RSS-Feed abonnieren
DOI: 10.1055/s-2005-873122
Funktionelle Reorganisation bei Aphasie
Functional Reorganisation in AphasiePublikationsverlauf
Publikationsdatum:
29. September 2005 (online)
Zusammenfassung
Inzwischen liegen einige Studien mit bildgebenden Verfahren zur funktionellen Reorganisation bei Aphasie vor. Diese untersuchen jedoch immer normale sprachliche Funktionen bei Aphasikern, z. B. den Zugriff auf Wortbedeutungen, und nicht aphasische Symptome wie z. B. Paraphasien oder Sprachautomatismen.
Während einige Autoren beobachten, dass geschädigte linkshemisphärische Areale durch homologe Areale der rechten Hemisphäre funktionell unterstützt bzw. ersetzt werden, betonen andere Autoren die Bedeutung der erhaltenen Areale der linken Hemisphäre für einen guten Rückbildungsverlauf. Neuere Studien postulieren einen Rückbildungsverlauf, währenddessen zunächst schwache Aktivierungen in linkshemisphärischen Arealen zu beobachten sind, die im Verlauf zunehmen und sich auf die rechte Hemisphäre ausdehnen und später im Zuge einer Konsolidierung der sprachlichen Leistungen wieder vorwiegend in der linken Hemisphäre zu beobachten sind.
Abstract
Several neuroimaging studies focus on functional reorganisation in aphasia. In these studies aphasic patients were always presented with normal language tasks, e. g. access to lexical meaning. Aphasic symptoms like paraphasias or automatisms, however, have not yet been studied.
While some authors observed activation in the right hemisphere in regions homologue to those which were damaged, others underline the importance of left hemisphere perilesional areas for a good outcome. Recent studies assume different phases of recovery: initially few activations in the left hemisphere, followed by an overall increase including the right hemisphere and finally a decrease and a re-shift to the left hemisphere in connection with consolidation of language abilities.
Literatur
- 1 Baron J C, D’Antona R, Pantano P. et al . Effects of thalamic stroke on energy metabolism of the cerebral cortex. Brain. 1986; 109 1243-1259
- 2 Calvert G A, Brammer M J, Morris R G. et al . Using fMRI to study recovery from acquired dysphasia. Brain Lang. 2000; 71 391-399
- 3 Cao Y, Vikingstad B S, George K P. et al . Cortical language activation in stroke patients recovering from aphasia. Stroke. 1999; 30 2331-2340
- 4 Cappa S F, Perani D, Grassi F. et al . A PET follow-up study of recovery after stroke in acute aphasics. Brain Lang. 1997; 56 55-67
- 5 Corballis M C. The lopsided ape. Evolution of the generative mind. New York; Oxford University Press 1991
- 6 Davidson RJ & Hugdahl K. Brain Asymmetry. Cambridge MA. MIT Press 1994
- 7 Feeny D M, Baron J C. Diaschisis. Stroke. 1986; 17 817-830
- 8 Fernandez B, Cardebat D, Démonet J F. et al . Functional MRI follow-up study of language processes in healthy subjects and during recovery in a case of aphasia. Stroke. 2004; 35 2171-2176
- 9 Flöel A, Ellger T, Breitenstein C. et al . Language perception activates the hand motor kortex: implications for motor theories of speech perception. Eur J Neurosci. 2003; 18 704-708
- 10 Gold B T, Kertesz A. Preserved visual lexicosemantics in global aphasia: a right-hemisphere contribution?. Brain Lang. 2000; 73 456-65
- 11 Grande M, Weis S, Willmes K. et al . Recovery of word form processing after left inferior parietal lesion: a single case fMRI study. Brain Lang. 2003; 87 124-125
- 12 Grande M, Longoni F, Hendrich V. et al . Different levels of lexical processing - evidence from an fMRI study with normal subjects and aphasic patients. Stem-, Sprak- en Taalpathologie. 2005; 13 49-55
- 13 Günther T, Longoni F, Sabri O. et al . A PET Study of Basic Syntax and Verb Morphology. NeuroImage. 2001; 13 538
- 14 Hadar U, Wenkert-Olenik D, Krauss R. et al . Gesture and the processing of speech: neuropsychological evidence. Brain Lang. 1998; 62 107-126
- 15 Heiss W D, Emunds H G, Herholz K. Cerebral glucose metabolism as a predictor of rehabilitation after ischemic stroke. Stroke. 1993; 24 1784-1788
- 16 Heiss W D, Karbe H, Weber-Luxenburger G. et al . Speech-induced cerebral metabolic activation reflects recovery from aphasia. J Neurol Sci. 1997; 145 213-217
- 17 Heiss W D, Kessler J, Thiel A. et al . Differential capacity of left and right hemispheric areas for compensation of poststroke aphasia. Ann Neurol. 1999; 45 430-438
-
18 Huber W, Poeck K, Weniger D. Aphasie. In: Hartje W & Poeck K (Hrsg)
Klinische Neuropsychologie . Stuttgart; Thieme 2002: 93-173 - 19 Hund-Georgiadis M, Lex U, Norris D G, von Cramon D Y. Cortical reafferentation following left subcortical hemorrhage: a serial functional MR study. Neurology. 2000; 55 1227-1230
- 20 Karbe H, Kessler J, Herholz K. et al . Long-term prognosis of poststroke aphasia studied with positron emission tomography. Arch Neurol. 1995; 52 186-190
- 21 Karbe H, Thiel A, Weber-Luxenburger G. et al . Brain plasticity in poststroke aphasia: What ist he contribution of the right hemisphere?. Brain Lang. 1998; 64 215-230
- 22 Longoni F, Grande M, Hendrich V. et al . An fMRI study on conceptual, grammatical and morpho-phonological processing. Brain Cogn. 2004; 57 131-134
- 23 Marshall J F. Brain function: neural adaptations and recovery from injury. Ann Rev Psych. 1984; 35 277-308
- 24 Meister I G, Boroojerdi B, Folty H. et al . Motor kortex hand area and speech: implications for the development of language. Neuropsychologia. 2003; 41 401-406
- 25 Mesulam M M. Large-scale neurocognitive networks and distributed processing for attention, language, and memory. Ann Neurol. 1990; 28 597-613
- 26 Metter E J, Jackson C A, Kempler D. et al . Temporoparietal cortex and the recovery of language comprehension in aphasia. Aphasiology. 1992; 6 349-358
- 27 Perani D, Cappa S F, Tettamanti M. et al . A fMRI study of word retrieval in aphasia. Brain Lang. 2003; 85 57-368
- 28 Poeck K. What do we mean by „aphasic syndromes”? A neurologist’s view. Brain Lang. 1983; 20 79-89
- 29 Price C J, Warburton E A, Moore C J. et al . Dynamic diaschisis: anatomically remote and context-sensitive human brain lesions. J Cogn Neurosci. 2001; 13 419-429
- 30 Rosen H J, Petersen S E, Linenweber M R. et al . Neural correlates of recovery from aphasia after damage to left inferior frontal cortex. Neurology. 2000; 55 1883-1894
- 31 Saur D, Lange R, Baumgaertner A. et al . Early activation and time course of recovery in aphasia. NeuroImage. 2004; 22 25
- 32 Saur D, Baumgärtner A, Lange R. et al .Dynamics of reorganisation in the langusage system after stroke: an fMRI-follow-up study from the acute to the chronic phase. Brain Lang (accepted)
- 33 Springer L, Huber W, Schlenck K J. et al . Agrammatism: Deficit or compensation? Consequences for aphasia therapy. Neuropsychol Rehabil. 2000; 10 279-309
- 34 Thulborn K R, Carpenter P A, Just M A. Plasticity of language-related brain function during recovery from stroke. Stroke. 1999; 30 749-754
- 35 Vallar G, Perani D, Cappa S F. et al . Recovery from aphasia and neglect after subcortical stroke: a neuropsychological and cerebral perfusion study. J Neurol Neurosurg Psych. 1988; 51 1269-1276
- 36 Weiller C, Isensee C, Rijntjes M. et al . Recovery from Wernicke’s aphasia: a positron emission tomographic study. Ann Neurol. 1995; 37 723-732
- 37 Weis S, Grande M, Pollrich S. et al . Processing of homonyms: a functional MRI study on the separation of word forms from concepts. Cortex. 2001; 37 745-749
- 38 Willmes K, Poeck K. To what extent can aphasic syndromes be localized?. Brain. 1993; 116 1527-1540
- 39 Zahn R, Huber W, Drews E. et al . Recovery of semantic word processing in transcortical sensory aphasia: a functional magnetic resonance imaging study. Neurocase. 2002; 8 376-386
- 40 Zahn R, Drews E, Specht K. et al . Recovery of semantic word processing in global aphasia: a functional MRI study. Cogn Brain Res. 2004; 18 322-336
-
41 Zaidel E. Language in the right hemisphere following callosal disconnection. In: Stemmer B & Whittaker HA (Hrsg.)
Handbook of neurolinguistics . San Diego; Academic Press 1998: 370-383
Dr. M. Grande
Universitätsklinikum RWTH Aachen
Neurologische Klinik
Lehr- und Forschungsgebiet Neurolinguistik
52057 Aachen
eMail: mgrande@ukaachen.de