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A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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Europa Medicophysica 2002 December;38(4):203-213

language: English

Language disorders following lesions to the thalamus and basal ganglia

Fabbro F. 1, 2, Vorano L. 3, Fabbro S. 2, Tavano A. 1, 2

1 Neurolinguistics Unit IRCCS E. Medea, Polo ­del Friuli Venezia Giulia San Vito al Tagliamento, Italy
2 Division of Physiology Faculty of Education Sciences University of Udine, Udine (Italy)
3 Rehabilitation Medicine Department Physical Medicine ­and Rehabilitation Institute, Udine (Italy)


We ­present a ­review of ­the lit­er­a­ture on sub­cor­ti­cal apha­sia ­and a fol­low up ­study of ­5 cas­es of sub­cor­ti­cal apha­sia in bilin­gual ­patients. Two cas­es ­involve dam­age to tha­lam­ic ­nuclei, ­while ­the remain­ing 3 main­ly ­involve dam­age to ­the cau­date nucle­us ­and ­the puta­men. Results sug­gest ­that ­the thal­a­mus ­and ­basal gan­glia of ­the ­left hem­is­fere ­may be ­involved in ­some lan­guage func­tions. The ­types of def­i­cits ­showed by tha­lam­ic ­patients impli­cate ­the thal­a­mus in ­voice ­and ­speech pro­duc­tion, sen­tence con­struc­tion ­and lex­i­cal ­access (Cases 1 ­and 2). Patterns of lan­guage recov­ery in ­these bilin­gual ­patients ­vary ­from dif­fe­ren­tial recov­ery (Case 1) to par­allel recov­ery (Case 2). Language dis­or­ders fol­low­ing ­lesions to ­the ­basal gan­glia (espe­cial­ly ­the ­head of ­the cau­date nucle­us ­and ­the puta­men) ­may pro­duce ­severe def­i­cits in com­pre­hen­sion, ­due to impair­ment of mor­pho­log­i­cal ­and syn­tac­tic lev­els (Case 3, ­which ­involved ­also a ­lesion to ­the ­left inter­nal cap­sule). However, mild­er lin­guis­tic def­i­cits ­are ­present ­with a ­main ­lesion to ­the puta­men (Case 4) or an iso­lat­ed ­lesion to ­the ­head of ­the cau­date nucle­us (Case 5). The pat­tern of lan­guage recov­ery ­was par­allel in Cases 3 ­and 5, ­but par­a­dox­i­cal in Case 4, ­where ­the ­patient recov­ered to a great­er ­extent a lan­guage (L2) ­she ­did ­not ­use ­for com­mu­ni­ca­tion. The lin­guis­tic def­i­cits ­observed in ­these ­patients ­are in ­line ­with ­the hypoth­e­sis ­that ­some spe­cif­ic sub­cor­ti­cal struc­tures (thal­a­mus ­and ­basal gan­glia) sub­serve ­some lan­guage func­tions. Therefore, ­these sub­cor­ti­cal struc­tures ­are like­ly to be ­involved in ­the reg­u­la­tion of ­the pho­nem­ic, syn­tac­tic ­and lex­i­cal ­chunks pro­cessed in ­the cere­bral cor­tex.

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