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Brain Struct Funct. 2016 Jan;221(1):563-76. doi: 10.1007/s00429-014-0925-3. Epub 2014 Oct 29.

Where language meets meaningful action: a combined behavior and lesion analysis of aphasia and apraxia.

Author information

1
Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, 52425, Jülich, Germany. p.h.weiss@fz-juelich.de.
2
Department of Neurology, University Hospital Cologne, 50924, Cologne, Germany. p.h.weiss@fz-juelich.de.
3
Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, 52425, Jülich, Germany. simon.ubben@yahoo.de.
4
Department of Neurology, University Hospital Cologne, 50924, Cologne, Germany. simon.ubben@yahoo.de.
5
Department of Neurology, University Hospital Cologne, 50924, Cologne, Germany. stephanie.kaesberg@uk-koeln.de.
6
Institute of Gerontology and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Psychological Gerontology, University of Vechta, 49377, Vechta, Germany. stephanie.kaesberg@uk-koeln.de.
7
Institute of Gerontology and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Psychological Gerontology, University of Vechta, 49377, Vechta, Germany. elke.kalbe@uni-vechta.de.
8
Department of Neurology, University Hospital Cologne, 50924, Cologne, Germany. josef.kessler@uk-koeln.de.
9
Department of Neuroradiology, University Hospital Cologne, 50924, Cologne, Germany. thomas.liebig@uk-koeln.de.
10
Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, 52425, Jülich, Germany. g.r.fink@fz-juelich.de.
11
Department of Neurology, University Hospital Cologne, 50924, Cologne, Germany. g.r.fink@fz-juelich.de.

Abstract

It is debated how language and praxis are co-represented in the left hemisphere (LH). As voxel-based lesion-symptom mapping in LH stroke patients with aphasia and/or apraxia may contribute to this debate, we here investigated the relationship between language and praxis deficits at the behavioral and lesion levels in 50 sub-acute stroke patients. We hypothesized that language and (meaningful) action are linked via semantic processing in Broca's region. Behaviorally, half of the patients suffered from co-morbid aphasia and apraxia. While 24% (n = 12) of all patients exhibited aphasia without apraxia, apraxia without aphasia was rare (n = 2, 4%). Left inferior frontal, insular, inferior parietal, and superior temporal lesions were specifically associated with deficits in naming, reading, writing, or auditory comprehension. In contrast, lesions affecting the left inferior frontal gyrus, premotor cortex, and the central region as well as the inferior parietal lobe were associated with apraxic deficits (i.e., pantomime, imitation of meaningful and meaningless gestures). Thus, contrary to the predictions of the embodied cognition theory, lesions to sensorimotor and premotor areas were associated with the severity of praxis but not language deficits. Lesions of Brodmann area (BA) 44 led to combined apraxic and aphasic deficits. Data suggest that BA 44 acts as an interface between language and (meaningful) action thereby supporting parcellation schemes (based on connectivity and receptor mapping) which revealed a BA 44 sub-area involved in semantic processing.

KEYWORDS:

Broca’s region; Brodmann areas; Lesion mapping; Neuroanatomy; Neuropsychological assessment; Stroke

PMID:
25352157
DOI:
10.1007/s00429-014-0925-3
[Indexed for MEDLINE]

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