Language and spatial attention can lateralize to the same hemisphere in healthy humans
Abstract
Background: Disorders of language classically occur after left brain lesions, and disorders of spatial attention after right brain lesions. It is unclear whether the hemispheric dissociation of functions is a fixed pattern of brain organization.
Objective: The authors determined whether lateralization of language and lateralization of spatial attention also dissociate in people with atypical (i.e., right hemispheric) language dominance.
Methods: The authors selected 10 subjects with typical, i.e., left hemispheric, and 10 with atypical, i.e., right hemispheric, language representation on a random basis from a sample of 326 healthy volunteers examined with functional transcranial Doppler sonography (fTCD) for language dominance. In these subjects, hemispheric lateralization of cerebral perfusion during a line bisection task was determined with fTCD.
Results: The authors found a dissociation between dominance for language and spatial attention in all but four subjects. In the latter subjects, there was a significant lateralization to the right hemisphere for both tasks. The four subjects showed normal intellectual, linguistic, and spatial performance, with normal EEG and MRI scans of the brain.
Conclusion: Even in the absence of brain pathology, the same hemisphere can be dominant in control of both language and spatial attention.
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Received: November 2, 2000
Accepted: May 12, 2001
Published online: September 25, 2001
Published in print: September 25, 2001
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We thank Dr. Stefanis for his valuable comments. His findings corroborate previous reports about patients with aphasia and hemineglect after unihemispheric lesions by demonstrating co-localization for language and visuospatial memory. [1, 2]
It stresses also the importance for the clinician to be aware of disturbances in visuospatial processing in-patients with aphasia. Deficits in attentional functions might aggravate the existing speech problems, and should be specifically addressed during therapy.
References:
1. Alexander MP, Fiscette MR, Fischer RS. Crossed aphasia can be mirror image of anomalous. Brain 1989;112:953-973.
2. Osmon DC, Panos J, Kautz P, Gandhavadi B. Crossed aphasia in a dextral: a test of the Alexander-Annett theory of anomalous organization of brain function. Brain Lang 1998; 63:426-438.
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I read with great interest the article by Floel et al. describing lateralization for spatial attention and language to the right hemisphere in the subgroup of healthy subjects. [1] As the authors discuss, this finding implies, that, at least in certain individuals, laterization of distinct cerebral functions may occur independently during cerebral development.
Apart from spatial attention, other cognitive modalities are also traditionally associated with the right hemisphere. One of these is visuospatial memory. [2] Previously, we reported the case of a right- handed individual, who following a cerebral infarction affecting the gray matter of the right superior temporal gyrus, manifested a conduction aphasia associated with profound visuospatial memory impairment. [3] The aphasia subtype and localization of the lesion would classify this case as a "mirror" crossed aphasia, in which language dominance is presumably switched to the right hemisphere. [4] The association in our case between the aphasic disturbance and modality-specific memory deficit imply that both language and visuospatial memory localized to the right hemisphere.
Therefore, we agree with the authors that, at least in certain individuals, cerebral functions may laterize and independently of each other.
References:
1. Floel A, Knecht S, Lohmann H, et al. Language and spatial attention can lateralize to the same hemisphere in healthy humans. Neurology 2001;57:1018-1024.
2. Milner B. Visual recognition after right temporal lobe excision in man. Neuropsychologia 1968;6:191-209.
3. Stefanis L, Desmond DW, Tatemichi TK. Crossed conduction aphasia associated with impairment of visuospatial memory. Neurocase 1997;3:201- 207.
4. Alexander MP, Fiscette MR, Fischer RS. Crossed aphasias can be mirror image or anomalous. Brain 1989;112:953-973.