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Publication Detail
Developmental conduction aphasia after neonatal stroke.
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Article
  • Authors:
    Northam GB, Adler S, Eschmann KCJ, Chong WK, Cowan FM, Baldeweg T
  • Publisher:
    Wiley-Blackwell
  • Publication date:
    01/04/2018
  • Journal:
    Annals of Neurology
  • Medium:
    Print-Electronic
  • Status:
    Published
  • Print ISSN:
    0364-5134
  • Language:
    eng
  • Addresses:
    Great Ormond Street Institute of Child Health, Developmental Neurosciences Programme, University College London, London, WC1N 1EH, UK.
Abstract
Impairment of speech repetition following injury to the dorsal language stream is feature of conduction aphasia - a well-described 'disconnection syndrome' in adults. The impact of similar lesions sustained in infancy has not been established.We compared language outcomes in term-born individuals with confirmed neonatal stroke (n=30; age: 7-18 years, left-sided lesions in 21 cases) to matched controls (n=40). Injury to the dorsal and/or ventral language streams was assessed using T1 - and T2 -weighted MRI and diffusion tractography. Language lateralization was determined using functional MRI.At the group level, left dorsal language stream injury was associated with selective speech repetition impairment for non-words (p=0.021) and sentences (p<0.0001). The majority of children with significant repetition impairment had retained left hemisphere language representation, but right hemisphere dominance was correlated with minimal or absent repetition deficits. Post-hoc analysis of the repetition-impaired group revealed additional language-associated deficits, but these were more subtle and variable.We conclude that (i) despite the considerable plasticity of the infant brain, early dorsal language stream injury can result in specific and long-lasting problems with speech repetition that are similar to the syndrome of conduction aphasia seen in adults, and that (ii) language reorganization to the contralateral hemisphere has a protective effect. This article is protected by copyright. All rights reserved.
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