[Non-aphasic misnaming: a case report and literature review].

A 71-year-old, right-handed woman was admitted to our hospital due to a sudden difficulty with conversation. On admission, she was alert, but had a euphoric mood, disorientation, and a disturbance of recent memory. Her speech was fluent. Her repetition and auditory word cognition were excellent, but she had a slight difficulty with naming visual objects. She frequently showed word-finding difficulty and irrelevant paraphasia during free conversation and a word fluency task. Her irrelevant paraphasia was observed more frequently when she was asked to explain her outbreak of anger at the hospital, i.e., it was situation-dependent. She also had anosognosia. MRI showed an infarct in the territory of the left tuberothalamic artery. Single-photon emission computed tomography revealed low-uptake lesions in the left thalamus and orbital frontal, medial frontal, and medial temporal lobes. The patient was diagnosed with non-aphasic misnaming. The clinical characteristics of patients with non-aphasic misnaming in the literature were reviewed. All of the patients with non-aphasic misnaming had word-finding difficulty and irrelevant paraphasia. Additionally, they had either emotional disturbance or anosognosia.

Thalamus and Language: What do we know from vascular and degenerative pathologies.

Language is a complex cognitive task that is essential in our daily life. For decades, researchers have tried to understand the different role of cortical and subcortical areas in cerebral language representations and language processing. Language-related cortical zones are richly interconnected with other cortical regions (particularly via myelinated fibre tracts), but they also participate in subcortical feedback loops within the basal ganglia (caudate nucleus and putamen) and thalamus. The most relevant thalamic functions are the control and adaptation of cortico-cortical connectivity and bandwidth for information exchange. Despite having the knowledge of thalamic and basal ganglionic involvement in linguistic operations, the specific functions of these subcortical structures remain rather controversial. The aim of this study is to better understand the role of thalamus in language network, exploring the functional configuration of basal network components. The language specificity of subcortical supporting activity and the associated clinical features in thalamic involvement are also highlighted.

Impaired neural discrimination of emotional speech prosody in children with autism spectrum disorder and language impairment.

Autism spectrum disorders (ASD) are characterized by deficient social and communication skills, including difficulties in perceiving speech prosody. The present study addressed processing of emotional prosodic changes (sad, scornful and commanding) in natural word stimuli in typically developed school-aged children and in children with ASD and language impairment. We found that the responses to a repetitive word were diminished in amplitude in the children with ASD, reflecting impaired speech encoding. Furthermore, the amplitude of the MMN/LDN component, reflecting cortical discrimination of sound changes, was diminished in the children with ASD for the scornful deviant. In addition, the amplitude of the P3a, reflecting involuntary orienting to attention-catching changes, was diminished in the children with ASD for the scornful deviant and tended to be smaller for the sad deviant. These results suggest that prosody processing in ASD is impaired at various levels of neural processing, including deficient pre-attentive discrimination and involuntary orientation to speech prosody.

A third-person perspective on co-speech action gestures in Parkinson's disease.

A combination of impaired motor and cognitive function in Parkinson's disease (PD) can impact on language and communication, with patients exhibiting a particular difficulty processing action verbs. Co-speech gestures embody a link between action and language and contribute significantly to communication in healthy people. Here, we investigated how co-speech gestures depicting actions are affected in PD, in particular with respect to the visual perspective-or the viewpoint - they depict. Gestures are closely related to mental imagery and motor simulations, but people with PD may be impaired in the way they simulate actions from a first-person perspective and may compensate for this by relying more on third-person visual features. We analysed the action-depicting gestures produced by mild-moderate PD patients and age-matched controls on an action description task and examined the relationship between gesture viewpoint, action naming, and performance on an action observation task (weight judgement). Healthy controls produced the majority of their action gestures from a first-person perspective, whereas PD patients produced a greater proportion of gestures produced from a third-person perspective. We propose that this reflects a compensatory reliance on third-person visual features in the simulation of actions in PD. Performance was also impaired in action naming and weight judgement, although this was unrelated to gesture viewpoint. Our findings provide a more comprehensive understanding of how action-language impairments in PD impact on action communication, on the cognitive underpinnings of this impairment, as well as elucidating the role of action simulation in gesture production.

[Dominant Thalamus and Aphasia].

Many studies have shown that lesions of the dominant thalamus precipitate language disorders in a similar manner to transcortical aphasias, in a phenomenon known as "thalamic aphasia." In some cases, however, aphasia may not occur or may appear transiently following thalamic lesions. Furthermore, dominant thalamic lesions can produce changes in character, as observed in patients with amnesic disorder. Previous work has explored the utility of thalamic aphasia as a discriminative feature for classification of aphasia. Although the thalamus may be involved in the function of the brainstem reticular activating system and play a role in attentional network and in memory of Papez circuit or Yakovlev circuit, the mechanism by which thalamic lesion leads to the emergence of aphasic disorders is unclear. In this review, we we survey historical and recent literature on thalamic aphasia in an attempt to understand the neural processes affected by thalamic lesions.

Language and central temporal auditory processing in childhood epilepsies.

Because of the relationship between rolandic, temporoparietal, and centrotemporal areas and language and auditory processing, the aim of this study was to investigate language and central temporal auditory processing of children with epilepsy (rolandic epilepsy and temporal lobe epilepsy) and compare these with those of children without epilepsy. Thirty-five children aged between eight and 14 years old were studied. Two groups of children participated in this study: a group with childhood epilepsy (n=19), and a control group without epilepsy or linguistic changes (n=16). There was a significant difference between the two groups, with the worst performance in children with epilepsy for the gaps-in-noise test, right ear (p<0.001) and left ear (p<0.001) tests, and duration pattern test--naming (p=0.002) and humming (p=0.002). In auditory P300, there was no significant difference in latency (p=0.343) and amplitude (p=0.194) between the groups. There was a significant difference between the groups, with the worst performance in children with epilepsy, for the auditory-receptive vocabulary (PPVT) (p<0.001) and phonological working memory (nonwords repetition task) tasks (p=0.001). We conclude that the impairment of central temporal auditory processing and language skills may be comorbidities in children with rolandic epilepsy and temporal lobe epilepsy.

Processing of audiovisually congruent and incongruent speech in school-age children with a history of specific language impairment: a behavioral and event-related potentials study.

Previous studies indicate that at least some aspects of audiovisual speech perception are impaired in children with specific language impairment (SLI). However, whether audiovisual processing difficulties are also present in older children with a history of this disorder is unknown. By combining electrophysiological and behavioral measures, we examined perception of both audiovisually congruent and audiovisually incongruent speech in school-age children with a history of SLI (H-SLI), their typically developing (TD) peers, and adults. In the first experiment, all participants watched videos of a talker articulating syllables 'ba', 'da', and 'ga' under three conditions - audiovisual (AV), auditory only (A), and visual only (V). The amplitude of the N1 (but not of the P2) event-related component elicited in the AV condition was significantly reduced compared to the N1 amplitude measured from the sum of the A and V conditions in all groups of participants. Because N1 attenuation to AV speech is thought to index the degree to which facial movements predict the onset of the auditory signal, our findings suggest that this aspect of audiovisual speech perception is mature by mid-childhood and is normal in the H-SLI children. In the second experiment, participants watched videos of audivisually incongruent syllables created to elicit the so-called McGurk illusion (with an auditory 'pa' dubbed onto a visual articulation of 'ka', and the expectant perception being that of 'ta' if audiovisual integration took place). As a group, H-SLI children were significantly more likely than either TD children or adults to hear the McGurk syllable as 'pa' (in agreement with its auditory component) than as 'ka' (in agreement with its visual component), suggesting that susceptibility to the McGurk illusion is reduced in at least some children with a history of SLI. Taken together, the results of the two experiments argue against global audiovisual integration impairment in children with a history of SLI and suggest that, when present, audiovisual integration difficulties in this population likely stem from a later (non-sensory) stage of processing.

Association between language development and auditory processing disorders.

INTRODUCTION: It is crucial to understand the complex processing of acoustic stimuli along the auditory pathway; comprehension of this complex processing can facilitate our understanding of the processes that underlie normal and altered human communication. AIM: To investigate the performance and lateralization effects on auditory processing assessment in children with specific language impairment (SLI), relating these findings to those obtained in children with auditory processing disorder (APD) and typical development (TD). MATERIAL AND METHODS: Prospective study. Seventy-five children, aged 6-12 years, were separated in three groups: 25 children with SLI, 25 children with APD, and 25 children with TD. All went through the following tests: speech-in-noise test, Dichotic Digit test and Pitch Pattern Sequencing test. RESULTS: The effects of lateralization were observed only in the SLI group, with the left ear presenting much lower scores than those presented to the right ear. The inter-group analysis has shown that in all tests children from APD and SLI groups had significantly poorer performance compared to TD group. Moreover, SLI group presented worse results than APD group. CONCLUSION: This study has shown, in children with SLI, an inefficient processing of essential sound components and an effect of lateralization. These findings may indicate that neural processes (required for auditory processing) are different between auditory processing and speech disorders.

Association between language development and auditory processing disorders / Associação entre transtornos no desenvolvimento de linguagem e processamento auditivo

INTRODUCTION: It is crucial to understand the complex processing of acoustic stimuli along the auditory pathway ;comprehension of this complex processing can facilitate our understanding of the processes that underlie normal and altered human communication. AIM: To investigate the performance and lateralization effects on auditory processing assessment in children with specific language impairment (SLI), relating these findings to those obtained in children with auditory processing disorder (APD) and typical development (TD). MATERIAL AND METHODS: Prospective study. Seventy-five children, aged 6-12 years, were separated in three groups: 25 children with SLI, 25 children with APD, and 25 children with TD. All went through the following tests: speech-in-noise test, Dichotic Digit test and Pitch Pattern Sequencing test. RESULTS: The effects of lateralization were observed only in the SLI group, with the left ear presenting much lower scores than those presented to the right ear. The inter-group analysis has shown that in all tests children from APD and SLI groups had significantly poorer performance compared to TD group. Moreover, SLI group presented worse results than APD group. CONCLUSION: This study has shown, in children with SLI, an inefficient processing of essential sound components and an effect of lateralization. These findings may indicate that neural processes (required for auditory processing) are different between auditory processing and speech disorders. .

INTRODUÇÃO: Entender como os estímulos acústicos são processados ao longo da via auditiva é fundamental para compreender os processos que subjazem à comunicação humana normal e alterada. OBJETIVO: Investigar o desempenho e efeitos de lateralidade na avaliação do processamento auditivo em crianças com distúrbio específico de linguagem (DEL), comparando os resultados obtidos aos encontrados em crianças com transtorno de processamento auditivo (TPA) e desenvolvimento típico (DT). MATERIAL E MÉTODO: Estudo Prospectivo. 75 crianças (6-12 anos), divididas em três grupos (25 crianças com DEL, 25 crianças com TPA e 25 crianças em DT), foram submetidas aos seguintes testes: Teste de Figura com Ruído, Teste Dicótico de Dígitos e Teste de Padrão de Frequência. RESULTADO: Os efeitos de lateralidade foram observados apenas no grupo DEL, sendo o desempenho na orelha esquerda inferior ao apresentado na orelha direita. Na comparação intergrupos, o desempenho dos grupos TPA e DEL foi significativamente inferior ao observado no grupo DT para todos os testes. Além disso, observamos nas crianças do grupo DEL um desempenho inferior às do grupo TPA. CONCLUSÃO: Este estudo constatou o processamento ineficiente de componentes cruciais de sons e o efeito de lateralidade em crianças com DEL. Esses achados evidenciam que os processos neurais que subjazem ao processamento auditivo são diferentes entre alterações de processamento auditivo e alterações de fala. .

Generating predictions: lesion evidence on the role of left inferior frontal cortex in rapid syntactic analysis.

A well-documented phenomenon in event-related electroencephalography (EEG) and magnetoencephalography (MEG) studies on language processing is that syntactic violations of different types elicit negativities as early as 100 msec after the violation point. Recently, these responses have been associated with activations in or very close to sensory cortices, suggesting the involvement of basic sensory mechanisms in the detection of syntactic violations. The present study investigated whether intact auditory cortices and adjacent temporal regions are sufficient to generate early syntactic negativities in the auditory event-related potential (ERP). We tested ten clinically non-aphasic patients with left inferior frontal lesions, but intact temporal cortices in a passive auditory ERP paradigm that had reliably elicited early negativities in response to violations of subject-verb agreement and word category in the past. Subject-verb agreement violations failed to elicit early grammaticality effects in these patients, whereas a group of ten age-matched controls showed a reliable early negativity. This finding supports the idea that sensory aspects of syntactic analysis as reflected in early syntactic negativities critically depend on top-down predictions generated by the left inferior frontal cortex. In contrast, word category violations elicited a small, marginally significant early negativity both in controls and patients, suggesting an additional involvement of temporal regions in early phrase structure processing. In an additional auditory oddball experiment patients showed a regular P300, but no N2b component in response to deviant tones, indicating that their deficit in generating sensory predictions extends beyond the language domain.

A potential "tuning" role for the outer hair cells in children with language disorders.

The cochlear outer hair cells serve a tuning function, and any dysfunction of their electromotile response can be reflected in language disorders. Otoacoustic emissions can be used to determine any dysfunction of these cells. A set of clinical records was established to register the neurological and auditory functioning in 42 children, followed by assessment with the Wechsler Intelligence Scale for Children (WISC), the Initial Language Test (ILT), the Auditory and Phonetic Discrimination Evaluation (APDE), tests for measuring Brainstem Auditory Evoked Potential (BAEP) and Transient Otoacoustic Emissions (TOAE). Subjects were classified into 3 groups in this study: Control (C; n = 20), Syntactic Phonological Disorder (SPD; n = 17), and those with Phonological Disability (PD; n = 5). BAEP studies showed a clear response when all children were stimulated to 20 dB. TOAE responses displayed clear and significant differences with half-octave band reproducibility for both ears, the largest effect being observed in the right ear. The results that were compared using ANOVA tests, showed that cochlear processing affects the brain language function, playing a critical role in the language phonetic process.

Semantic memory and language dysfunction in early Alzheimer's disease: a review.

BACKGROUND: Language impairment in Alzheimer's disease occurs early, and language function deteriorates with progression of the illness to cause significant disability. This review focuses on language dysfunction in Alzheimer's disease and the contribution of semantic memory impairment. METHODS: Electronic publication databases were searched for literature relevant to the review. Additionally, individual references were examined to elicit further studies not found by online search. RESULTS: Language impairment in Alzheimer's disease initially affects verbal fluency and naming before breakdown in other facets. Naming and fluency require integrity of semantic concepts, and dysfunction may be a marker of primary semantic memory impairment rather than overall cognitive decline. Research suggests the presence of semantic loss several years prior to diagnosis. Imaging studies indicate an altered connectivity state with respect to language networks, and this is associated with potential semantic failure. This state may also be present in individuals with established risk factors for Alzheimer's disease. Compensatory recruitment of alternative cortical areas to supplement language function appears to occur and may be a target for future intervention. CONCLUSIONS: Identifying and classifying the nature and degree of language impairment more closely could aid in developing targeted therapies. Treatments already established in other aphasic states, such as post-stroke, may be especially relevant. The nature of these and the protective nature of cognitive reserve are potential therapeutic avenues.

Auditory magnetic mismatch field latency: a biomarker for language impairment in autism.

BACKGROUND: Auditory processing abnormalities are frequently observed in autism spectrum disorders (ASD), and these abnormalities may have sequelae in terms of clinical language impairment (LI). The present study assessed associations between language impairment and the amplitude and latency of the superior temporal gyrus magnetic mismatch field (MMF) in response to changes in an auditory stream of tones or vowels. METHODS: Fifty-one children with ASD, and 27 neurotypical control subjects, all aged 6 to 15 years, underwent neuropsychological evaluation, including tests of language function, as well as magnetoencephalographic recording during presentation of tones and vowels. The MMF was identified in the difference waveform obtained from subtraction of responses to standard from deviant stimuli. RESULTS: Magnetic mismatch field latency was significantly prolonged (p < .001) in children with ASD, compared with neurotypical control subjects. Furthermore, this delay was most pronounced (∼50 msec) in children with concomitant LI, with significant differences in latency between children with ASD with LI and those without (p < .01). Receiver operator characteristic analysis indicated a sensitivity of 82.4% and specificity of 71.2% for diagnosing LI based on MMF latency. CONCLUSIONS: Neural correlates of auditory change detection (the MMF) are significantly delayed in children with ASD, and especially those with concomitant LI, suggesting a neurobiological basis as well as a clinical biomarker for LI in ASD.

Electrophysiological correlates of rapid auditory and linguistic processing in adolescents with specific language impairment.

Brief tonal stimuli and spoken sentences were utilized to examine whether adolescents (aged 14;3-18;1) with specific language impairments (SLI) exhibit atypical neural activity for rapid auditory processing of non-linguistic stimuli and linguistic processing of verb-agreement and semantic constraints. Further, we examined whether the behavioral and electrophysiological indices for rapid auditory processing were correlated with those for linguistic processing. Fifteen adolescents with SLI and 15 adolescents with normal language met strict criteria for displaying consistent diagnoses from kindergarten through the eighth grade. The findings provide evidence that auditory processing for non-linguistic stimuli is atypical in a significant number of adolescents with SLI compared to peers with normal language and indicate that reduced efficiency in auditory processing in SLI is more vulnerable to rapid rates (200ms ISI) of stimuli presentation (indexed by reduced accuracy, a tendency for longer RTs, reduced N100 over right anterior sites, and reduced amplitude P300). Many adolescents with SLI displayed reduced behavioral accuracy for detecting verb-agreement violations and semantic anomalies, along with less robust P600s elicited by verb-agreement violations. The results indicate that ERPs elicited by morphosyntactic aspects of language processing are atypical in many adolescents with SLI. Additionally, correlational analyses between behavioral and electrophysiological indices of processing non-linguistic stimuli and verb-agreement violations suggest that the integrity of neural functions for auditory processing may only account for a small proportion of the variance in morphosyntactic processing in some adolescents.

Brainstem correlates of temporal auditory processing in children with specific language impairment.

Deficits in identification and discrimination of sounds with short inter-stimulus intervals or short formant transitions in children with specific language impairment (SLI) have been taken to reflect an underlying temporal auditory processing deficit. Using the sustained frequency following response (FFR) and the onset auditory brainstem responses (ABR) we evaluated if children with SLI show abnormalities at the brainstem level consistent with a temporal processing deficit. To this end, the neural encoding of tonal sweeps, as reflected in the FFR, for different rates of frequency change, and the effects of reducing inter-stimulus interval on the ABR components were evaluated in 10 4-11-year-old SLI children and their age-matched controls. Results for the SLI group showed degraded FFR phase-locked neural activity that failed to faithfully track the frequency change presented in the tonal sweeps, particularly at the faster sweep rates. SLI children also showed longer latencies for waves III and V of the ABR and a greater prolongation of wave III at high stimulus rates (>30/sec), suggesting greater susceptibility to neural adaptation. These results taken together appear to suggest a disruption in the temporal pattern of phase-locked neural activity necessary to encode rapid frequency change and an increased susceptibility to desynchronizing factors related to faster rates of stimulus presentation in children with SLI.

Auditory brain stem response to complex sounds: a tutorial.

This tutorial provides a comprehensive overview of the methodological approach to collecting and analyzing auditory brain stem responses to complex sounds (cABRs). cABRs provide a window into how behaviorally relevant sounds such as speech and music are processed in the brain. Because temporal and spectral characteristics of sounds are preserved in this subcortical response, cABRs can be used to assess specific impairments and enhancements in auditory processing. Notably, subcortical auditory function is neither passive nor hardwired but dynamically interacts with higher-level cognitive processes to refine how sounds are transcribed into neural code. This experience-dependent plasticity, which can occur on a number of time scales (e.g., life-long experience with speech or music, short-term auditory training, on-line auditory processing), helps shape sensory perception. Thus, by being an objective and noninvasive means for examining cognitive function and experience-dependent processes in sensory activity, cABRs have considerable utility in the study of populations where auditory function is of interest (e.g., auditory experts such as musicians, and persons with hearing loss, auditory processing, and language disorders). This tutorial is intended for clinicians and researchers seeking to integrate cABRs into their clinical or research programs.

Spectral vs. temporal auditory processing in specific language impairment: a developmental ERP study.

Pre-linguistic sensory deficits, especially in "temporal" processing, have been implicated in developmental language impairment (LI). However, recent evidence has been equivocal with data suggesting problems in the spectral domain. The present study examined event-related potential (ERP) measures of auditory sensory temporal and spectral processing, and their interaction, in typical children and those with LI (7-17 years; n=25 per group). The stimuli were three CV syllables and three consonant-to-vowel transitions (spectral sweeps) isolated from the syllables. Each of these six stimuli appeared in three durations (transitions: 20, 50, and 80 ms; syllables: 120, 150, and 180 ms). Behaviorally, the group with LIs showed inferior syllable discrimination both with long and short stimuli. In ERPs, trends were observed in the group with LI for diminished long-latency negativities (the N2-N4 peaks) and a developmentally transient enhancement of the P2 peak. Some, but not all, ERP indices of spectral processing also showed trends to be diminished in the group with LI specifically in responses to syllables. Importantly, measures of the transition N2-N4 peaks correlated with expressive language abilities in the LI children. None of the group differences depended on stimulus duration. Therefore, sound brevity did not account for the diminished spectral resolution in these LI children. Rather, the results suggest a deficit in acoustic feature integration at higher levels of auditory sensory processing. The observed maturational trajectory suggests a non-linear developmental deviance rather than simple delay.

Altered language processing in autosomal dominant partial epilepsy with auditory features.

BACKGROUND: Autosomal dominant partial epilepsy with auditory features (ADPEAF) is an idiopathic focal epilepsy syndrome with auditory symptoms or receptive aphasia as major ictal manifestations, frequently associated with mutations in the leucine-rich, glioma inactivated 1 (LGI1) gene. Although affected subjects do not have structural abnormalities detected on routine MRI, a lateral temporal malformation was identified through high resolution MRI in one family. We attempted to replicate this finding and to assess auditory and language processing in ADPEAF using fMRI and magnetoencephalography (MEG). METHODS: We studied 17 subjects (10 affected mutation carriers, 3 unaffected carriers, 4 noncarriers) in 7 ADPEAF families, each of which had a different LGI1 mutation. Subjects underwent high-resolution structural MRI, fMRI with an auditory description decision task (ADDT) and a tone discrimination task, and MEG. A control group comprising 26 volunteers was also included. RESULTS: We found no evidence of structural abnormalities in any of the 17 subjects. On fMRI with ADDT, subjects with epilepsy had significantly less activation than controls. On MEG with auditory stimuli, peak 2 auditory evoked field latency was significantly delayed in affected individuals compared to controls. CONCLUSIONS: These findings do not support the previous report of a lateral temporal malformation in autosomal dominant partial epilepsy with auditory features (ADPEAF). However, our fMRI and magnetoencephalography data suggest that individuals with ADPEAF have functional impairment in language processing.

Early cognitive and language skills are linked to resting frontal gamma power across the first 3 years.

High-frequency cortical activity in humans and animals has been linked to a wide variety of higher cognitive processes. This research suggests that specific changes in neuronal synchrony occur during cognitive processing, distinguished by emergence of fast oscillations in the gamma frequency range. To determine whether the development of high-frequency brain oscillations can be related to the development of cognitive abilities, we studied the power spectra of resting EEG in children 16, 24 and 36 months of age. Individual differences in the distribution of frontal gamma power during rest were highly correlated with concurrent language and cognitive skills at all ages. Gamma power was also associated with attention measures; children who were observed as having better inhibitory control and more mature attention shifting abilities had higher gamma power density functions. We included a group of children with a family history of language impairment (FH+) and thus at higher risk for language disorders. FH+ children, as a group, showed consistently lower gamma over frontal regions than the well-matched FH- controls with no such family history (FH-). We suggest that the emergence of high-frequency neural synchrony may be critical for cognitive and linguistic development, and that children at risk for language impairments may lag in this process.

Cortico-subcortical organization of language networks in the right hemisphere: an electrostimulation study in left-handers.

We have studied the configuration of the cortico-subcortical language networks within the right hemisphere (RH) in nine left-handers, being operated on while awake for a cerebral glioma. Intraoperatively, language was mapped using cortico-subcortical electrostimulation, to avoid permanent deficit. In frontal regions, cortical stimulation elicited articulatory disorders (ventral premotor cortex), anomia (dorsal premotor cortex), speech arrest (pars opercularis), and semantic paraphasia (dorsolateral prefrontal cortex). Insular stimulation generated dysarthria, parietal stimulation phonemic paraphasias, and temporal stimulation semantic paraphasias. Subcortically, the superior longitudinal fasciculus (inducing phonological disturbances when stimulated), inferior occipito-frontal fasciculus (eliciting semantic disturbances during stimulation), subcallosal fasciculus (generating control disturbances when stimulated), and common final pathway (inducing articulatory disorders during stimulation) were identified. These cortical and subcortical structures were preserved, avoiding permanent aphasia, despite a transient immediate postoperative language worsening. Both intraoperative results and postsurgical transitory dysphasia support the major role of the RH in language in left-handers, and provide new insights into the anatomo-functional cortico-subcortical organization of the language networks in the RH-suggesting a "mirror" configuration in comparison to the left hemisphere.