左侧颞叶的非典型语言皮层与双侧语言的关系  

Atypical language cortex in the left temporal lobe: Relationship to bilateral language

作　　者：Jabbour R.A. Penovich P.E. Risse G.L. 袁海峰 

机构地区：[1]Minnesota Epilepsy Group, 310 Smith Ave. N., St. Paul, MN 55102- 2383, United StatesDr

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第4期41-42,共2页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Background: The intracarotid amobarbital procedure (IAP) is widely used in the preoperative evaluation for epilepsy surgery to lateralize language dominance and memory functions. However, language mapping has most often been accomplished with cortical brain stimulation. Objective: To examine left temporal lobe language cortex representation using this technique in patients with bilateral language (BL) as compared with patients with left language dominance (LD). Methods: The language maps of each patient were reviewed retrospectively. Group I consisted of 10 patients with BL and Group II consisted of 10 matched control patients with LD. Each stimulation trial included a brief assessment of confrontation naming, automatic speech, reading, repetition, and comprehension. Clusters of errors that included comprehension, repetition, and naming defined primary temporal lobe language areas. Results: Mapping revealed two distinct language areas in 60% of patients in Group I and 10% in Group II (p = 0.019). In Group I, two patients had both language areas in the same gyrus (either the superior or the middle temporal gyrus), whereas two showed one language area each in the superior and middle temporal gyri and the remaining two had one in the superior temporal gyrus and the other intermixed between the superior and middle temporal gyri. In Group II, both language areas were intermixed between the superior and middle temporal gyri. Conclusions: Bilateral language (BL) representation in the intracarotid amobarbital procedure is frequently associated with more than one noncontiguous language area in the left temporal lobe. A careful search for multiple language areas, particularly in patients with BL, is prudent prior to surgical resection.Background: The intracarotid amobarbital procedure (IAP) is widely used in the preoperative evaluation for epilepsy surgery to lateralize language dominance and memory functions. However, language mapping has most often been accomplished with cortical brain stimulation. Objective: To examine left temporal lobe language cortex representation using this technique in patients with bilateral language (BL) as compared with patients with left language dominance (LD). Methods: The language maps of each patient were reviewed retrospectively. Group I consisted of 10 patients with BL and Group II consisted of 10 matched control patients with LD. Each stimulation trial included a brief assessment of confrontation naming, automatic speech, reading, repetition, and comprehension. Clusters of errors that included comprehension, repetition, and naming defined primary temporal lobe language areas. Results: Mapping revealed two distinct language areas in 60% of patients in Group I and 10% in Group II (p = 0.019). In Group I, two patients had both language areas in the same gyrus (either the superior or the middle temporal gyrus), whereas two showed one language area each in the superior and middle temporal gyri and the remaining two had one in the superior temporal gyrus and the other intermixed between the superior and middle temporal gyri. In Group II, both language areas were intermixed between the superior and middle temporal gyri. Conclusions: Bilateral language (BL) representation in the intracarotid amobarbital procedure is frequently associated with more than one noncontiguous language area in the left temporal lobe. A careful search for multiple language areas, particularly in patients with BL, is prudent prior to surgical resection.

关 键 词：左侧颞叶 颞中回 语言皮质 语言区 颞上回 异戊巴比妥 语言中枢 语言优势半球 大脑皮质 刺激试验 

分 类 号：R651[医药卫生—外科学]