Skip to main content
Log in

Impairment of language is related to left parieto-temporal glucose metabolism in aphasic stroke patients

  • Original Investigations
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Summary

Twenty-six aphasic patients who had an ischaemic infarct in the territory of the left middle cerebral artery (MCA) were investigated. Cranial computed tomography (CT) showed various lesion sites: infarcts restricted to cortical structures in 12 patients, combined cortical and subcortical infarcts in 7 and isolated subcortical infarcts sparing the left cortex in another 7 cases. 18F-2-fluoro-2-deoxyglucose positron emission tomography revealed remote hypometabolism of the left convexity cortex and of the left basal ganglia, which was extended further than the morphological infarct zone in all cases. Types and degrees of aphasia were classified using the Aachener Aphasie Test (AAT): 10 patients had global aphasia, 2 Broca's, 5 Wernicke's, and 5 amnesic aphasia. Four patients suffered from minimal or residual aphasic symptoms. The AAT results were compared with the regional cerebral metabolic rates of glucose of the left hemisphere. Irrespective of the infarct location all five AAT subtests (Token test, repetition, written language, confrontation naming, auditory and reading comprehension) were closely correlated among each other and with left parieto-temporal metabolic rates, whereas left frontal and left basal ganglia metabolism showed no significant correlation. The close relation between left temporo-parietal functional activity and all five AAT subtests suggests that the different aspects of aphasia tested by AAT can be related to a common disorder of language processing in those areas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alexander MP, Naeser MA, Palumbo CL (1987) Correlations of subcortical CT lesion sites and aphasia profiles. Brain 110:961–991

    Google Scholar 

  2. Basso A, LeCours AR, Moraschini S, Vanier M (1985) Anatomical correlations of the aphasias as determined through computerized tomography: exceptions. Brain Lang 26:201–229

    Google Scholar 

  3. Broca P (1861) Remarques sur le siège de la faculté de language articulé, suivies d'une observation d'aphemie (perte de la parole). Bull Soc Anthropol 6:333

    Google Scholar 

  4. Damasio AR, Damasio H, Rizzo M, Varney N, Gersch F (1982) Aphasia with non-hemorrhagic lesions in the basal ganglia and internal capsule. Arch Neurol 39:15–20

    Google Scholar 

  5. De Renzi E, Vignolo LA (1962) The Token Test: a sensitive test to detect receptive disturbances in aphasia. Brain 85:665–678

    Google Scholar 

  6. Heiss WD, Pawlik G, Wagner R, Ilsen HW, Herholz K, Wienhard K (1983) Functional hypometabolism of noninfarcted brain regions in ischemic stroke. J Cereb Blood Flow Metabol 3 [Suppl 1]:S582–583

    Google Scholar 

  7. Heiss WD, Pawlik G, Herholz K, Wagner R, Göldner H, Wienhard K (1984) Regional kinetic constants and CMRglu in normal volunteers determined by dynamic positron emission tomography of (18F)-2-fluoro-2-deoxy-D-glucose. J Cereb Blood Flow Metabol 4:212–223

    Google Scholar 

  8. Herholz K, Pawlik G, Wienhard K, Heiss WD (1985) Computer assisted mapping in quantitative analysis of cerebral positron emission tomograms. J Comput Assist Tomogr 9:154–161

    Google Scholar 

  9. Huber W, Stachowiak FJ, Poeck K, Kerschensteiner M (1975) Die Wernicke-Aphasie. Klinisches Bild und Überlegungen zur neurolinguistischen Struktur. J. Neurol 210:77–97

    Google Scholar 

  10. Huber W, Poeck K, Weniger D, Willmes K (1983) Aachener Aphasie Test. Verlag für Psychologie, Göttingen

    Google Scholar 

  11. Karbe H, Herholz K, Szelies B, Pawlik G, Wienhard K, Heiss WD (1989) Regional metabolic correlates of Token test results in cortical and subcortical left hemispheric infarction. Neurology 39:1083–1088

    Google Scholar 

  12. Kerschensteiner M, Poeck K, Huber W, Stachowiak FJ, Weniger D (1978) Die Broca-Aphasia. Klinisches Bild und Überlegungen zur neurolinguistischen Struktur. J Neurol 217:223–242

    Google Scholar 

  13. Kuhl DE, Phelps ME, Kowell Ap, Metter EJ, Selin C, Winter J (1980) Effects of stroke on local cerebral metabolism and perfusion: mapping by emission computed tomography of 18FDG and 13NH3. Ann Neurol 8:47–60

    Google Scholar 

  14. Lenzi GL, Frackowiak RSJ, Jones T (1982) Cerebral oxygen metabolism and blood flow in human cerebral ischemic infarction. J Cereb Blood Flow Metabol 2:321–335

    Google Scholar 

  15. Liebermann RR, Ellenberg M, Restum WH (1986) Aphasia associated with vertified subcortical lesions: three case reports. Arch Phys Med Rehabil 67:410–414

    Google Scholar 

  16. Mazziotta JC, Metter EJ (1988) Brain cerebral metabolic mapping of normal and abnormal language and its requisition during development. In: Plum F (ed) Language, communication and the brain. Raven Press, New York, pp 245–266

    Google Scholar 

  17. Metter EJ (1987) Review: neuroanatomy and physiology of aphasia: evidence from positron emission tomography. Aphasiology 1:3–33

    Google Scholar 

  18. Metter EJ, Wasterlain CG, Kuhl DE, Hanson WR, Phelps ME (1981) 18FDG positron emission computed tomography in a study of aphasia. Ann Neurol 10:173–183

    Google Scholar 

  19. Metter EJ, Riege WH, Hanson WR, Kuhl DE, Phelps ME, Squire LR, Wasterlain CG, Benson DF (1983). Comparison of metabolic rates, language and memory in subcortical aphasias. Brain Lang 19:33–47

    Google Scholar 

  20. Murdoch BE, Afford RJ, Ling AR, Ganguley B (1986) Acute CT-scans: their value for localization of lesions and as a prognostic indicator in aphasia. J Commun Dis 19:311–345

    Google Scholar 

  21. Naeser MA, Alexander MP, Helm Estabrooks N, Levine HL, Laughlin SA, Geschwind N (1982) Aphasia with predominantly subcortical lesion sites. Arch Neurol 39:2–14

    Google Scholar 

  22. Poeck K (1979) Studies on language comprehension in hemispherectomy, split brain and aphasia patients: a possible contribution to the knowledge of psychological mechanisms of speech comprehension. Exp Brain Res [Suppl II]:217–227

  23. Poeck K, Kerschensteiner M, Stachowiak FJ, Huber W (1974) Die amnestische Aphasie. Klinisches Bild und Überlegungen zur neurolinguistischen Struktur. J Neurol 207:1–17

    Google Scholar 

  24. Poeck K, Bleser R de, Graf v. Keyserlingk D (1984) Neurolinguistic status and localization of lesion in aphasic patients with exclusively consonant-vowel recurring utterances. Brain 107:199–217

    Google Scholar 

  25. Posner IM, Petersen SE, Fox PT, Raichle ME (1988) Localization of cognitive operations in the human brain. Science 240:1627–1631

    Google Scholar 

  26. Stachowiak FJ, Huber W, Kerschensteiner M, Poeck K, Weniger D (1977) Die globale Aphasie. Klinisches Bild und Überlegungen zur neurolinguistischen Struktur. J Neurol 214:75–87

    Google Scholar 

  27. Vignolo LA, Boccardi E, Caverni L (1986) Unexpected CT-scan findings in global aphasia. Cortex 22:55–69

    Google Scholar 

  28. Wernicke C (1874) Der aphasische Symptomenkomplex. Cohn and Weigert, Breslau. Reprint, Springer, Berlin Heidelberg New York, 1974

    Google Scholar 

  29. Wienhard K, Pawlik G, Herholz K, Wagner R, Heiss WD (1985) Estimation of local cerebral glucose utilization by positron emission tomography of (18F)2-fluoro-2-deoxy-d-glucose: a critical appraisal of optimization procedures. J Cereb Blood Flow Metabol 5:115–125

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Karbe, H., Szelies, B., Herholz, K. et al. Impairment of language is related to left parieto-temporal glucose metabolism in aphasic stroke patients. J Neurol 237, 19–23 (1990). https://doi.org/10.1007/BF00319662

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00319662

Key words

Navigation