| Reperfusion of specific brain regions by raising blood pressure restores selective language functions in subacute stroke. | |
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MedLine Citation:
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PMID: 11781056 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We report a series of six single subject studies examining the effects of pharmacological blood pressure elevation on regional brain perfusion and language function. Previous reports indicate that hypoperfusion of specific brain regions, as delineated by magnetic resonance perfusion weighted imaging (PWI), is associated with disruption of selective lexical functions. On this basis, we hypothesized that reperfusion of the same regions, in the absence of infarct in that region, would restore the associated lexical function. We present five patients with impaired lexical-semantics associated with poor perfusion, but not infarction, of Brodmann's area 22 (BA 22), and one patient with impaired lexical-semantics and a superimposed deficit in retrieving the phonological representations of words, associated with poor perfusion Brodmann's area 37 (BA 37) as well as BA 22. Each patient was treated with induced blood pressure elevation to increase perfusion of the ischemic and dysfunctional tissue. Daily testing of naming and comprehension, with stimulus sets matched for frequency, familiarity, and length, showed improved lexical-semantics in the patients who showed reperfusion of BA 22 and improved oral naming (but not lexical-semantics) in the patient who showed reperfusion of BA 37. These cases illustrate that loss of function with hypoperfusion of a circumscribed area of the brain, and recovery of the same function with improved perfusion of that brain region, can reveal brain/language relationships prior to reorganization after brain injury. |
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Authors:
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A E Hillis; A Kane; E Tuffiash; J A Ulatowski; P B Barker; N J Beauchamp; R J Wityk |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Brain and language Volume: 79 ISSN: 0093-934X ISO Abbreviation: Brain Lang Publication Date: 2001 Dec |
Date Detail:
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Created Date: 2002-01-08 Completed Date: 2002-04-18 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7506220 Medline TA: Brain Lang Country: United States |
Other Details:
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Languages: eng Pagination: 495-510 Citation Subset: IM |
Copyright Information:
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Copyright 2001 Elsevier Science. |
Affiliation:
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Department of Neurology, Johns Hopkins University School of Medicine, USA. argye@JHMI.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adrenergic alpha-Agonists / pharmacology*, therapeutic use* Aged Aged, 80 and over Blood Pressure / drug effects* Brain / blood supply*, physiopathology* Cerebrovascular Circulation / physiology Female Humans Male Middle Aged Phenylephrine / pharmacology*, therapeutic use* Semantics Speech / physiology Speech Perception / physiology* Stroke / drug therapy, physiopathology*, therapy* Tomography, Emission-Computed Vocabulary |
| Grant Support | |
ID/Acronym/Agency:
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K23 DC00174-01/DC/NIDCD NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic alpha-Agonists; 59-42-7/Phenylephrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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