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Volume 17, Number 1,
Issue of January 1, 1997
pp. 353-362
Copyright ©1997 Society for Neuroscience
Human Brain Language Areas Identified by Functional Magnetic
Resonance Imaging
Jeffrey R. Binder1, 2,
Julie A. Frost1,
Thomas A. Hammeke1,
Robert W. Cox3,
Stephen M. Rao1, 2, and
Thomas Prieto1
Departments of 1 Neurology and 2 Cellular
Biology and Anatomy, and 3 Biophysics Research Institute,
Medical College of Wisconsin, Milwaukee, Wisconsin 53226
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
FOOTNOTES
REFERENCES
ABSTRACT
Functional magnetic resonance imaging (FMRI) was used to identify
candidate language processing areas in the intact human brain. Language
was defined broadly to include both phonological and lexical-semantic
functions and to exclude sensory, motor, and general executive
functions. The language activation task required phonetic and semantic
analysis of aurally presented words and was compared with a control
task involving perceptual analysis of nonlinguistic sounds. Functional
maps of the entire brain were obtained from 30 right-handed subjects.
These maps were averaged in standard stereotaxic space to produce a
robust "average activation map" that proved reliable in a
split-half analysis. As predicted from classical models of language
organization based on lesion data, cortical activation associated with
language processing was strongly lateralized to the left cerebral
hemisphere and involved a network of regions in the frontal, temporal,
and parietal lobes. Less consistent with classical models were (1) the
existence of left hemisphere temporoparietal language areas outside the
traditional "Wernicke area," namely, in the middle temporal,
inferior temporal, fusiform, and angular gyri; (2) extensive left
prefrontal language areas outside the classical "Broca area"; and
(3) clear participation of these left frontal areas in a task
emphasizing "receptive" language functions. Although partly in
conflict with the classical model of language localization, these
findings are generally compatible with reported lesion data and provide
additional support for ongoing efforts to refine and extend the
classical model.
Key words:
language;
functional magnetic resonance imaging;
brain
mapping;
semantic;
phonological;
auditory cortex
INTRODUCTION
Language-related functions were among the first to
be ascribed a specific location in the human brain (Broca, 1861 ) and
have been the subject of intense research for well over a century. A
"classical model" of language organization, based on data from aphasic patients with brain lesions, was popularized during the late
19th century and remains in common use (Wernicke, 1874 ; Lichtheim, 1885 ; Geschwind, 1971 ; Benson, 1985 ; Mayeux and Kandel, 1985 ). In its
most general form, this model proposes a frontal, "expressive" area
for planning and executing speech and writing movements, named after
Broca (Broca, 1861 ), and a posterior, "receptive" area for analysis
and identification of linguistic sensory stimuli, named after Wernicke
(Wernicke, 1874 ). Although many researchers would accept this basic
scheme, a more detailed account of language organization has not yet
gained widespread approval. There is not universal agreement, for
example, on such basic issues as which cortical areas make up the
receptive language system (Bogen and Bogen, 1976 ) or on the specific
linguistic role of Broca's area (Marie, 1906 ; Mohr, 1976 ).
Noninvasive functional imaging methods are a potential source of new
data on language organization in the intact human brain (Petersen et
al., 1988 ; Démonet et al., 1992 ; Bottini et al., 1994 ).
Functional magnetic resonance imaging (FMRI) is one such method, which
is based on monitoring regional changes in blood oxygenation resulting
from neural activity (Ogawa et al., 1990 , 1992 ). Although certain
technical issues remain to be resolved, the capabilities of FMRI for
localizing primary sensory and motor areas are now well established
(Kim et al., 1993 ; Rao et al., 1993 ; Binder et al., 1994b ; DeYoe et
al., 1994 ; Sereno et al., 1995 ). Preliminary studies of higher
cognitive functions also have been reported, but the validity of the
activation procedures used and the reliability of responses in these
procedures remain unclear (Hinke et al., 1993 ; McCarthy et al., 1993 ;
Cohen et al., 1994 ; Rueckert et al., 1994 ; Binder et al., 1995 ; Demb et
al., 1995 ; Shaywitz et al., 1995 ).
We used FMRI to investigate the cortical regions involved in language
processing in normal, right-handed subjects. The linguistic task, which
required meaning-based decisions about aurally presented words, was
designed to elicit receptive language processing at both phonetic
(speech perceptual) and semantic (associative) levels, with the goal of
identifying as many candidate "receptive language" areas as
possible. A baseline task, which required pitch-based decisions about
tone sequences, was used to control for activation of early auditory
processors, nonspecific executive functions mediating attention and
arousal, and motor response systems. Preliminary studies using this
language task demonstrated left hemisphere lateralization of blood
oxygenation responses and a strong correlation between this
lateralization measure and language lateralization as determined by the
intracarotid amobarbital procedure (Binder et al., 1995 , 1996b ). These
preliminary studies investigated individual subject activation patterns
only and did not include imaging of medial brain regions. A more recent
report presented averaged group activation patterns but only for the
lateral third of the left hemisphere (Binder et al., 1996a ). In the
present study, we imaged the entire brain in 30 subjects, merged the
spatially normalized data to obtain an average activation pattern, and
checked the reliability of this pattern by comparing two matched
subgroups from the original sample. As in previous functional imaging
studies, the findings are partly in conflict with the classical model
of language localization (Petersen et al., 1988 ; Démonet et al., 1992 ; Bottini et al., 1994 ; Damasio et al., 1996 ) but are generally compatible with a large body of recent lesion data (Damasio, 1981 ; Kertesz et al., 1982 ; Freedman et al., 1984 ; Warrington and Shallice, 1984 ; Alexander et al., 1989 ; Hart and Gordon, 1990 ; Hillis and Caramazza, 1991 ; Rapcsak and Rubens, 1994 ; Damasio et al., 1996 ), suggesting a need to refine and extend the classical model.
MATERIALS AND METHODS
Subjects. Subjects were 30 healthy adults (15 women,
15 men), ranging in age from 18 to 29 years, with no history of
neurological, psychiatric, or auditory symptoms. Edinburgh Handedness
Inventory laterality quotients (Oldfield, 1971 ) ranged from 58 to 100, indicating strong right-hand preferences for all subjects. Subjects
were recruited on a voluntary basis, gave written informed consent, and
were paid a small hourly stipend. All studies received prior approval
by the Medical College of Wisconsin Human Research Review Committee.
Apparatus and scanning procedures. Scanning was conducted at
1.5 Tesla on a General Electric (GE Medical Systems, Milwaukee, WI)
Signa scanner using a three-axis local gradient coil with an insertable
transmit-receive radiofrequency coil optimized for whole-brain
echo-planar imaging (EPI). Functional imaging used a gradient-echo EPI
sequence with the following parameters: 40 msec echo time, 4 sec
repetition time, 24 cm field of view, 64 × 64 pixel matrix, and
3.75 × 3.75 × 7.0 mm voxel dimensions. Seventeen to 19 contiguous sagittal slice locations were imaged, encompassing the
entire brain. One-hundred sequential images were collected at each of
the slice locations. High-resolution, T1-weighted anatomical reference
images were obtained as a set of 124 contiguous sagittal slices using a
three-dimensional spoiled-gradient-echo sequence (SPGR, GE Medical
Systems, Milwaukee, WI).
Subjects were scanned with eyes closed and room lights dimmed. Padding
was placed behind the neck and around the head as needed to relax the
cervical spine and to pack the space between the head and inner surface
of the coil. This padding minimizes the range of motion that can occur
and provides tactile feedback for subjects who are attempting to remain
motionless. Each 100-image EPI series began with four baseline images
(16 sec) to allow magnetic resonance (MR) signal to reach equilibrium,
followed by 96 images during which two comparison conditions were
alternated every 24 sec. Each image series thus consisted of eight task
alternation cycles (12 images/cycle).
Stimuli and activation tasks. Stimuli were 16-bit digitally
synthesized tones and sampled male speech sounds presented binaurally at precise intervals using a computer playback system. Sounds were
amplified near the scanner using a magnetically shielded transducer
system and were delivered to the subject via air conduction through 180 cm paired plastic tubes. The tubes were threaded through tightly
occlusive ear inserts that attenuated background scanner noise to ~75
dB sound pressure level (SPL). Background scanner noise was constant
throughout all rest and task conditions. Intensity of the experimental
stimuli averaged 100 dB SPL and remained constant across all subjects
and all stimuli. Subjects reported that the experimental stimuli were
subjectively louder than the background scanner noise.
Comparison conditions included an unspecified "rest" state and two
explicit behavioral tasks. For the rest condition, subjects were
instructed to remain relaxed and motionless but were given no other
instructions or stimuli. The behavioral tasks were designed to direct
subjects' attention either to physical characteristics of
nonlinguistic stimuli ("tone decision") or to semantically related
information pertaining to linguistic stimuli ("semantic decision").
The rationale for these tasks was given previously (Binder et al.,
1995 ) and will be briefly summarized. First, it is hypothesized that a
variety of general-purpose, nonlinguistic functional systems are
activated during most language behaviors. These could include early
sensory processors, motor systems, short-term memory systems, and
attention-arousal networks. Although vital to language behavior, these
systems are not the focus of interest of this study insofar as they are
also activated during nonlinguistic behaviors. Second, it is known that
a considerable amount of "automatic" processing of linguistic
stimuli takes place at phonological and semantic levels regardless of
the behavioral situation in which stimulus presentation occurs (Carr et
al., 1982 ; Marcel, 1983 ; Van Orden, 1987 ; Price et al., 1996 ). The
nonlinguistic comparison task used in this study (tone decision) was
therefore designed to (1) control for activation of sensory, motor, and
general-purpose executive systems; and (2) accomplish this with minimal
"automatic" activation of language systems.
Stimuli in the tone decision task were 500 and 750 Hz pure tones, with
a duration of 150 msec and 5 msec onset and offset envelopes. These
were presented as sequences of three to seven tones, with 250 msec of
silence separating each tone in a sequence and 1000 msec separating
each sequence. Sequences contained an average of five tones, resulting
in an average total stimulus duration of 750 msec. Subjects were
required to respond by button press for any sequence containing two 750 Hz tones. Stimuli in the semantic decision task were spoken English
nouns designating animals (e.g., "turtle"). These words had an
average usage frequency of 9.3 per million (SD 26.2, range 0-203)
(Francis and Kucera, 1982 ) and contained an average of 5.2 phonemes (SD
2.0, range 2-10). Each animal word was used only once during the
entire imaging session. Stimuli were edited to an average duration of
750 msec and were followed by a 2250 msec interstimulus interval.
Subjects were required to respond by button press for animals they
considered to be both "native to the United States" and "used by
humans." The tasks were matched on stimulus intensity, average
stimulus duration per trial (750 msec), average trial duration (3 sec), and frequency of positive targets (1 target/8 sec). Responses consisted
of a thumb press to a hand-held button device placed in the subject's
left hand. Button responses produced a visual signal in the control
room that was used to log performance accuracy.
Two functional image series were acquired. In the tone decision-rest
comparison, subjects performed the tone decision task eight times, with
eight intervening epochs of rest. In the semantic decision-tone
decision comparison, subjects performed the semantic decision task
eight times with eight intervening periods of tone decision.
Instructions and brief practice trials on each task were given before
scanning.
Data analysis. To compensate for artifactual signal
intensity changes caused by head movement, a modified version of the
automated image registration program developed by Woods et al. (Woods
et al., 1992 ) was used to register the EPI images within each time series. This program uses an iterative procedure to minimize the variance in voxel intensity ratios of two images. In the present study,
images 5-100 in each time series were registered with image 4, and
only these images were used in additional analyses. Each registered
96-image series was then viewed as a cine loop to detect residual
visible head motion. Images showing such motion made up <2% of the
total acquired data and were not included in subsequent analyses. No
96-image series contained more than four motion-contaminated images.
For each functional time series, t tests were conducted at
each voxel to measure changes in signal intensity between comparison conditions. For the purposes of this analysis, one of the comparison conditions was designated the activation, or "probe," condition and
the other the "control" condition. First, the final four images within each of the eight probe epochs were averaged to produce an image
of average signal intensity values during the last 12 sec of each probe
epoch. This procedure ensured that the measured values would reflect
steady-state activation levels after completion of the hemodynamic
response (Binder et al., 1995 ). Next, the final four images obtained
during control epochs before and after each probe epoch were averaged,
and a probe-control difference image was created for each activation
cycle by subtracting the average control image from the corresponding
average probe image (Binder et al., 1994a ). This use of a "local
baseline" lessens the effects of signal instability caused by scanner
"drift" and low-frequency spontaneous oscillations. Finally, these
mean probe-control difference values were compared, on a voxel-by-voxel
basis, against a hypothetical mean of zero using pooled-variance
Student's t tests. This procedure generates statistical
parametric maps (SPMs) of t deviates reflecting differences
between probe and control states at each voxel location for each
subject. For the sake of simplicity, such differences are referred to
below as "activation."
Individual anatomical (SPGR) scans and SPMs were then transformed into
the standard stereotaxic space of Talairach and Tournoux (1988) , using
the MCW-AFNI software package (Cox, 1996 ). This procedure involves
marking fiducial points on the high-resolution anatomical scans at the
anterior commissure, posterior commissure, midsagittal plane, and brain
edges. To compensate for normal variation in anatomy across subjects
(Toga et al., 1993 ), the unthresholded, stereotaxically resampled
three-dimensional SPMs were smoothed slightly with a Gaussian filter of
root-mean-square radius 4 mm. These data sets were then merged across
subjects by averaging the t statistics in each voxel. The
procedure of averaging statistics was chosen to guard against nonequal
MR signal variances among subjects. This heteroscedasticity could arise
from many causes; differing degrees of subject motion, differing
amounts of cardiac-induced tissue pulsatility, and variability in the
scanner between sessions are three likely sources. The averaged
t statistics were then thresholded to identify voxels in
which the mean change in MR signal between comparison conditions was
unlikely to be zero. The average of a set of t deviates is
not a tabulated distribution. Therefore, the Cornish-Fisher expansion
of the inverse distribution of a sum of random deviates was used to
select a threshold for rejection of the null hypothesis (Fisher and
Cornish, 1960 ). Only average t scores 0.875 were
considered significant (p < 0.0001).
Individual three-dimensional SPGR data from the 30 subjects were also
merged to produce an "average brain" for anatomical reference.
Anatomical labels for activated areas were derived by interactive
three-dimensional inspection of stereotaxically registered functional
and anatomical data using MCW-AFNI software (Cox, 1996 ) and by
reference to the atlas of Talairach and Tournoux (1988) . Activated
regions were typically large expanses of cortex following gyral and
sulcal topography rather than small foci and were thus more completely
described by reference to anatomical structures than in terms of point
coordinates. Activation areas were given anatomical labels only when
the borders of the area followed borders of a gyral or sulcal structure
in the Talairach and Tournoux atlas and the label was supported by
three-dimensional inspection of the averaged anatomical
data.
A split-half procedure was used to estimate how well the semantic
decision-tone decision activation pattern would generalize to other
subject samples, analogous to the use of this procedure in test theory
for estimating item homogeneity (Crocker and Algina, 1986 ). Subjects
were divided into two independent samples of 15 subjects each, matched
on gender, age, and handedness. Individual subject SPMs from the
semantic decision-tone decision comparison were averaged within each
subgroup. These average SPMs were then correlated on a voxel-by-voxel
basis after masking voxels in nonbrain regions of the image, yielding a
reliability coefficient for the two halves of the total sample. A
reliability coefficient for the activation pattern obtained from the
entire sample of 30 subjects was then estimated using the
Spearman-Brown prophecy formula, XX = 2 AB/(1 + AB), where XX is
the estimated reliability coefficient for the entire sample, and
AB is the split-half correlation (Spearman, 1910 ).
Finally, a visual comparison of the location of activation peaks in
each subgroup was made after thresholding each subgroup SPM at an
average t score of 1.30 (p < 0.0001).
RESULTS
Task performance
All subjects learned the tasks easily and tolerated the scanning
procedure well. Performance on the tone decision task was uniformly
good, with subjects attaining an average score of 98.3% correct
(range, 89-100%). Responses by each subject on the semantic decision
task were compared with those given by a group of 50 normal
right-handed controls on the same stimulus set. Items responded to with
a probability >0.75 by controls were categorized as targets, and items
responded to with a probability <0.25 by controls were categorized as
foils. Subjects' percent correct scores in discriminating targets from
foils averaged 92.6% (range, 73-100%).
Tone-task activation
Compared with the resting state, performance of the tone task
produced blood oxygenation changes in multiple areas of both cerebral
hemispheres, cerebellum bilaterally, bilateral deep nuclei, and
brainstem (Fig. 1). The superior temporal gyri (STG)
were activated bilaterally. This activation extended throughout much of
the STG, including Heschl's (transverse temporal) gyrus, the superior
temporal plane posterior and anterior to Heschl's gyrus, and much of
the lateral surface of the STG excluding cortex near the anterior
aspect of the superior temporal sulcus (STS). Activation in the STG did
not spread ventrally beyond the STS in the left hemisphere but did so
in the right hemisphere, involving the posterior half of the middle
temporal gyrus (MTG). Activation of the superior temporal plane
anterior to Heschl's gyrus (planum polare) did not include temporal
cortex adjacent to the insula and did not spread to adjacent insular
cortex. In both hemispheres, activation spread posteriorly along the
planum temporale and the lower bank of the posterior ascending ramus of
the sylvian fissure (planum parietale) and into the surrounding
supramarginal gyrus. This activation of the supramarginal gyrus was
much more extensive in the right hemisphere.
Fig. 1.
Top. FMRI activation map for the tone
decision-rest comparison. The data are presented as sequential
sagittal sections from left to right,
with the stereotaxic coordinate x-axis,
L-R given for each section (see Talairach and
Tournoux, 1988 ). The anteroposterior commissural line
(y-axis) and vertical AC line (z-axis) are shown in green. Activated
voxels are shown superimposed on stereotaxically averaged anatomical
brain images. Probability values for these voxels are coded using the
color scale at bottom. One centimeter tick marks are provided to help
relate the large activation regions to Talairach and Tournoux (1988) .
Structures showing bilateral activation include the STG and planum
temporale, the supramarginal gyrus, premotor cortex and SMA,
midanterior cingulate gyrus, anterior insula, anterior putamen,
thalamus, midbrain, and posterior cerebellum. Modest right hemisphere
lateralization is evidenced by right unilateral activation in the IFG
and MTG and by relative rightward asymmetry in most of the other
activated regions.
Fig. 2.
Bottom. FMRI activation map for the semantic
decision-tone decision comparison. The data are formatted as in Figure 1. The blue-cyan color scale codes probability values for voxels activated by the tone decision task relative to the semantic decision task. Left temporal lobe activation by the language task is
demonstrated in the STS and MTG (L60-48), ITG (L54-48), fusiform gyrus
(L42-30), and parahippocampus (L30-18). The left angular gyrus is
activated over a large region (L54-30). Left frontal activation
involves the entire IFG (L54-36), rostral and caudal (but not central) middle frontal gyrus (L42-24), and superior frontal gyrus rostral to
the SMA (L24-6). On the medial wall, there is activation spreading into
anterior cingulate (L6) and a focus involving retrosplenial cortex and
neighboring precuneus (L12-6). The posterior right cerebellum is
activated by the semantic decision task (R6-42). Small language
activation foci are noted in the left anterior thalamus and caudate,
left medial cerebellum, right retrosplenial region, and right angular
gyrus. Portions of the premotor cortex, planum temporale, supramarginal
gyrus, and right MTG were activated more strongly by the tone decision
(control) task (i.e., showed relative signal "decreases" during the
semantic decision task).
[View Larger Version of this Image (138K GIF file)]
Activation also involved the inferior, middle, and superior frontal
gyri bilaterally. In the left hemisphere, this followed the length of
the precentral sulcus, involving (premotor) cortex on either side of
this sulcus. Right hemisphere frontal activation was also observed
along the length of the precentral sulcus but also extended anteriorly
to involve the pars opercularis, portions of the pars triangularis, and
prefrontal cortex along the inferior frontal sulcus and in the middle
frontal gyrus. In both hemispheres, there was activation of anterior
insular cortex underneath the activated region of frontal operculum.
Activation of the superior frontal gyrus involved a region just
anterior to the paracentral lobule, probably representing the
supplementary motor area (SMA) bilaterally (x = ±6,
y = 5, z = 61). In both hemispheres,
this SMA focus was contiguous laterally with the activation centered on
the precentral sulcus and was contiguous ventrally with an area of
activation in the midanterior cingulate gyrus. Activation in all these
frontal lobe areas was somewhat more extensive in the right hemisphere.
A small activation focus was present in the region of the right central
sulcus, approximately at the site of motor representation for the left
hand.
Subcortical activation was observed bilaterally in the anterior
putamen, genu of the internal capsule, thalamus, and dorsal midbrain.
Activation in these structures was also somewhat more prominent on the
right. Details of these subcortical activations will be the subject of
a subsequent report. The posterior and lateral cerebellum was activated
bilaterally, more extensively on the left.
In summary, the tone task was associated with bilateral activation of
multiple cortical areas including primary and association auditory
cortex of the STG, supramarginal gyrus, premotor cortex and SMA,
anterior cingulate, and anterior insula. The right supramarginal gyrus
was clearly more active than the left. The MTG and several prefrontal
areas were activated in the right hemisphere only.
Language areas
Areas that were activated more strongly by the semantic decision
task than by the tone task were defined as language areas and were
found almost exclusively in the left hemisphere or in the right
cerebellum (Fig. 2). In contrast to the tone task, which activated the left STG but not MTG, the semantic decision task activated cortex on both sides of the STS and most of the MTG in the
left hemisphere. This activation also spread ventrally across portions
of the inferior temporal gyrus (ITG) and fusiform and parahippocampal
gyri in the ventral temporal lobe. In contrast, several other temporal
lobe areas responded more strongly to the tone task than to the
semantic task (i.e., showed relative signal "decreases" during the
semantic task). These included the planum temporale bilaterally and the
posterior MTG in the right hemisphere. The other bilateral STG
(auditory) areas that had been activated by the tone task relative to
rest showed no difference in level of activation by the tone and
semantic tasks.
Virtually the entire inferior frontal gyrus (IFG) was activated by the
semantic decision task, including pars opercularis, pars triangularis,
pars orbitalis, and cortex along the inferior frontal sulcus. Rostral
and caudal areas of the middle frontal gyrus were active, whereas the
midportion of this gyrus (approximately Brodmann area 9) was not. Much
of the superior frontal gyrus anterior to the vertical AC line
demonstrated activation, including the pre-SMA and medial aspect of
Brodmann areas 8-10 (Picard and Strick, 1996 ). Left medial frontal
activation also spread ventrally to involve part of the anterior
cingulate gyrus. This overlapped but was mostly rostral to the
cingulate region activated by the tone task. Much smaller anterior
cingulate and superior frontal gyrus activations were observed in the
right hemisphere. The SMA and premotor cortex along the precentral
sulcus were not activated by the semantic task more than the tone task;
premotor cortex of the right hemisphere and a small area of
dorsolateral premotor cortex in the left hemisphere responded more
strongly to the tone task.
A third major focus of activation by the semantic task was in the left
angular gyrus. A much smaller angular gyrus activation was observed in
the right hemisphere. These areas were immediately posterior to the
planum temporale and supramarginal gyrus foci that had been activated
by the tone task. Like the planum temporale, the supramarginal gyrus in
both hemispheres was more strongly activated by the tone task than the
semantic task.
A fourth large cortical region activated by the semantic task involved
the posterior cingulate gyrus, a portion of the precuneus, retrosplenial cortex, and cingulate isthmus in the left hemisphere. A
much smaller retrosplenial activation was present in the right hemisphere. Deep structures activated by the semantic task relative to
the tone task included a portion of the caudate nucleus, anterior internal capsule, and anterior thalamus in the left hemisphere only.
Semantic task activation involved a large part of the posterior right
cerebellum. A much smaller activation was observed near the posterior
midline of the left cerebellum.
In summary, four distinct cortical language-related areas were observed
in the left hemisphere. These were: (1) a lateral and ventral temporal
lobe region that included STS, MTG, and parts of the ITG and fusiform
and parahippocampal gyri; (2) a prefrontal region that included much of
the inferior and superior frontal gyri, rostral and caudal aspects of
the middle frontal gyrus, and a portion of the anterior cingulate; (3)
angular gyrus; and (4) a perisplenial region including posterior
cingulate, ventromedial precuneus, and cingulate isthmus. These regions
were clearly distinct from auditory, premotor, SMA, and supramarginal
gyrus areas that had been bilaterally activated by the tone task. The
other large region activated by the semantic task was the right
posterior cerebellum.
Reliability of language activation patterns
The pattern of language activation observed in the group average
was also visible in the individual subjects' data, as exemplified by
the subject shown in Figure 3. Language activation
patterns were very similar in the two matched samples of 15 subjects
(Fig. 4A,B).
Although the overall level of activation was somewhat greater in
subgroup 2 (Fig. 4B), the four left hemisphere
language regions in the temporal lobe, frontal lobe, angular gyrus, and
perisplenial cortex were clearly evident in both subgroups, as was the
focus in right posterior cerebellum. Voxel-by-voxel correlation between the activation maps from the two subgroups was 0.86, and the
Spearman-Brown estimated reliability coefficient for the entire sample
of 30 subjects was 0.92. This result indicates the level of correlation that would be expected between the activation pattern from this sample
and activation patterns from other random samples of 30 subjects
matched to this sample on age, handedness, and gender.
Fig. 3.
Top. Language areas identified in a
26-year-old male subject. Activated areas in the left hemisphere
include STS and MTG (L56), ITG (L56-44), fusiform gyrus (L44), angular
gyrus (L56-32), IFG (L56-44), rostral and caudal middle frontal gyrus
(L44-32), superior frontal gyrus (L20-8), anterior cingulate (L8), and
perisplenial cortex/precuneus (L8). The right posterior cerebellum is
activated, as are small foci in right dorsal prefrontal cortex and
right angular gyrus.
Fig. 4.
Bottom. Reproducibility of FMRI language
activations. Areas activated by the semantic decision task at a
p < 0.0001 level are displayed in
red for subgroup 1 (A) and subgroup 2 (B). Background images were obtained by merging
anatomical data within each group. The activation patterns are
qualitatively very similar in the two groups and are strongly
correlated ( = 0.86).
[View Larger Version of this Image (162K GIF file)]
DISCUSSION
This FMRI study sought to identify candidate language processing
areas in the intact human brain and to distinguish these from
nonlanguage areas. The language activation task emphasized perceptual
analysis of speech sounds ("phonetic processing") and retrieval of
previously learned verbal information associated with the speech sounds
("semantic processing"). Because this task used linguistic stimuli
(single words), there may also have been automatic activation of other
neural codes related to linguistic aspects of the stimuli, such as
those pertaining to orthographic and syntactic representations. By
comparing this task with a nonlanguage control task, areas activated
equally by both tasks, such as those involved in low-level auditory
processing, maintenance of attention, and response production, were
"subtracted" from the resulting activation map, revealing areas
likely to be involved in language processing. Empirical support for
this interpretation comes from a study showing very close
correspondence between this FMRI language measure and language
lateralization data obtained from intracarotid amobarbital injection
(Binder et al., 1996b ). The observed language activation pattern
appears to be reliable, in that essentially the same result was
obtained from two smaller, matched samples.
This "language map" differs in important respects from the
classical model of language localization, which views Broca's area, Wernicke's area, and the connections between these areas as the primary or core language system. In the following paragraphs, we very
briefly discuss points of agreement among the FMRI data, lesion data,
and previous functional imaging studies, which indicate the need for at
least some revision to this classical model. These converging sources
all suggest that (1) Wernicke's area, although important for auditory
processing, is not the primary location where language comprehension
occurs; (2) language comprehension involves several left
temporoparietal regions outside Wernicke's area, as well as the left
frontal lobe; and (3) the frontal areas involved in language extend
well beyond the traditional Broca's area to include much of the
lateral and medial prefrontal cortex.
Language comprehension and Wernicke's area
Isolated damage to the left STG (Wernicke's area) probably does
not produce multimodal language comprehension deficits (Henschen, 1920 -1922). STG lesions, even when fairly extensive and involving adjacent MTG, result instead in the syndrome of pure word deafness, in
which there is a defect in decoding the complex acoustic signals in
speech but preserved comprehension of language at a semantic level
(Barrett, 1910 ; Henschen, 1918 -1919; Kanshepolsky et al., 1973 ; Tanaka
et al., 1987 ). These observations are consonant with functional imaging
data, which demonstrate that the STG is activated bilaterally by both
speech and complex nonspeech sounds, and that this activation is
modulated neither by the semantic content ("meaningfulness") of
stimuli nor by the type of cognitive task performed by the subject
(Wise et al., 1991 ; Binder et al., 1994a ,b, 1996a; Millen et al.,
1995 ).
In contrast, multimodal comprehension disturbances, involving both
auditory and visual material, are typically associated with large
lesions extending beyond the STG and including the MTG, angular, and
supramarginal gyri (Kertesz et al., 1979 , 1993 ; Naeser et al., 1981 ;
Selnes et al., 1984 ; Damasio, 1989 ; Metter et al., 1990 ). Isolated
angular gyrus lesions are well known to produce language deficits,
particularly for written material (Dejerine, 1892 ; Marie, 1917 ;
Henschen, 1920 -1922; Nielsen, 1946 ; Penfield and Roberts, 1959 ;
Geschwind, 1965 ). An increasing number of imaging studies confirm that
isolated lesions of the left MTG and ITG produce multimodal
comprehension deficits (Damasio, 1981 ; Kertesz et al., 1982 ; Alexander
et al., 1989 ). A striking feature of some of these cases is the
selective nature of the linguistic disturbance, which may affect only a
particular lexical-semantic category or word class, leading to the
hypothesis that it is the stored knowledge or selective retrieval
mechanism related to these categories or classes that is lost as a
result of the lesion (Warrington and Shallice, 1984 ; Hart and Gordon,
1990 ; Hillis and Caramazza, 1991 ; Damasio and Tranel, 1993 ; Damasio et
al., 1996 ).
Data obtained from invasive electrophysiology also confirm the
existence of language areas in the lateral and ventral left temporal
lobe, including the fusiform gyrus (Penfield and Roberts, 1959 ; Ojemann
et al., 1989 ; Lüders et al., 1991 ; Hart et al., 1992 ; Nobre et
al., 1994 ). Finally, many positron emission tomographic (PET) studies
demonstrate activation associated with language processing in left
temporoparietal regions outside the STG, including the angular gyrus,
MTG, and ITG (Frith et al., 1991 ; Démonet et al., 1992 ; Howard et
al., 1992 ; Bottini et al., 1994 ; Raichle et al., 1994 ; Bookheimer et
al., 1995 ; Damasio et al., 1996 ; Fiez et al., 1996 ; Price et al., 1996 ;
Warburton et al., 1996 ). The location of left temporoparietal
activations in these various reports agrees quite closely with the
results of the present study, a somewhat surprising outcome given the
diversity of language tasks used by the different investigators.
In summary, converging evidence from lesion and functional imaging
research suggests that the left STG plays an important role in
analyzing speech sounds. However, this region has been somewhat
overemphasized in traditional neuroanatomical models of language
processing to the exclusion of large temporoparietal regions in the
left hemisphere that probably play a more important role in
comprehension at a linguistic-semantic level. These areas include, but
may not be limited to, the angular gyrus, MTG, ITG, and fusiform gyrus
(approximately Brodmann areas 39, 21, 20, 37, and 36).
Frontal lobe language areas
Lesions confined to Broca's area (i.e., the posterior left IFG,
variously including the pars opercularis, pars triangularis, or both)
typically cause apraxic deficits of articulation, with, at most, a
transient disturbance of language (Mohr, 1976 ; Mohr et al., 1978 ). In
contrast, the linguistic deficits characterizing Broca's aphasia are
associated with much larger lesions, usually involving the anterior
IFG, middle frontal gyrus, insula, ventral pre- and postcentral gyri,
or anterior parietal areas in addition to Broca's area (Mohr, 1976 ;
Mohr et al., 1978 ). Aphasic disorders also occur after left frontal
lesions entirely outside Broca's area, in dorsolateral prefrontal
cortex and in the superior frontal gyrus (Rubens, 1976 ; Freedman et
al., 1984 ; Rapcsak and Rubens, 1994 ). Linguistic deficits reported in
such patients include impaired comprehension for syntactically complex
material, agrammatism, verbal paraphasia, inability to formulate
narrative discourse, and a striking inability to generate word lists
(Rubens, 1976 ; Alexander and Schmitt, 1980 ; Freedman et al., 1984 ;
Stuss and Benson, 1986 ; Costello and Warrington, 1989 ). Together, these data indicate the existence of language cortex in several prefrontal regions outside Broca's area.
Extensive left frontal activation during language processing is a
frequent finding in PET research (Frith et al., 1991 ; Wise et al.,
1991 ; Démonet et al., 1992 ; Raichle et al., 1994 ; Fiez et al.,
1996 ; Price et al., 1996 ). Activation involving all three frontal gyri
and anterior cingulate, similar to our results, was noted in a few
instances (Bottini et al., 1994 ; Bookheimer et al., 1995 ; Warburton et
al., 1996 ), whereas other studies showed IFG activation extending into
the posterior middle frontal gyrus, with a separate focus in the medial
frontal lobe (Wise et al., 1991 ; Raichle et al., 1994 ; Price et al.,
1996 ). A striking finding in the present study was that although
language activation involved much of the left prefrontal cortex, a
large region in the center of the middle frontal gyrus (approximately
Brodmann area 9) was not activated, suggesting that this area has
functions clearly distinct from those of other prefrontal areas.
Although the left frontal lobe is traditionally understood as having
"expressive" or "output" functions, our study and several others demonstrated left frontal activation during receptive language tasks with little or no requirement for speech production
(Démonet et al., 1992 ; Bottini et al., 1994 ; Price et al., 1996 ).
The classical view of frontal lobe language function arose from lesion
studies, most of which were conducted well after the acute illness and were intended to reveal the areas "critical" for a given function. Functional imaging techniques, in contrast, do not distinguish critical
areas from those that participate in a function but can be compensated
by other areas. Left frontal regions may participate in receptive
language processing in the normal, uninjured state, playing a
"language executive" role in coordinating the sensory and semantic
processes occurring in posterior areas and accommodating moment-by-moment shifts in goals and strategies. After left frontal injury, it is possible that many of these coordinating functions are
taken over by other areas. This would explain the observation that
patients with large left frontoparietal lesions usually manifest global
aphasia and significant comprehension disturbances in the acute period
after injury, only later evolving into the typical "expressive"
aphasia syndrome (Mohr, 1976 ; Mohr et al., 1978 ).
Other activated areas
Functional activation of the right cerebellum during word
generation tasks is a consistent finding in PET studies that include the cerebellum (Petersen et al., 1989 ; Pardo and Fox, 1993 ; Raichle et
al., 1994 ). The present data extend this observation to a semantic decision task that does not require word retrieval. The cerebellum may
play a general role in facilitating complex neural computations (Keele
and Ivry, 1990 ; Leiner et al., 1991 ), although the precise nature of
this role remains somewhat speculative. Several patients were reported
to show cognitive deficits in association with cerebellar damage
(Bracke-Tolkmitt et al., 1989 ; Fiez et al., 1992 ), yet frank aphasic
disturbances are rare.
A major activation during the semantic decision task occurred
near the splenium of the corpus callosum. Much of this region probably
coincides with retrosplenial cortex (Vogt, 1976 ), which has connections
with hippocampus, parahippocampus (Mufson and Pandya, 1984 ; Suzuki and
Amaral, 1994 ), and anterolaterodorsal thalamus (Sripanidkulchai and
Wyss, 1986 ). This connectivity pattern suggests an involvement in
memory functions, and left hemisphere lesions in this general region
reportedly cause a verbal amnestic syndrome (Valenstein et al., 1987 ;
Rudge and Warrington, 1991 ). Retrosplenial activation may therefore be
related to memory-encoding processes that accompanied performance of
the semantic decision task. Although identification of memory systems
was not an intended goal, processing at a semantic level is known to
enhance storage of episodic memories compared with processing at a
perceptual level (Craik and Lockhart, 1972 ). Thus, the episodic memory
encoding system was likely activated during the semantic task relative to the tone task. This interpretation could also account for the activation observed in left parahippocampus, another structure closely tied to memory function (von Cramon et al., 1988 ; Zola-Morgan et al., 1989 ).
The supramarginal gyrus was activated bilaterally by the tone decision
task relative to the semantic decision task and, therefore, was not
considered to be a language area. This finding deserves comment,
because the left supramarginal gyrus is usually considered part of the
perisylvian language "core" (Wernicke, 1874 ; Marie, 1917 ; Penfield
and Roberts, 1959 ; Geschwind, 1965 ; Benson, 1985 ; Mayeux and Kandel,
1985 ). Lesions in or near this structure cause speech output
disturbances characterized by phonemic paraphasias in repetition
(Geschwind, 1965 ; Damasio and Damasio, 1980 ) and other phonological
deficits (Caplan et al., 1995 ). One hypothesis that would reconcile
these various findings is that the supramarginal gyrus may be involved
in short-term storage of auditory information (Warrington et al., 1971 ;
Caramazza et al., 1981 ; Paulesu et al., 1993 ). The tone decision task,
which involved monitoring arbitrary sequences of up to seven tones,
probably placed more demand on short-term auditory memory resources
than did the semantic task, which involved familiar word stimuli.
Relative lateralization of supramarginal gyrus activation to the right
hemisphere is consistent with data showing right hemisphere dominance
for short-term storage of nonlinguistic auditory information (Zatorre
and Samson, 1991 ; Zatorre et al., 1994 ).
FOOTNOTES
Received Aug. 1, 1996; revised Oct. 7, 1996; accepted Oct. 11, 1996.
This work was supported by a grant from the McDonnell-Pew Program in
Cognitive Neuroscience, National Institute of Neurological Diseases and
Stroke Grant RO1 NS33576, and National Institute of Mental Health Grant
PO1 MH51358. We thank J. Hyde, A. Jesmanowicz, W. O'Reilly, and L. Estkowski for discussion and technical assistance.
Correspondence should be addressed to Dr. J. R. Binder, Department of
Neurology, Medical College of Wisconsin, 9200 West Wisconsin Avenue,
Milwaukee, WI 53226.
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R. J. Zatorre and P. Belin
Spectral and Temporal Processing in Human Auditory Cortex
Cereb Cortex,
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P. C. Fletcher and R. N. A. Henson
Frontal lobes and human memory: Insights from functional neuroimaging
Brain,
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T. A. Keller, P. A. Carpenter, and M. A. Just
The Neural Bases of Sentence Comprehension: a fMRI Examination of Syntactic and Lexical Processing
Cereb Cortex,
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L. A. Petitto, R. J. Zatorre, K. Gauna, E. J. Nikelski, D. Dostie, and A. C. Evans
From the Cover: Speech-like cerebral activity in profoundly deaf people processing signed languages: Implications for the neural basis of human language
PNAS,
December 5, 2000;
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S. K. Scott, C. C. Blank, S. Rosen, and R. J. S. Wise
Identification of a pathway for intelligible speech in the left temporal lobe
Brain,
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J. P. Rauschecker and B. Tian
Mechanisms and streams for processing of "what" and "where" in auditory cortex
PNAS,
October 24, 2000;
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X. Wang
On cortical coding of vocal communication sounds in primates
PNAS,
October 24, 2000;
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[Abstract]
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R. A. W. Galuske, W. Schlote, H. Bratzke, and W. Singer
Interhemispheric Asymmetries of the Modular Structure in Human Temporal Cortex
Science,
September 15, 2000;
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A. V. Apkarian, P. A. Gelnar, B. R. Krauss, and N. M. Szeverenyi
Cortical Responses to Thermal Pain Depend on Stimulus Size: A Functional MRI Study
J Neurophysiol,
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K. Nakamura, M. Honda, T. Okada, T. Hanakawa, K. Toma, H. Fukuyama, J. Konishi, and H. Shibasaki
Participation of the left posterior inferior temporal cortex in writing and mental recall of kanji orthography: A functional MRI study
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J.R. Binder, J.A. Frost, T.A. Hammeke, P.S.F. Bellgowan, J.A. Springer, J.N. Kaufman, and E.T. Possing
Human Temporal Lobe Activation by Speech and Nonspeech Sounds
Cereb Cortex,
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R. L. Buckner, W. Koutstaal, D. L. Schacter, and B. R. Rosen
Functional MRI evidence for a role of frontal and inferior temporal cortex in amodal components of priming
Brain,
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S. Knecht, M. Deppe, B. Drager, L. Bobe, H. Lohmann, E.-B. Ringelstein, and H. Henningsen
Language lateralization in healthy right-handers
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I. S. Johnsrude, V. B. Penhune, and R. J. Zatorre
Functional specificity in the right human auditory cortex for perceiving pitch direction
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R. S. Herz, C. McCall, and L. Cahill
Hemispheric Lateralization in the Processing of Odor Pleasantness versus Odor Names
Chem Senses,
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M. Steinschneider, I. O. Volkov, M. D. Noh, P. C. Garell, and M. A. Howard III
Temporal Encoding of the Voice Onset Time Phonetic Parameter by Field Potentials Recorded Directly From Human Auditory Cortex
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November 1, 1999;
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J. A. Springer, J. R. Binder, T. A. Hammeke, S. J. Swanson, J. A. Frost, P. S. F. Bellgowan, C. C. Brewer, H. M. Perry, G. L. Morris, and W. M. Mueller
Language dominance in neurologically normal and epilepsy subjects: A functional MRI study
Brain,
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Y. Cao, E. M. Vikingstad, K. P. George, A. F. Johnson, and K. M. A. Welch
Cortical Language Activation in Stroke Patients Recovering From Aphasia With Functional MRI
Stroke,
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A. R. Halpern and R. J. Zatorre
When That Tune Runs Through Your Head: A PET Investigation of Auditory Imagery for Familiar Melodies
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T. L. Richards, S. R. Dager, D. Corina, S. Serafini, A. C. Heide, K. Steury, W. Strauss, C. E. Hayes, R. D. Abbott, S. Craft, et al.
Dyslexic Children Have Abnormal Brain Lactate Response to Reading-Related Language Tasks
AJNR Am. J. Neuroradiol.,
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J. I. Breier, P. G. Simos, G. Zouridakis, J. W. Wheless, L. J. Willmore, J. E. C. Constantinou, W. W. Maggio, and A. C. Papanicolaou
Language dominance determined by magnetic source imaging: A comparison with the Wada procedure
Neurology,
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R. Green, A. Clark, W. Hickey, J. Hutsler, and M. Gazzaniga
Braincutting for Psychiatrists: The Time Is Ripe
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M. St George, M. Kutas, A. Martinez, and M. I. Sereno
Semantic integration in reading: engagement of the right hemisphere during discourse processing
Brain,
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R. R. Benson, D. B. FitzGerald, L. L. LeSueur, D. N. Kennedy, K. K. Kwong, B. R. Buchbinder, T. L. Davis, R. M. Weisskoff, T. M. Talavage, W. J. Logan, et al.
Language dominance determined by whole brain functional MRI in patients with brain lesions
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J. Pujol, J. Deus, J. M. Losilla, and A. Capdevila
Cerebral lateralization of language in normal left-handed people studied by functional MRI
Neurology,
March 1, 1999;
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J. A. Frost, J. R. Binder, J. A. Springer, T. A. Hammeke, P. S.F. Bellgowan, S. M. Rao, and R. W. Cox
Language processing is strongly left lateralized in both sexes: Evidence from functional MRI
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K. Sakatani, Y. Xie, W. Lichty, S. Li, and H. Zuo
Language-Activated Cerebral Blood Oxygenation and Hemodynamic Changes of the Left Prefrontal Cortex in Poststroke Aphasic Patients : A Near-Infrared Spectroscopy Study
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S. A. Bunge, T. Klingberg, R. B. Jacobsen, and J. D. E. Gabrieli
A resource model of the neural basis of executive working memory
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