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The Journal of Neuroscience, August 2, 2006, 26(31):8069-8073; doi:10.1523/JNEUROSCI.2088-06.2006

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Brief Communications
Restoring Cerebral Blood Flow Reveals Neural Regions Critical for Naming

Argye E. Hillis,^1,2,4 Jonathan T. Kleinman,¹ Melissa Newhart,¹ Jennifer Heidler-Gary,¹ Rebecca Gottesman,¹ Peter B. Barker,³ Eric Aldrich,^1,2 Rafael Llinas,¹ Robert Wityk,¹ and Priyanka Chaudhry¹

Departments of ¹Neurology, ²Physical Medicine and Rehabilitation, and ³Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, and ⁴Department of Cognitive Science, Johns Hopkins University, Baltimore, Maryland 21218

Correspondence should be addressed to Argye E. Hillis, Department of Neurology, Phipps 126, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287. Email: argye{at}jhmi.edu

We identified areas of the brain that are critical for naming pictures of objects, using a new methodology for testing which components of a network of brain regions are essential for that task. We identified areas of hypoperfusion and structural damage with magnetic resonance perfusion- and diffusion-weighted imaging immediately after stroke in 87 individuals with impaired picture naming. These individuals were reimaged after 3–5 d, after a subset of patients underwent intervention to restore normal blood flow, to determine areas of the brain that had reperfused. We identified brain regions in which reperfusion was associated with improvement in picture naming. Restored blood flow to left posterior middle temporal/fusiform gyrus, Broca's area, and/or Wernicke's area accounted for most acute improvement after stroke. Results show that identifying areas of reperfusion that are associated with acute improvement of a function can reveal the brain regions essential for that function.

Key words: aphasia; stroke; perfusion; ischemia; cognitive; cortex; language; mapping; magnetic resonance imaging

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Received April 12, 2006; revised June 6, 2006; accepted June 24, 2006.

Correspondence should be addressed to Argye E. Hillis, Department of Neurology, Phipps 126, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287. Email: argye{at}jhmi.edu

This article has been cited by other articles:

				A. E. Hillis, L. Gold, V. Kannan, L. Cloutman, J. T. Kleinman, M. Newhart, J. Heidler-Gary, C. Davis, E. Aldrich, R. Llinas, et al. Site of the ischemic penumbra as a predictor of potential for recovery of functions Neurology, July 15, 2008; 71(3): 184 - 189. [Abstract] [Full Text] [PDF]

				P. Molenberghs, C. R. Gillebert, R. Peeters, and R. Vandenberghe Convergence between Lesion-Symptom Mapping and Functional Magnetic Resonance Imaging of Spatially Selective Attention in the Intact Brain J. Neurosci., March 26, 2008; 28(13): 3359 - 3373. [Abstract] [Full Text] [PDF]

				A. E. Hillis Aphasia: Progress in the last quarter of a century Neurology, July 10, 2007; 69(2): 200 - 213. [Abstract] [Full Text] [PDF]

				J. DeLeon, R. F. Gottesman, J. T. Kleinman, M. Newhart, C. Davis, J. Heidler-Gary, A. Lee, and A. E. Hillis Neural regions essential for distinct cognitive processes underlying picture naming Brain, May 1, 2007; 130(5): 1408 - 1422. [Abstract] [Full Text] [PDF]

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