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. 2019 Jan;9(1):e01202.
doi: 10.1002/brb3.1202. Epub 2018 Dec 26.

Perilesional and homotopic area activation during proverb comprehension after stroke

You Gyoung Yi  1 , Dae Yul Kim  2 , Woo Hyun Shim  3 , Joo Young Oh  4 , Ho Sung Kim  3 , Minji Jung  2
Affiliations

Perilesional and homotopic area activation during proverb comprehension after stroke

You Gyoung Yi et al. Brain Behav. 2019 Jan.

Abstract

Introduction: The mechanism of functional recovery in right hemisphere (RH) stroke patients when attempting to comprehend a proverb has not been identified. We previously reported that there is bilateral hemisphere involvement during proverb comprehension in the normal population. However, the underlying mechanisms of proverb comprehension following a right middle cerebral artery (MCA) infarction have not yet been fully elucidated.

Methods: We here compared the brain regions activated by literal sentences and by opaque or transparent proverbs in right MCA infarction patients using functional magnetic resonance imaging (fMRI). Experimental stimuli included 18 opaque proverbs, 18 transparent proverbs, and 18 literal sentences that were presented pseudorandomly in 1 of 3 predesigned sequences.

Results: Fifteen normal adults and 17 right MCA infarction patients participated in this study. The areas of the brain in the stroke patients involved in understanding a proverb compared with a literal sentence included the right middle frontal gyrus (MFG) and frontal pole, right anterior cingulate gyrus/paracingulate gyrus and left inferior frontal gyrus (IFG), middle temporal gyrus (MTG), precuneus, and supramarginal gyrus (SMG). When the proverbs were presented to these stroke patients in the comprehension tests, the left supramarginal, postcentral gyrus, and right paracingulate gyrus were activated for the opaque proverbs compared to the transparent proverbs.

Conclusions: These findings suggest that the functional recovery of language in stroke patients can be explained by perilesional activation, which is thought to arise from the regulation of the excitatory and inhibitory neurotransmitter system, and by homotopic area activation which has been characterized by decreased transcallosal inhibition and astrocyte involvement.

Keywords: functional MRI; language; neural inhibition; proverb; right middle cerebral artery infarction.

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Figures

Figure 1
Figure 1
Experimental Design. (reproduced with permission from Yi et al., 2017). In each trial, the sentence (both proverbs and literal sentences) appeared in the center of the screen for 6 s. The 54 sentences used were randomly assigned to an 18‐s block containing three sentences of the same type arranged in a pseudorandom order. A total of 18 blocks composed of six blocks of transparent figurative proverbs, six blocks of opaque proverbs, and six blocks of literal sentences
Figure 2
Figure 2
Activated areas of the brain during proverb comprehension compared with that for literal sentences in the right MCA infarction patients. The images show regions of significant differences in activation (p < 0.001, uncorrected [T ≥ 3.30]). The spatial extent of that activation (kE) was ≥10 voxels. (a) Proverb > literal sentence in right MCA infarction patients (b) Proverb > literal sentence, right MCA infarction patients > normal subjects (c) Opaque proverb > transparent proverb in right MCA infarction patients. H: hemisphere; L: left; R: right
See this image and copyright information in PMC

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