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Brain Advance Access originally published online on March 2, 2007
Brain 2007 130(5):1408-1422; doi:10.1093/brain/awm011
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© 2007 The Author(s)
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial use License (http://creativecommons.org/lisences/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distributed, and reproduction in medium, provided the original work is properly cited.

Neural regions essential for distinct cognitive processes underlying picture naming

Jessica DeLeon3, Rebecca F. Gottesman1, Jonathan T. Kleinman1, Melissa Newhart1, Cameron Davis1, Jennifer Heidler-Gary1, Andrew Lee1 and Argye E. Hillis1,2,3

1Departments of Neurology, 2Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine and 3Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA

Correspondence to: Argye E. Hillis, MD, Department of Neurology, Phipps 126, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA. E-mail: argye{at}JHMI.edu

We hypothesized that distinct cognitive processes underlying oral and written picture naming depend on intact function of different, but overlapping, regions of the left hemisphere cortex, such that the distribution of tissue dysfunction in various areas can predict the component of the naming process that is disrupted. To test this hypothesis, we evaluated 116 individuals within 24 h of acute ischaemic stroke using a battery of oral and written naming and other lexical tests, and with magnetic resonance diffusion and perfusion imaging to identify the areas of tissue dysfunction. Discriminant function analysis, using the degree of hypoperfusion in various Brodmann's areas—BA 22 (including Wernicke's area), BA 44 (part of Broca's area), BA 45 (part of Broca's area), BA 21 (inferior temporal cortex), BA 37 (posterior, inferior temporal/fusiform gyrus), BA 38 (anterior temporal cortex) and BA 39 (angular gyrus)—as discriminant variables, classified patients on the basis of the primary component of the naming process that was impaired (defined as visual, semantics, modality-independent lexical access, phonological word form, orthographic word form and motor speech by the pattern of performance and types of errors across lexical tasks). Additionally, linear regression analysis demonstrated that the areas contributing the most information to the identification of patients with particular levels of impairment in the naming process were largely consistent with evidence for the roles of these regions from functional imaging. This study provides evidence that the level of impairment in the naming process reflects the distribution of tissue dysfunction in particular regions of the left anterior, inferior and posterior middle/superior temporal cortex, posterior inferior frontal and inferior parietal cortex. While occipital cortex is also critical for picture naming, it is likely that bilateral occipital damage is necessary to disrupt visual recognition. These findings provide new evidence that a network of brain regions supports naming, but separate components of this network are differentially required for distinct cognitive processes or representations underlying the complex task of naming pictures.

Key Words: aphasia; magnetic resonance perfusion weighted imaging; naming; anomia; language

Abbreviations: BA, Brodmann's area; DWI, diffusion-weighted imaging; PWI, perfusion-weighted imaging; TTP, time to peak

Received June 8, 2006. Revised October 23, 2006. Accepted January 12, 2007.


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