Brain Advance Access first published online on April 2, 2007
This version published online on April 17, 2007
Brain, doi:10.1093/brain/awm042
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Paul Broca's historic cases: high resolution MR imaging of the brains of Leborgne and Lelong
1VA Northern California Health Care System, University of California, Davis and University of California, San Diego, CA, USA 2Faculté de Médecine, Université Paris-Descartes, Paris V and APHP GH Pitié-Salpêtrière, Epileptology Department, Paris, France 3Université Pierre et Marie Curie Paris VI, Faculté Pierre et Marie Curie and Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, Neuroimaging Department, Paris, France 4Université Pierre et Marie Curie Paris VI, Faculté Pierre et Marie Curie, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, Neuroimaging Department and Académie Nationale de Médecine, Paris, France
Correspondence to:
Nina F. Dronkers, PhD, Center for Aphasia and Related Disorders, VA Northern California Health Care System, 150 Muir Road (126s), Martinez, CA 94553, USA E-mail: dronkers{at}ucdavis.edu
In 1861, the French surgeon, Pierre Paul Broca, described two patients who had lost the ability to speak after injury to the posterior inferior frontal gyrus of the brain. Since that time, an infinite number of clinical and functional imaging studies have relied on this brain–behaviour relationship as their anchor for the localization of speech functions. Clinical studies of Broca's aphasia often assume that the deficits in these patients are due entirely to dysfunction in Broca's area, thereby attributing all aspects of the disorder to this one brain region. Moreover, functional imaging studies often rely on activation in Broca's area as verification that tasks have successfully tapped speech centres. Despite these strong assumptions, the range of locations ascribed to Broca's area varies broadly across studies. In addition, recent findings with language-impaired patients have suggested that other regions also play a role in speech production, some of which are medial to the area originally described by Broca on the lateral surface of the brain. Given the historical significance of Broca's original patients and the increasing reliance on Broca's area as a major speech centre, we thought it important to re-inspect these brains to determine the precise location of their lesions as well as other possible areas of damage. Here we describe the results of high resolution magnetic resonance imaging of the preserved brains of Broca's two historic patients. We found that both patients’ lesions extended significantly into medial regions of the brain, in addition to the surface lesions observed by Broca. Results also indicate inconsistencies between the area originally identified by Broca and what is now called Broca's area, a finding with significant ramifications for both lesion and functional neuroimaging studies of this well-known brain area.
Key Words: aphasia; Broca; history; language; magnetic resonance imaging
Abbreviations: MRI, magnetic resonance imaging; CT, computerized tomography; S(RH), sagittal image of the right hemisphere; S(LH), sagittal image of the left hemisphere; SLF, superior longitudinal fasciculus
Received June 30, 2006. Revised December 19, 2006. Accepted February 13, 2007.
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