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Developmental Dynamic Dysphasia: Are Bilateral Brain Abnormalities a Signature of Inefficient Neural Plasticity?

Frontiers in Human Neuroscience. 2020;14 DOI 10.3389/fnhum.2020.00073

 

Journal Homepage

Journal Title: Frontiers in Human Neuroscience

ISSN: 1662-5161 (Online)

Publisher: Frontiers Media S.A.

LCC Subject Category: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry

Country of publisher: Switzerland

Language of fulltext: English

Full-text formats available: PDF, HTML, ePUB, XML

 

AUTHORS


Marcelo L. Berthier (Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain)

Guadalupe Dávila (Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain)

Guadalupe Dávila (Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology, University of Malaga, Málaga, Spain)

María José Torres-Prioris (Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain)

María José Torres-Prioris (Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology, University of Malaga, Málaga, Spain)

Ignacio Moreno-Torres (Department of Spanish Language I, University of Malaga, Málaga, Spain)

Jordi Clarimón (Department of Neurology and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain)

Jordi Clarimón (Center for Networked Biomedical Research into Neurodegenerative Diseases, Madrid, Spain)

Oriol Dols-Icardo (Department of Neurology and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain)

Oriol Dols-Icardo (Center for Networked Biomedical Research into Neurodegenerative Diseases, Madrid, Spain)

María J. Postigo (Neurophysiology Unit, Regional University Hospital Carlos Haya, Málaga, Spain)

Victoria Fernández (Neurophysiology Unit, Regional University Hospital Carlos Haya, Málaga, Spain)

Lisa Edelkraut (Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain)

Lisa Edelkraut (Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology, University of Malaga, Málaga, Spain)

Lorena Moreno-Campos (Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain)

Diana Molina-Sánchez (Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain)

Paloma Solo de Zaldivar (Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain)

Diana López-Barroso (Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Malaga, Málaga, Spain)

Diana López-Barroso (Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology, University of Malaga, Málaga, Spain)

EDITORIAL INFORMATION

Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 14 weeks

 

Abstract | Full Text

The acquisition and evolution of speech production, discourse and communication can be negatively impacted by brain malformations. We describe, for the first time, a case of developmental dynamic dysphasia (DDD) in a right-handed adolescent boy (subject D) with cortical malformations involving language-eloquent regions (inferior frontal gyrus) in both the left and the right hemispheres. Language evaluation revealed a markedly reduced verbal output affecting phonemic and semantic fluency, phrase and sentence generation and verbal communication in everyday life. Auditory comprehension, repetition, naming, reading and spelling were relatively preserved, but executive function was impaired. Multimodal neuroimaging showed a malformed cerebral cortex with atypical configuration and placement of white matter tracts bilaterally and abnormal callosal fibers. Dichotic listening showed right hemisphere dominance for language, and functional magnetic resonance imaging (fMRI) additionally revealed dissociated hemispheric language representation with right frontal activation for phonology and bilateral dominance for semantic processing. Moreover, subject D also had congenital mirror movements (CMM), defined as involuntary movements of one side of the body that mirror intentional movements of the other side. Transcranial magnetic stimulation and fMRI during voluntary unimanual (left and right) hand movements showed bilateral motor cortex recruitment and tractography revealed a lack of decussation of bilateral corticospinal tracts. Genetic testing aimed to detect mutations that disrupt the development of commissural tracts correlating with CMM (e.g., Germline DCC mutations) was negative. Overall, our findings suggest that DDD in subject D resulted from the underdevelopment of the left inferior frontal gyrus with limited capacity for plastic reorganization by its homologous counterpart in the right hemisphere. Corpus callosum anomalies probably contributed to hinder interhemispheric connectivity necessary to compensate language and communication deficits after left frontal involvement.