Language and developmental plasticity after perinatal stroke.

The mature human brain is lateralized for language, with the left hemisphere (LH) primarily responsible for sentence processing and the right hemisphere (RH) primarily responsible for processing suprasegmental aspects of language such as vocal emotion. However, it has long been hypothesized that in early life there is plasticity for language, allowing young children to acquire language in other cortical regions when LH areas are damaged. If true, what are the constraints on functional reorganization? Which areas of the brain can acquire language, and what happens to the functions these regions ordinarily perform? We address these questions by examining long-term outcomes in adolescents and young adults who, as infants, had a perinatal arterial ischemic stroke to the LH areas ordinarily subserving sentence processing. We compared them with their healthy age-matched siblings. All participants were tested on a battery of behavioral and functional imaging tasks. While stroke participants were impaired in some nonlinguistic cognitive abilities, their processing of sentences and of vocal emotion was normal and equal to that of their healthy siblings. In almost all, these abilities have both developed in the healthy RH. Our results provide insights into the remarkable ability of the young brain to reorganize language. Reorganization is highly constrained, with sentence processing almost always in the RH frontotemporal regions homotopic to their location in the healthy brain. This activation is somewhat segregated from RH emotion processing, suggesting that the two functions perform best when each has its own neural territory.

Dissociable Cognitive Systems for Recognizing Places and Navigating through Them: Developmental and Neuropsychological Evidence.

Recent neural evidence suggests that the human brain contains dissociable systems for "scene categorization" (i.e., recognizing a place as a particular kind of place, for example, a kitchen), including the parahippocampal place area, and "visually guided navigation" (e.g., finding our way through a kitchen, not running into the kitchen walls or banging into the kitchen table), including the occipital place area. However, converging behavioral data - for instance, whether scene categorization and visually guided navigation abilities develop along different timelines and whether there is differential breakdown under neurologic deficit - would provide even stronger support for this two-scene-systems hypothesis. Thus, here we tested scene categorization and visually guided navigation abilities in 131 typically developing children between 4 and 9 years of age, as well as 46 adults with Williams syndrome, a developmental disorder with known impairment on "action" tasks, yet relative sparing on "perception" tasks, in object processing. We found that (1) visually guided navigation is later to develop than scene categorization, and (2) Williams syndrome adults are impaired in visually guided navigation, but not scene categorization, relative to mental age-matched children. Together, these findings provide the first developmental and neuropsychological evidence for dissociable cognitive systems for recognizing places and navigating through them.SIGNIFICANCE STATEMENT Two decades ago, Milner and Goodale showed us that identifying objects and manipulating them involve distinct cognitive and neural systems. Recent neural evidence suggests that the same may be true of our interactions with our environment: identifying places and navigating through them are dissociable systems. Here we provide converging behavioral evidence supporting this two-scene-systems hypothesis - finding both differential development and breakdown of "scene categorization" and "visually guided navigation." This finding suggests that the division of labor between perception and action systems is a general organizing principle for the visual system, not just a principle of the object processing system in particular.