Lesion localization of speech comprehension deficits in chronic aphasia.
OBJECTIVE
Voxel-based lesion-symptom mapping (VLSM) was used to localize impairments specific to multiword (phrase and sentence) spoken language comprehension.


METHODS
Participants were 51 right-handed patients with chronic left hemisphere stroke. They performed an auditory description naming (ADN) task requiring comprehension of a verbal description, an auditory sentence comprehension (ASC) task, and a picture naming (PN) task. Lesions were mapped using high-resolution MRI. VLSM analyses identified the lesion correlates of ADN and ASC impairment, first with no control measures, then adding PN impairment as a covariate to control for cognitive and language processes not specific to spoken language.


RESULTS
ADN and ASC deficits were associated with lesions in a distributed frontal-temporal parietal language network. When PN impairment was included as a covariate, both ADN and ASC deficits were specifically correlated with damage localized to the mid-to-posterior portion of the middle temporal gyrus (MTG).


CONCLUSIONS
Damage to the mid-to-posterior MTG is associated with an inability to integrate multiword utterances during comprehension of spoken language. Impairment of this integration process likely underlies the speech comprehension deficits characteristic of Wernicke aphasia.
From the Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee. sapillay@mcw.edu.
Sara B
SB
Pillay
From the Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee.
Jeffrey R
JR
Binder
From the Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee.
Colin
C
Humphries
From the Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee.
William L
WL
Gross
From the Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee.
Diane S
DS
Book
D000161:Acoustic Stimulation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D001931:Brain Mapping; D032882:Comprehension / Q000502:physiology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012660:Semantics; D013060:Speech / Q000502:physiology*; D020521:Stroke / Q000150:complications