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Thesis

French

ID: <

10670/1.f4d213

>

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Changing the neuroanatomy of language between 1910 and 2010: Has it changed the definition of language and aphasia?

Abstract

abstract: Introduction: Since the 19th century, technological and technical advances have made it possible to make major advances in the neuro-anatomical understanding of language. This work consists of comparing three anatomical representations of language established between 1910 and 2010. Question: Changing the neuroanatomy of language between 1910 and 2010: Has it changed the definition of language and aphasia? Methodology: Study of primary and secondary literature. Results: Dejerine (1900s) described the ‘language area’ by an anatomo-pathological approach, consisting of three brain centres connected by combination beams; the third frontal circumvolution (1), the first temporary circumference and the supramarginal gyrus (2) and the angular gyrus (3). The upper longitudinal beam or arched beam connects centres 1 and 3 to centre 2, the lower longitudinal beam connects centres 2 and 3, the occipito-frontal beam connects centres 2 and 3 to centre 1 and the unlit beam connects centres 2 and 1. Clinical tables of motive and sensory aphasia with an injury to the area shall be detailed. The second representation was described not by Geschwind and Damasio in the years 1960-80 and was marked by the introduction of the CT-scan and the development of a linguistic model of language. The brain function of the language is depicted in accordance with the principles of Flechsig and Bailey and Bonin. It involves “key areas” which interact with each other by “intermediate areas” of cortex. The angular and supramarginal gyri are presented as a “terminal area” that would support the language function. Damasio then introduced new areas of secondary association according to this principle. New regions associated with aphasia have been found, such as INNEST, basal ganglia and thalamus, and new clinical tables of aphasia have been described. The third representation is described by Price in the 2000s using the functional MRI and the moderation and cognitive language developed in the 80s. Unlike the other two representations, Price was able to highlight the regions active in response to different language stimuli and concluded that the brain system was integrated into a network. This has led to a widening of the brain regions involved in language, and has refined the role of certain structures such as the post-lower temporal cortex, the base ganglia and the cervelet. Aphasia is a constellation of symptoms relating to a given lesion in the network, without the affected area being the seat of loss-making functions. Conclusion: The foundations of the anatomy of language had already been discovered in the 19th century. The introduction of CT-scan and functional MRI, together with new language and cognitive language models, has led to a widening of the language area and anatomical refinement of language functions, in particular in the production process and in the semantic field. Classical tables of aphasia remain a good reflection of the cerebral areas essential to language and are useful to clinicians as a basis for reflection, but the functional MRI has shown that linking a clinical picture to brain localisation is obsolete.

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