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Brain Advance Access originally published online on August 18, 2009
Brain 2009 132(9):2309-2316; doi:10.1093/brain/awp206
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© The Author (2009). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Review Article

The role of the arcuate fasciculus in conduction aphasia

Byron Bernal1 and Alfredo Ardila2

1 Department of Radiology/Brain Institute, Miami Children's Hospital, Miami, FL, USA 2 Department of Communication Sciences and Disorders, Florida International University. Miami, FL 33199, USA

Correspondence to: Alfredo Ardila, PhD, Department of Communication Sciences and Disorders, HLS 139, Florida International University, Miami, FL 33199 E-mail: ardilaa{at}fiu.edu

In aphasia literature, it has been considered that a speech repetition defect represents the main constituent of conduction aphasia. Conduction aphasia has frequently been interpreted as a language impairment due to lesions of the arcuate fasciculus (AF) that disconnect receptive language areas from expressive ones. Modern neuroradiological studies suggest that the AF connects posterior receptive areas with premotor/motor areas, and not with Broca's area. Some clinical and neurophysiological findings challenge the role of the AF in language transferring. Unusual cases of inter-hemispheric dissociation of language lateralization (e.g. Broca's area in the left, and Wernicke's area in the right hemisphere) have been reported without evident repetition defects; electrocortical studies have found that the AF not only transmits information from temporal to frontal areas, but also in the opposite direction; transferring of speech information from the temporal to the frontal lobe utilizes two different streams and conduction aphasia can be found in cases of cortical damage without subcortical extension. Taken altogether, these findings may suggest that the AF is not required for repetition although could have a subsidiary role in it. A new language network model is proposed, emphasizing that the AF connects posterior brain areas with Broca's area via a relay station in the premotor/motor areas.

Key Words: arcuate fasciculus; conduction aphasia; language repetition; tractography; vocal imitation

Abbreviations: AF, arcuate fasciculus

Received March 4, 2009. Revised June 15, 2009. Accepted June 29, 2009.


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