Abstract - Janeiro a Julho de 2020
Disruption of the Frontal Aslant Tract is Not Associated with Long-Term Postoperative Language Deficits: A Case Report - NEUROCIÊNCIAS
World Neurosurg. 2020 Jan;133:192-195. Epub 2019 Sep 28.
Young JS, Morshed RA, Mansoori Z, Cha S, Berger MS.
University of California, San Francisco.
BACKGROUND and Importance: The frontal aslant tract (FAT) is a white matter fiber pathway connecting the superior frontal gyrus to Broca area. This tract in the dominant hemisphere has been shown to play a role in speech initiation and production, and direct subcortical stimulation can induce stuttering and speech arrest in a patient. However, controversy remains as to whether disruption of this pathway will lead to a permanent language deficit and if it is even necessary to map this tract during tumor resections of the dominant frontal lobe.
CLINICAL PRESENTATION: Here, we report a case of a patient with a lower grade diffuse glioma invading the dominant FAT that was removed with an asleep craniotomy. In the immediate postoperative state, the patient had a transcortical motor dysphasia and was unable to initiate speech. These immediate language deficits quickly recovered, and the patient was neurological intact at the time of discharge a few days after surgery.
CONCLUSION: Given the high likelihood for a complete neurological recovery including transient aphasia, we propose that awake mapping for the purpose of identifying the dominant FAT is unnecessary during tumor resection and that disruption of this tract is not associated with any long-term language deficits.
PMID: 31574328 DOI: 10.1016/j.wneu.2019.09.128
The Neurocognition of Developmental Disorders of Language - NEUROCIÊNCIAS
Annu Rev Psychol. 2020 Jan 4; 71: 389-417. Epub 2019 Jul 23
Ullman MT, Earle FS, Walenski M, Janacsek K.
Georgetown University, Washington; University of Delaware, Newark, Delaware, USA; Northwestern University, Evanston, Illinois, USA; Eotvos Lorand University (ELTE), Budapest, Hungary; Hungarian Academy of Sciences, Budapest, Hungary.
Developmental disorders of language include developmental language disorder, dyslexia, and motor-speech disorders such as articulation disorder and stuttering. These disorders have generally been explained by accounts that focus on their behavioral rather than neural characteristics; their processing rather than learning impairments; and each disorder separately rather than together, despite their commonalities and comorbidities. Here we update and review a unifying neurocognitive account-the Procedural circuit Deficit Hypothesis (PDH). The PDH posits that abnormalities of brain structures underlying procedural memory (learning and memory that rely on the basal ganglia and associated circuitry) can explain numerous brain and behavioral characteristics across learning and processing, in multiple disorders, including both commonalities and differences. We describe procedural memory, examine its role in multiple aspects of language, and then present the PDH and relevant evidence across language-related disorders. The PDH has substantial explanatory power, and both basic research and translational implications. Expected final online publication date for the Annual Review of Psychology Volume 71 is January 4, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
PMID: 31337273 DOI: 10.1146/annurev-psych-122216-011555