Regional cerebral blood flow in aphasia

Regional cerebral blood flow (rCBF) was studied in 13 aphasic patients with left hemisphere lesions, using the intracarotid xenon 133 injection method and a 254-detector gamma camera system. The rCBF was measured during rest and during various function tests, including a simple speech test. In motor (nonfluent) aphasia, the rCBF method showed areas of cortical dysfunction that always included the lower part of the rolandic area while Broca's area was not consistently affected. In sensory (fluent) aphasia, the superior-posterior temporal cortex was involved in all cases. In global aphasia, the abnormalities included both regions consistently involved in the other types of aphasia. The 133Xe injection method for mapping abnormalities relevant for localizing the cortical speech areas was superior to the classical neuroradiological methods in that several cases failed to show any relevant lesion whatsoever. This is probably related to the functional nature of the rCBF method: subnormal flow values and lack of the normal flow increase during function tests apparently may disclose functionally inactivated but structurally intact cortex.