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  How right hemisphere damage after stroke can impair speech comprehension

Gajardo-Vidal, A., Lorca-Puls, D. L., Hope, T. M. H., Parker Jones, O., Seghier, M. L., Prejawa, S., et al. (2018). How right hemisphere damage after stroke can impair speech comprehension. Brain, 141(12), 3389-3404. doi:10.1093/brain/awy270.

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https://doi.org/10.1093/brain/awy270 (Publisher version)
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 Creators:
Gajardo-Vidal, Andrea 1, 2, Author
Lorca-Puls, Diego L.1, Author
Hope, Thomas M. H.1, Author
Parker Jones, Oiwi 3, Author
Seghier, Mohamed L.1, 4, Author
Prejawa, Suse5, Author           
Crinion, Jennifer T.6, Author
Leff, Alex P.6, 7, Author
Green, David W.8, Author
Price, Cathy J.1, Author
Affiliations:
1Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, United Kingdom, ou_persistent22              
2Faculty of Health Sciences, Universidad del Desarrollo, Concepcion, Chile, ou_persistent22              
3FMRIB Centre, University of Oxford, United Kingdom, ou_persistent22              
4Cognitive Neuroimaging Unit, Emirates College for Advanced Education, Abu Dhabi, United Arab Emirates, ou_persistent22              
5Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_634549              
6Institute of Cognitive Neuroscience, University College London, United Kingdom, ou_persistent22              
7Department of Brain Repair & Rehabilitation, University College London, United Kingdom, ou_persistent22              
8Department of Experimental Psychology, Faculty of Brain Sciences, University College London, United Kingdom, ou_persistent22              

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Free keywords: Right-hemisphere stroke; Lesion-deficit mapping; Functional MRI; Sentence comprehension; Working memory
 Abstract: Acquired language disorders after stroke are strongly associated with left hemisphere damage. When language difficulties are observed in the context of right hemisphere strokes, patients are usually considered to have atypical functional anatomy. By systematically integrating behavioural and lesion data from brain damaged patients with functional MRI data from neurologically normal participants, we investigated when and why right hemisphere strokes cause language disorders. Experiment 1 studied right-handed patients with unilateral strokes that damaged the right (n = 109) or left (n = 369) hemispheres. The most frequently impaired language task was: auditory sentence-to-picture matching after right hemisphere strokes; and spoken picture description after left hemisphere strokes. For those with auditory sentence-to-picture matching impairments after right hemisphere strokes, the majority (n = 9) had normal performance on tests of perceptual (visual or auditory) and linguistic (semantic, phonological or syntactic) processing. Experiment 2 found that these nine patients had significantly more damage to dorsal parts of the superior longitudinal fasciculus and the right inferior frontal sulcus compared to 75 other patients who also had right hemisphere strokes but were not impaired on the auditory sentence-to-picture matching task. Damage to these right hemisphere regions caused long-term speech comprehension difficulties in 67% of patients. Experiments 3 and 4 used functional MRI in two groups of 25 neurologically normal individuals to show that within the regions identified by Experiment 2, the right inferior frontal sulcus was normally activated by (i) auditory sentence-to-picture matching; and (ii) one-back matching when the demands on linguistic and non-linguistic working memory were high. Together, these experiments demonstrate that the right inferior frontal cortex contributes to linguistic and non-linguistic working memory capacity (executive function) that is needed for normal speech comprehension. Our results link previously unrelated literatures on the role of the right inferior frontal cortex in executive processing and the role of executive processing in sentence comprehension; which in turn helps to explain why right inferior frontal activity has previously been reported to increase during recovery of language function after left hemisphere stroke. The clinical relevance of our findings is that the detrimental effect of right hemisphere strokes on language is (i) much greater than expected; (ii) frequently observed after damage to the right inferior frontal sulcus; (iii) task dependent; (iv) different to the type of impairments observed after left hemisphere strokes; and (v) can result in long-lasting deficits that are (vi) not the consequence of atypical language lateralization.

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Language(s): eng - English
 Dates: 2018-08-162018-02-012018-09-122018-11-092018-12-01
 Publication Status: Issued
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1093/brain/awy270
PMID: 30418586
PMC: PMC6262220
 Degree: -

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Project name : -
Grant ID : 203147/Z/16/Z ; 205103/Z/16/Z
Funding program : -
Funding organization : Wellcome Trust
Project name : -
Grant ID : MR/M023672/1
Funding program : -
Funding organization : Medical Research Council (MRC)
Project name : -
Grant ID : TSA 2014/02 ; TSA PDF 2017/02
Funding program : -
Funding organization : Stroke Association
Project name : -
Grant ID : CONICYT BECAS-CHILE 72140131 ; CONICYT BECAS-CHILE 73101009
Funding program : -
Funding organization : Chilean National Commission for Scientific and Technological Research (CONICYT)

Source 1

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Title: Brain
  Other : Brain
Source Genre: Journal
 Creator(s):
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Publ. Info: London : Macmillan
Pages: - Volume / Issue: 141 (12) Sequence Number: - Start / End Page: 3389 - 3404 Identifier: ISSN: 0006-8950
CoNE: https://pure.mpg.de/cone/journals/resource/954925385135