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Subcortical Aphasia

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Abstract

Purpose of Review

Subcortical structures have long been thought to play a role in language processing. Increasingly spirited debates on language studies, arising from as early as the nineteenth century, grew remarkably sophisticated as the years pass. In the context of non-thalamic aphasia, a few theoretical frameworks have been laid out. The disconnection hypothesis postulates that basal ganglia insults result in aphasia due to a rupture of connectivity between Broca and Wernicke’s areas. A second viewpoint conjectures that the basal ganglia would more directly partake in language processing, and a third stream proclaims that aphasia would stem from cortical deafferentation. On the other hand, thalamic aphasia is more predominantly deemed as a resultant of diaschisis. This article reviews the above topics with recent findings on deep brain stimulation, neurophysiology, and aphasiology.

Recent Findings

The more recent approach conceptualizes non-thalamic aphasias as the offspring of unpredictable cortical hypoperfusion. Regarding the thalamus, there is mounting evidence now pointing to leading contributions of the pulvinar/lateral posterior nucleus and the anterior/ventral anterior thalamus to language disturbances. While the former appears to relate to lexical-semantic indiscrimination, the latter seems to bring about a severe breakdown in word selection and/or spontaneous top-down lexical-semantic operations.

Summary

The characterization of subcortical aphasias and the role of the basal ganglia and thalamus in language processing continues to pose a challenge. Neuroimaging studies have pointed a path forward, and we believe that more recent methods such as tractography and connectivity studies will significantly expand our knowledge in this particular area of aphasiology.

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  1. Laboratorio de Neurociencias (LIM-27), Faculdade de Medicina, Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 785, SP, 05403-903, São Paulo, Brazil

    Marcia Radanovic

  2. Faculdade de Letras, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil

    Victor N Almeida

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Table 3 Non-thalamic lesions: correlation between clinical findings and lesion site
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Radanovic, M., Almeida, V.N. Subcortical Aphasia. Curr Neurol Neurosci Rep 21, 73 (2021). https://doi.org/10.1007/s11910-021-01156-5

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