Recovery of Language Disorders

Homologous Contralateral or Connected Ipsilateral Compensation?
  • Andrew Kertesz


The study of recovery from language deficit is more than just a practical, prognostic exercise for the clinician or a base line for therapy. It also provides an important theoretical framework for cerebral reorganization. Human brain damage caused by stroke or trauma produces deficits that recover in two stages. The first stage is related to recovery from the acute effect of membrane failure, ionic imbalance, hemorrhage, cellular reaction, and possibly to the reestablishment of the circulation in the ischemic penumbra (Astrup et al., 1981). Our interest has focused on second-stage recovery that takes place months, even years, after injury, and its mechanisms remain largely a mystery. A significant amount of physiological and functional recovery is probably related to intact structures compensating for the functional loss. Axonal regrowth and collateral sprouting are important mechanisms in the peripheral and, in certain instances, in the central nervous system. However, in large lesions in man causing focal cognitive or language loss, compensation is likely affected by (1) ipsilateral physiologically and anatomically connected structures, (2) contralateral homologous cortical areas, or (3) subcortical systems hierarchically and physiologically related to the damaged structures or function in question.


Left Hemisphere Dichotic Listening Language Disorder Initial Severity Speech Output 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Ades, H. W., and Raab, D. H., 1946, Recovery of motor function after two-stage extirpation of area 4 in monkeys, J. Neurophysiol. 9:55–60.PubMedGoogle Scholar
  2. Astrup, J., Siesjo, B. K., and Symon, L., 1981, Thresholds in cerebral ischemia—the ischemic penumbra, Stroke 12:723–725.PubMedCrossRefGoogle Scholar
  3. Basser, L. S., 1962, Hemiplegia of early onset and the faculty of speech with special reference to the effects of hemispherectomy, Brain 85:427–460.PubMedCrossRefGoogle Scholar
  4. Black, S. E., Garnett, E. S., Nicholson, R. L., Carr. T., Nahmias, C., and Kertesz, A., 1984, NMR and PET studies in a crossed dextral aphasie, Ann. Neurol. 16(1): 155.Google Scholar
  5. Bryden, M., and Allard, F., 1978, Dichotic listening and the development of linguistic processes, in: Asymmetrical Function of the Brain (M. Kinsboume, ed.), Cambridge University Press, Cambridge, pp. 392–404.Google Scholar
  6. Bucy, P. C. 1934, The relation of the premotor cortex to motor activity, J. Nerv. Ment. Dis. 79:621–630.CrossRefGoogle Scholar
  7. Burklund, C. W., and Smith, A., 1977, Language and the cerebral hemispheres, Neurology (Minneap.) 27:627–633.Google Scholar
  8. Cambier, J., Elghozi, D., Signoret, J. L., and Henin, D., 1983, Contribution of the right hemisphere to language in aphasic patients. Disappearance of this language after a right-sided lesion, Rev. Neurol. 139:55–63.PubMedGoogle Scholar
  9. Cummings, J. L., Benson, D. F., Walsh, M. J., and Levine, J. L., 1979, Left-to-right transfer of language dominance: A case study, Neurology (Minneap.) 29:1547–1550.Google Scholar
  10. Czopf, J., 1972, Role of the non-dominant hemisphere in the restitution of speech in aphasia, Arch. Psychiatr. Nervenkr. 216:162–171.PubMedCrossRefGoogle Scholar
  11. Dax, M., 1865, Lesions de la moitie gauche de l’encephale coincidant avec l’oubli des signes de la pensee (lu a Montpellier en 1836), Gaz. Hebd. Med. Chir. 2:259–262.Google Scholar
  12. Demeurisse, G., Verhas, M., Capon, A., and Paternot, J., 1983, Lack of evolution of the cerebral blood flow during clinical recovery of a stroke, Stroke 14:77–81.PubMedCrossRefGoogle Scholar
  13. Dennis, M., and Kohn, B., 1975, Comprehension of syntax in infantile hemiplegics after cerebral hemidecortication: Left hemisphere superiority, Brain Lang. 2:472–482.PubMedCrossRefGoogle Scholar
  14. Franz, S. I., and Oden, R., 1917, On cerebral motor control: The recovery from experimentally produced hemiplegia, Psychobiology 1:3–18.CrossRefGoogle Scholar
  15. French, L. A., Johnson, D. R., Brown, I. A., and van Berger, F. B., 1955, Cerebral hemispherectomy for control of intractable convulsive seizures, J. Neurosurg. 12:154–164.PubMedCrossRefGoogle Scholar
  16. Gardner, W. J., Karnosh, L. J., McClure, C. C., Jr., and Gardner, A. K., 1955, Residual function following hemispherectomy for tumour and for infantile hemiplegia, Brain 78:487–502.PubMedCrossRefGoogle Scholar
  17. Gazzaniga, M. S., and LeDoux, J., 1978, The Integrated Mind, Plenum Press, New York.Google Scholar
  18. Gazzaniga, M. S., and Sperry, R. W., 1967, Language after section of cerebral commissures, Brain 90:131–148.PubMedCrossRefGoogle Scholar
  19. Geschwind, N., 1974, Late changes in the nervous system: An overview in plasticity and recovery of function in the central nervous system, in: Plasticity and Recovery of Function in the Central Nervous System (D. Stein, J. Rosen, and N. Butters, eds.). Academic Press, New York, pp. 467–508.Google Scholar
  20. Geschwind, N., and Levitsky, W., 1968, Human brain, left-right asymmetries in temporal speech regions, Science 161:186–187.PubMedCrossRefGoogle Scholar
  21. Gloning, I., Gloning, K., Haub, G., and Quartember, R., 1969, Comparison of verbal behavior in right-handed and nonright-handed patients with anatomically verified lesion of one hemisphere, Cortex 5:43–52.PubMedGoogle Scholar
  22. Gloning, K., Trappl, R., Heiss, W. D., and Quartember, R., 1976, Prognosis and Speech Therapy in Aphasia in Neurolinguistics, Volume 4, Recovery in Aphasics, Swets & Zeitlinger, Amsterdam.Google Scholar
  23. Godfrey, C. M., and Douglass, E., 1959, The recovery process in aphasia, Can. Med. Assoc. J. 80:618–824.Google Scholar
  24. Gordon, H. W., 1980, Right hemisphere comprehension of verbs in patients with complete fore-brain commissurotomy. Use of the dichotic method and manual performance, Brain Lang. 11: 76–86.PubMedCrossRefGoogle Scholar
  25. Gott, P. S., 1973, Language after dominant hemispherectomy, J. Neurol. Neurosurg. Psychiatry 36:1082–1088.PubMedCrossRefGoogle Scholar
  26. Henschen, S. E., 1920–22, Klinische und anatomische Beitrage zur Pathologie des Gehirns, Volumes 5–7, Nordiska Bokhandel, Stockholm.Google Scholar
  27. Hillier, W. F., Jr., 1954, Total left cerebral hemispherectomy for malignant glioma, Neurology (Minneap.) 4:718–721.Google Scholar
  28. Jackson, J. H., 1873, On the anatomical and physiological localization of movements in the brain, Lancet 1:232–234.CrossRefGoogle Scholar
  29. Kertesz, A., 1979, Aphasia and Associated Disorders: Taxonomy, Localization and Recovery, Grune & Stratton, New York.Google Scholar
  30. Kertesz, A., 1982, The Western Aphasia Battery, Grune & Stratton, New York.Google Scholar
  31. Kertesz, A., 1988, What do we learn from recovery from aphasia?, in: Advances in Neurology, Vol. 47: Functional Recovery in Neurological Disease (S. G. Waxman, ed.) Raven Press, New York, pp. 277–292.Google Scholar
  32. Kertesz, A., and McCabe, P., 1977, Recovery patterns and prognosis in aphasia, Brain 100:1–18.PubMedCrossRefGoogle Scholar
  33. Kertesz, A., Harlock, W., and Coates, R., 1979, Computer tomographic localization, lesion size and prognosis in aphasia, Brain Lang. 8:34–50.PubMedCrossRefGoogle Scholar
  34. Kertesz, A., Black, S. E., Polk, M., and Howell, J., 1986, Cerebral asymmetries on magnetic resonance imaging, Cortex 22:117–127.PubMedGoogle Scholar
  35. Kinsbourne, M., 1971, The minor cerebral hemisphere as a source of aphasic speech, Arch. Neurol. 25:302–206.PubMedGoogle Scholar
  36. Kinsbourne, M., 1974, Mechanisms of hemispheric interaction in man, in: Hemispheric Disconnection and Cerebral Function (M. Kinsbourne and W. L. Smith, eds.), Charles C. Thomas, Springfield, IL., pp. 260–286.Google Scholar
  37. Knopman, D. S., Selnes, O. A., Niccum, N., and Rubens, A. B., 1983, A longitudinal study of speech fluency in aphasia: CT scan correlates of recovery and persistent nonfluency, Neurology (Minneap.) 33:1170–1178.Google Scholar
  38. Knopman, D. S., Rubens, A. B., Seines, O. A., Klassen, A. C., and Meyer, M. W., 1984, Mechanisms of recovery from aphasia: Evidence from serial xenon 133 cerebral blood flow studies, Ann. Neurol. 15(6):530–535.PubMedCrossRefGoogle Scholar
  39. Krashen, S., and Harshman, R., 1972, Lateralization and the critical period, UCLA Work. Papers Phonet. 22:6.Google Scholar
  40. Krynauw, R. A., 1950, Infantile hemiplegia treated by removing one cerebral hemisphere, J. Neurol. Neurosurg. Psychiatry 13:243–267.PubMedCrossRefGoogle Scholar
  41. Kuhl, D. E., Phelps, M. E., Kowell, A. P., Metter, E. J., Selin, C., and Winter, J., 1980, Effect ofstroke on local cerebral metabolism and perfusion: Mapping by emission computed tomography of 18FDG and 13NH3, Ann. Neurol. 8:47–60.PubMedCrossRefGoogle Scholar
  42. Landis, T., Cummings, J. L., and Benson, D. F., 1980, Passage of language dominance to the right hemisphere: Interpretation of delayed recovery after global aphasia, Rev. Med. Suisse Rom. 100:171–177.PubMedGoogle Scholar
  43. Lansdell, H., 1969, Verbal and nonverbal factors in right-hemisphere speech: Relation to early neurological history, J. Comp. Physiol Psychol. 69:734–738.PubMedCrossRefGoogle Scholar
  44. Lashley, K. S., 1938, Factors limiting recovery after central nervous lesions, J. Nerv. Mem. Dis. 88:733–755.CrossRefGoogle Scholar
  45. Lenneberg, E. H., 1967, Biological Foundations of Language, John Wiley & Sons, New York.Google Scholar
  46. Levine, D. M., and Mohr, J. P., 1979, Language after bilateral cerebral infarctions: Role of the minor hemisphere, Neurology (Minneap.) 29:927–938.Google Scholar
  47. Levy, J., and Trevarthen, C., 1976, Metacontrol of hemispheric function in human splitbrain patients, J. Exp. Psychol [Hum. Percept.] 2:299–312.CrossRefGoogle Scholar
  48. Lieberman, A. M., 1974, The specialization of the language hemisphere, in: The Neurosciences; Third Study Program (F. O. Schmitt and F. G. Worden, eds.), The MIT Press, Cambridge, pp. 43–56.Google Scholar
  49. Lomas, J., and Kertesz, A., 1978, Patterns of spontaneous recovery in aphasic groups: A study of adult stroke patients, Brain Lang. 5:388–401.PubMedCrossRefGoogle Scholar
  50. Ludlow, C. L., Rosenberg, J., Fair, C., Buck, D., Schesselman, S., and Salazar, A., 1986, Brain lesions associated with nonfluent aphasia fifteen years following penetrating head injury, Brain 109:55–80.PubMedCrossRefGoogle Scholar
  51. Martin, W. R. W., and Raichle, M. E., 1983, Cerebellar blood flow and metabolism in cerebral hemisphere infarction, Ann. Neurol. 14:168–176.PubMedCrossRefGoogle Scholar
  52. Mateer, C., 1983, Motor and perceptual functions of the left hemisphere and their interaction, in: Language Functions and Brain Organization (S. J. Segalowitz, ed.), Academic Press, New York, pp. 145–170.Google Scholar
  53. McGlone, J., 1980, Sex differences in human brain asymmetry: a critical survey, Behav. Brain Sci. 5:215–264.CrossRefGoogle Scholar
  54. Metter, E. J., Wasterlain, C. G., Kuhl, D. E., Hanson, W. R., and Phelps, M. E., 1981, FDG positron emission computed tomography in a study of aphasia, Ann. Neurol. 10:173–183.PubMedCrossRefGoogle Scholar
  55. Milner, B., Branch, C., and Rasmussen, T., 1964, Observations on cerebral dominance, in: Ciba Foundation Symposium on Disorders of Language (A. V. S. de Reuck and M. O’Connor, eds.), Little, Brown, Boston, pp. 200–214.Google Scholar
  56. Milner, B., Taylor, L., and Sperry, R., 1968, Lateralized suppression of dichotically presented digits after commissural section in man, Science 161:184–185.PubMedCrossRefGoogle Scholar
  57. Monakow, C., von, 1914, Die Lokalisation im Grosshirn und der Abbau der Funktionen durch corticale Herde, Bergmann, Wiesbaden.Google Scholar
  58. Moscovitch, M., 1981, Right hemisphere language, Top. Lang. Disord. 1(3):41–61.CrossRefGoogle Scholar
  59. Nagata, K., Yunoki, K., Kabe, S., Suzuki, A., and Araki, G., 1986, Regional cerebral blood flow correlates of aphasia outcome in cerebral hemorrhage and cerebral infarction. Stroke 17(3):417–423.PubMedCrossRefGoogle Scholar
  60. Nielsen, J. M., 1946, Agnosia, Apraxia, and Aphasia, Hoeber, New York.Google Scholar
  61. Perlstein, M. A., and Sugar, O., 1954, Hemispherectomies in infantile hemiplegia, Arch. Neurol. Psychiatry 72:256–257.Google Scholar
  62. Pieniadz, J. M., Naeser, M. A., Koff, E., and Levine, H. L., 1983, CT scan cerebral hemispheric asymmetry measurements in stroke cases with global aphasia: Atypical asymmetries associated with improved recovery, Cortex 19:371–391.PubMedGoogle Scholar
  63. Sands, E., Sarno, M. T., and Shankweiler, D., 1969, Long-term assessment of languge function in aphasia due to stroke, Arch. Phys. Med. Rehabil. 50:202–222.PubMedGoogle Scholar
  64. Sarno, M. T., Silverman, M., and Sands, E., 1970a, Speech therapy and language recovery in severe aphasia, J. Speech Hear. Res. 13:607–623.PubMedGoogle Scholar
  65. Sarno, M. T., Silverman, M., and Levita, E., 1970b, Psychosocial factors and recovery in geriatric patients with severe aphasia, J. Am. Geriatr. Soc. 18:405–409.PubMedGoogle Scholar
  66. Schuell, A., Jenkins, J. J., and Pabon, J., 1964, Aphasia in Adults, Harper & Row, New York.Google Scholar
  67. Selnes, O. A., Knopman, D. S., Niccum, N., and Rubens, A. B., 1983, CT scan correlates of auditory comprehension deficits in aphasia: A prospective recovery study, Ann. Neurol. 13:558–566.PubMedCrossRefGoogle Scholar
  68. Smith, A., 1966, Speech and other functions after left (dominant) hemispherectomy, J. Neurol. Neurosurg. Psychiatry 29:467–471.PubMedCrossRefGoogle Scholar
  69. Sparks, R., and Geschwind, N., 1968, Dichotic listening in man after section of neocortical commissures, Cortex 4:3–16.Google Scholar
  70. Sperry, R. W., and Gazzaniga, M. S., 1967, Language following surgical disconnection of the hemispheres, in: Brain Mechanisms Underlying Speech and Language (C. Millikan and F. Darley, eds.), Grune & Stratton, New York.Google Scholar
  71. Subirana, A., 1969, Handedness and cerebral dominance, in: Handbook of Clinical Neurology (P. J. Vinken and G. W. Bruyn, eds.), North Holland, Amsterdam.Google Scholar
  72. Tezner, D., Tzavaras, A., Gruner, J., and Hecaen, H., 1972, L’asymetrie droite-gauche du planum temporale: A propos de l’etude anatomique de 100 cerveaux, Rev. Neurol. 126:444–449.Google Scholar
  73. Wada, J., Clarke, R., and Hamm, A., 1975, Cerebral hemispheric asymmetry in humans, Arch. Neurol. 32:239–246.PubMedGoogle Scholar
  74. Wernicke, C., 1874, Der aphasische Symptomenkomlex, Cohn and Weigart, Breslau.Google Scholar
  75. Wernicke, C., 1886, Die neueren Arbeiten uber Aphasie, Fortschr. Med. 4:371–377.Google Scholar
  76. Witelson, S., and Pallie, W., 1973, Left hemispheric specialization for language in the human newborn: Neuroanatomical evidence of asymmetry. Brain 96:641–646.PubMedCrossRefGoogle Scholar
  77. Woods, B. T., and Teuber, H. L., 1978, Changing pattern of childhood aphasia, Ann. Neurol. 3:273–280.PubMedCrossRefGoogle Scholar
  78. Zaidel, E., 1976, Auditory vocabulary in the right hemisphere following brain bisection or hemidecortication, Cortex 12:191–211.PubMedGoogle Scholar
  79. Zaidel, E., 1978, Lexical organization in the right hemisphere, in: Cerebral Correlates of Conscious Experience (P. A. Buser and A. Rougeul-Buser, eds.), Elsevier-North-Holland, Amsterdam, pp. 177–197.Google Scholar

Copyright information

© Plenum Press, New York 1988

Authors and Affiliations

  • Andrew Kertesz
    • 1
  1. 1.Department of Clinical Neurosciences, Research Institute, St. Joseph’s HospitalUniversity of Western OntarioLondonCanada

Personalised recommendations