Brain Advance Access originally published online on November 29, 2006
Brain 2007 130(3):610-622; doi:10.1093/brain/awl331
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Review Article |
Stimulating language: insights from TMS
1FMRIB Centre, Department of Clinical Neurology, University of Oxford, John Radcliffe Hospital and 2Department of Experimental Psychology, University of Oxford, Oxford, UK
Correspondence to: Joseph T. Devlin FMRIB Centre, Department of Clinical Neurology, University of Oxford, John Radcliffe Hospital, Headley Way, Headington, Oxford, UK E-mail: devlin{at}fmrib.ox.ac.uk
Fifteen years ago, Pascual-Leone and colleagues used transcranial magnetic stimulation (TMS) to investigate speech production in pre-surgical epilepsy patients and in doing so, introduced a novel tool into language research. TMS can be used to non-invasively stimulate a specific cortical region and transiently disrupt information processing. These ‘virtual lesion’ studies offer not only the ability to explore causal relations between brain regions and language functions absent in functional neuroimaging, but also spatial and temporal precision not typically available in patient studies. For instance, TMS has been used to demonstrate functionally distinct sub-regions of the left inferior frontal gyrus; to clarify the relationship between pre-morbid language organization and susceptibility to unilateral lesions and to investigate the contribution of both left and right hemisphere language areas in recovery from aphasia. When TMS is used as a measure of functional connectivity, it demonstrates a close link between action words and motor programmes; it suggests a potential evolutionary link between hand gestures and language and it suggests a role in speech perception for the motor system underlying speech production. In combination with functional neuroimaging, it can elucidate the circuits responsible for this involvement. Finally, TMS may even be useful for enhancing recovery in aphasic patients. In other words, TMS has already become an important tool for studying language at both the cognitive and neural levels, and it is clear that further developments in TMS methodology are likely to result in even greater opportunities for language research.
Key Words: virtual lesion; functional connectivity; aphasia
Abbreviations: DLPFC, dorso-lateral prefrontal cortex; IAT, intra amytal test; LIFG, left inferior frontal gyrus; MEP, motor evoked potential; RIFG, right inferior frontal gyrus; RT, reaction time; rTMS, repetitive TMS; TMS, transcranial magnetic stimulation
Received May 22, 2006. Revised October 13, 2006. Accepted October 22, 2006.
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