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Related Experiment Video

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Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping

Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping

Published on: September 25, 2019

[Aphasia associated with lacunar infarctions].

Konstantin Kohlhase¹, Jan Hendrik Schaefer¹, Sriramya Lapa¹

¹Klinik für Neurologie, Goethe-Universität Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Deutschland.

|February 16, 2021

Summary

Lacunar stroke, typically not causing aphasia, can lead to speech deficits when affecting specific lateral brain areas and speech-relevant fiber tracts like the arcuate fascicle.

Keywords:

Aphasia Arcuate fascicle Ischemic stroke Lacunar Subcortical

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Area of Science:

Neurology
Neuroimaging
Speech Pathology

Background:

Lacunar syndromes typically do not involve aphasia.
Aphasia is rarely reported in atypical lacunar syndromes.

Purpose of the Study:

To describe the clinical presentation (phenomenology) of aphasia in lacunar stroke.
To identify the affected white matter fiber tracts in patients with lacunar stroke-induced aphasia.

Main Methods:

A case series of three patients with lacunar stroke confirmed by magnetic resonance imaging (MRI).
Fiber tracking analysis using MRI data from patients and healthy controls to map affected tracts.

Main Results:

Lacunar strokes causing aphasia were located in the lateral middle cerebral artery territory, extending into the external capsule.
Patients presented with mild to moderate nonfluent aphasia and syntactic deficits, despite unaffected cortex, thalamus, and basal ganglia.
Fiber tracking revealed involvement of the arcuate fascicle, frontostriatal tract, and frontal aslant tract in aphasic patients.

Conclusions:

Left lateral lacunar stroke can induce clinically significant aphasia.
Disruption of specific speech-relevant fiber tracts underlies aphasia in these cases.