091 Montpellier, France. Electronic address: h-duffau@chu-montpellier.fr.
authors.forename: Hugues
authors.initials: H
authors.lastname: Duffau
authors.affiliation: Institut of Neuroscience of Montpellier, INSERM U1051, Team "Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors", Hôpital Saint Eloi, CHU Montpellier, 80 Avenue Augustin Fliche, 34091 Montpellier, France; Department of Neurology, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 Avenue Augustin Fliche, 34295 Montpellier, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Moritz-Gasser
authors.affiliation: Department of Neurosurgery, Hôpital Lariboisière, Paris, France; University Paris Diderot, France; IMNC, UMR 8165, Orsay, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mandonnet
mesh_terms: D001037:Aphasia / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D001921:Brain / Q000473:pathology / Q000502:physiology*; D001931:Brain Mapping; D032882:Comprehension / Q000502:physiology*; D006801:Humans; D007802:Language; D008960:Models, Psychological; D009434:Neural Pathways; D010364:Pattern Recognition, Visual / Q000502:physiology*; D010775:Photic Stimulation; D012660:Semantics; D014851:Wakefulness
keywords: Anatomo-functional connectivity; Awake surgery; Axonal pathways; Brain networks; Brain plasticity; Direct electrical stimulation; Hodotopy; Language