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Language Pathways Defined in a Patient with Left Temporal Lobe Damage

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Language Pathways Defined in a Patient with Left Temporal Lobe Damage Brigham Young University BYU ScholarsArchive Theses and Dissertations 2014-12-01 Language Pathways Defined in a atientP with Left Temporal Lobe DamageSecondary to Traumatic Brain Injury: A QEEG & MRI Study Janelle Lee Bailey Brigham Young University - Provo Follow this and additional works at: https://scholarsarchive.byu.edu/etd Part of the Communication Sciences and Disorders Commons BYU ScholarsArchive Citation Bailey, Janelle Lee, "Language Pathways Defined in a atientP with Left Temporal Lobe DamageSecondary to Traumatic Brain Injury: A QEEG & MRI Study" (2014). Theses and Dissertations. 4363. https://scholarsarchive.byu.edu/etd/4363 This Thesis is brought to you for free and open access by BYU ScholarsArchive. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of BYU ScholarsArchive. For more information, please contact [email protected], [email protected]. Language Pathways Defined in a Patient with Left Temporal Lobe Damage Secondary to Traumatic Brain Injury: A QEEG & MRI Study Janelle Lee Bailey A thesis submitted to the faculty of Brigham Young University in partial fulfillment of the requirements for the degree of Master of Science David L. McPherson, Chair Erin Bigler Christopher Dromey Richard W. Harris Department of Communication Disorders Brigham Young University December 2014 Copyright © 2014 Janelle Lee Bailey All Rights Reserved ABSTRACT Language Pathways Defined in a Patient with Left Temporal Lobe Damage Secondary to Traumatic Brain Injury: A QEEG and MRI Study Janelle Lee Bailey Department of Communication Disorders, BYU Master of Science Though the current understanding of language processing is incomplete, it has been established that the left hemisphere is dominant for language in the majority of the population. Damage to language centers of the brain and to white matter tracts connecting these language centers results in a language deficit known as aphasia. Neuroplasticity in the brain can often compensate for these language deficits by strengthening neuronal connections between the right and left hemisphere, or by enhancing the neuronal connectivity of undamaged areas in the left hemisphere. Thus the brain can compensate for damaged language centers by using alternative cortical areas. These compensatory language areas may be homologous areas of the right hemisphere, or other undamaged portions of the left hemisphere. Various imaging techniques have been used to demonstrate this phenomenon. The current neuroimaging technique known as quantitative electroencephalographic brain imaging allows investigators to evaluate the functional anatomical location of language processing. When this mapping is overlaid on a magnetic resonance image, investigators are able to locate areas in the brain of the participant that are electrically activated during elicited speech tasks. This method was used in a single case study to examine the brain of an individual with a unique traumatic brain injury in which the anterior portion of the individual’s left temporal lobe was surgically removed and considerable recovery of language subsequently occurred. The stimulus for the quantitative electroencephalography included identifying syntactically incorrect sentences. Imaging results from the participant with traumatic brain injury were compared to imaging results obtained from an age-matched control. Differences in quantitative electroencephalography between the two participants included a delayed P1-N1-P2 response and an absent P600 in the participant with traumatic brain injury. Behavioral results include an increased number of incorrect responses from the participant with traumatic brain injury as compared to the control participant. These results imply an interesting cortical distribution of language processing that could be further assessed by functional magnetic resonance imaging. Keywords: Boston Diagnostic Aphasia Examination, language processing, language recovery, left temporal lobe craniotomy, MRI, QEEG, TBI, Wernicke’s aphasia. ACKNOWLEDGEMENTS I would like to thank my thesis committee for their guidance in making the completion of this thesis a learning opportunity. Over the course of this project I have developed a greater enthusiasm for research and its contribution to improved quality of life for individuals who have experienced some of life’s greatest and frustrating traumas. In particular, I would like to thank Dr. David McPherson for his effort and hard work in data collection and analysis, as well as the review of many thesis drafts. I also thank Dr. Erin Bigler for sharing his passion for neuro research by introducing me to participant TB, and thus connecting me with a fascinating and unique case to study. Besides being an compelling research participant, TB is a person who has overcome almost impossible odds and recognizes the miracles that have occurred in his life; I thank him and am grateful for his willingness to share his story and participate in various research projects, including my own. I would like to thank my uncle, Phillip Wilson, for his support during this endeavor. My parents, Richard and Sandra Bailey, have always been my top supporters. I thank them for their examples, their commitment to higher education, and their encouragement to achieve success both in academics and, more importantly, in the quest to become a better person. iv TABLE OF CONTENTS LIST OF TABLES ................................................................................................................... vi LIST OF FIGURES ................................................................................................................ vii LIST OF APPENDICES ........................................................................................................ viii DESCRIPTION OF STRUCTURE AND CONTENT ............................................................ ix Introduction ............................................................................................................................... 1 Language and Aphasia .................................................................................................... 1 Wernicke’s aphasia .............................................................................................. 5 Neuroplasticity. .................................................................................................... 5 Neuroimaging and Patterns of Activation ....................................................................... 7 Diffusion tensor imaging. .................................................................................... 7 Functional magnetic resonance imaging .............................................................. 8 Quantitative electroencephalography................................................................... 9 Method .................................................................................................................................... 13 Participants .................................................................................................................... 13 Participant with Traumatic Brain Injury. ........................................................... 13 Age-matched control subject ............................................................................. 22 Hearing testing. .................................................................................................. 22 Quantitative Electroencephalography Testing .............................................................. 22 Stimulus preparation .......................................................................................... 22 Instrumentation for hearing screening ............................................................... 23 v Quantitative electroencephalography data collection. ....................................... 23 Stimuli. ............................................................................................................... 24 Data Analysis ................................................................................................................ 25 Results ..................................................................................................................................... 25 Language Testing .......................................................................................................... 25 Quantitative Electroencephalography Testing .............................................................. 28 Behavioral Testing ........................................................................................................ 31 Discussion ............................................................................................................................... 32 Language Recovery and Handedness ........................................................................... 32 Behavioral Results ........................................................................................................ 33 P1-N1-P2....................................................................................................................... 34 P600 .............................................................................................................................. 35 Limitations and Further Research ................................................................................. 35 References ............................................................................................................................... 38 vi LIST OF TABLES
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