Cross-modal recruitment of auditory and orofacial areas during sign language in a deaf subject.

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Cross-modal recruitment of auditory and orofacial areas during sign language in a deaf subject.

World Neurosurg. 2017 Jun 05;:

Authors: Martino J, Velasquez C, Vázquez-Bourgon J, Marco de Lucas E, Gomez E

Abstract
BACKGROUND: Modern signed languages of the deaf are fully expressive, natural human languages that are perceived visually and produced manually.The literature contains little data concerning human brain organization in conditions of deficient sensory information such as deafness.
CASE DESCRIPTION: Here, we describe an original case of a deaf-mute patient with a left temporo-insular low-grade glioma that was operated. The patient underwent awake surgery with intraoperative electrical stimulation mapping, allowing for the first time in the literature, to directly study the cortical and subcortical organization of signed language. We found a similar distribution of language sites to what has been reported in mapping studies of patients with oral language: 1) speech perception areas inducing anomias and alexias close to the auditory cortex (at the posterior portion of the superior temporal gyrus and supramarginal gyrus). 2) Speech production areas inducing speech arrest (anarthria) at the ventral premotor cortex, close to the lip motor area and away from the hand motor area. 3) Subcortical stimulation induced semantic paraphasias at the inferior fronto-occipital fasciculus at the temporal isthmus.
CONCLUSIONS: The intraoperative setup for sign language mapping with intraoperative electrical stimulation in deaf-mute patients is similar to the described in oral language patients. To elucidate the type of language errors, a sign language interpreter in close interaction with the neuropsychologist is necessary. Sign language is perceived visually and produced manually, however the present case revealed a cross-modal recruitment of auditory and orofacial motor areas.

PMID: 28602887 [PubMed - as supplied by publisher]

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