Language: neuroanatomical and

neurophysiological bases
CLAUDIO ALEXANDER RIVAS PALACIOS
Postgraduate Student Third Year
Specialization in Neurosurgery
Faculty of Medicine
University of Cartagena
2021

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Thematic development
• Overview
• Neuroanatomical structures
• Physiological language connections
• Clinical relevance

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 Higher brain functions

Orientation Attention Praxia

Gnosia Memory Language

1. Fustinoni O. Semiología del sistema nervioso, 15a ed., 1a reimp. Cap 14: Palabra y funciones cerebrales superiores: lenguaje, praxia, gnosia, memoria. Pág
335-352. Ciudad Autónoma de Buenos Aires. Editorial El Ateneo, 2016. 3
 Concepts
Language:
• Spoken language:
Complex neuropsychological • Respiration
function, of a cortical order. It is • Phonation
the means that man has to • Resonance
express himself through symbols, • Prosody
which can be spoken, written or • Articulation
mimic (gestures)
Word production:
Word: • Semantics
Is the motor expression of spoken • Lexicon
language. • Grammar
1. Fustinoni O. Semiología del sistema nervioso, 15a ed., 1a reimp. Cap 14: Palabra y funciones cerebrales superiores: lenguaje, praxia, gnosia, memoria. Pág
335-352. Ciudad Autónoma de Buenos Aires. Editorial El Ateneo, 2016. 4
 Concepts
Semantics: Grammar:
The meaning of words and The set of rules and principles that
expressions, that is, what words governs a language. Is the art of
mean when we speak or write. speaking and writing a language
• Denotative correctly.
• Connotative Grammar is divided into three
parts:
Lexicon:
• Morphology
Set of words that make up a language
is called. • Syntax
• Mental lexicon • Phonetics and phonology
1. Fustinoni O. Semiología del sistema nervioso, 15a ed., 1a reimp. Cap 14: Palabra y funciones cerebrales superiores: lenguaje, praxia, gnosia, memoria. Pág
335-352. Ciudad Autónoma de Buenos Aires. Editorial El Ateneo, 2016. 5
 Mechanism of language
The person who speaks: The person who listens:
1) Have an idea (stage of 1) hear the words
abstraction) articulated by the
2) Remembering, interlocutor (sensory
recognizing and selecting stage)
the appropriate words for 2) identify them with the
the idea to be expressed idea they express
(mnesicosymbolic stage) (mnesicosymbolic stage)
3) articulate words (motor 3) understand its meaning
stage). (stage of abstraction).

1. Fustinoni O. Semiología del sistema nervioso, 15a ed., 1a reimp. Cap 14: Palabra y funciones cerebrales superiores: lenguaje, praxia, gnosia, memoria. Pág
335-352. Ciudad Autónoma de Buenos Aires. Editorial El Ateneo, 2016. 6
 Language models
Classical model Dual stream model

2. Chang EF, Raygor KP, and Berger MS. Contemporary model of language organization: an overview for neurosurgeons. J Neurosurg (2014). 132647 7
 Hemispheric “dominance of
language”
Hemispheric asymmetries ³⁻⁶ • Forkhead box P2 gene
(FOXP2) ³⁻⁵
Complementary specialization of both structures ⁶: • KIAA0319/TTRAP/THEM2
• Categorical hemisphere: in charge of serial-analytical locus ⁵
processes
• NMDA
• Representational hemisphere: dedicated to visuospatial receptor 2B subunit
relations
gene (GRIN2B) ⁵
• Cholecystokinin A receptor
gene (CCKAR) ⁵
• The Proteolipid Protein 1
gene (PLP1) ⁵
3. Duboc V, Dufourcq P, Blader P and Roussigné M. Asymmetry of the brain: development and implications. Annu. Rev. Genet. 2015. 49:647–72.
4. Güntürkün O, Ströckens F, Ocklenburg S. Brain Lateralization: A Comparative Perspective. Physiol Rev 100: 1019–1063, 2020.
5. Schmitz J, Güntürkün O and Ocklenburg S. Building an asymmetrical brain: the molecular perspective. Front. Psychol. (2019) 10:982. 8
6. Cai Q, Van der Haegen L et al. Complementary hemispheric specialization for language production and visuospatial attention. Proc Natl Acad Sci. 2013;110 (4)
 Brain language areas
• The frontal language area
• Broca´s area
• Broca’s complex
• Basal nucleus
 Language production and
grammar
• The posterior language area
• Wernicke’s area
• “Extended Wernicke’s area”
 Language reception and
understanding
7. Gagliardi F. Operative Cranial Neurosurgical Anatomy. 1th edition 2019. Chap 3, anatomical landmarks and cranial anthropometry. Pag 13-18
8. Friederici AD. The brain basis of language processing: from structure to function. Physiol Rev 91: 1357–1392, 2011 9
 • Language reception and
Understanding (Lexical-semantic
system): BA22, BA21, BA41, BA42,
BA20, BA37, BA38, BA39, and
BA40
• Language production
(Grammatical system): BA44,
BA45, BA46, BA47, BA6 and basal
nucleus
• The Insula as a language
coordinating system: BA13
9. Archives of Clinical Neuropsychology, Volume 31, Issue 1 (2016), pag. 112–122. 10
 • Anterior language area (ALA):
pars opercularis, pars
triangularis.
• Posterior language area (PLA):
posterior part of the superior
temporal gyrus, angular gyrus.
• Basal temporal language area
(BTLA): parahippocampal
gyrus (PHG), fusiform gyrus
(FG), inferior temporal gyrus
(ITG).

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10. Front. Hum. Neurosci. (2021) 15:619521.
 Visual system and language
• BA 18-19 Dorsolateral 
¿Where, how?
• BA 18-19 Ventral  ¿What?

Conditioner of language
processing and expression
Mime language
Written langauge

11. Bonner MF & Epstein RA. Object representations in the human brain reflect the co-occurrence statistics of vision and language. Nature
comunications. (2021) 12:4081 12
 Structural connections between the
language cortices

• Subcortical structures
• White matter: fascicles

2. Chang EF, Raygor KP, and Berger MS. Contemporary model of language organization: an overview for neurosurgeons. J Neurosurg (2014). 132647
8. Friederici AD. The brain basis of language processing: from structure to function. Physiol Rev 91: 1357–1392, 2011.
12. Dick AS, Bernal B and Tremblay P. The language connectome: new pathways, new concepts. The Neuroscientist 2014, Vol. 20(5) 453–467. 13
13. Rhoton AL Jr. The white matter tracts of the cerebrum in ventricular surgery and hydrocephalus. J Neurosurg 126:945–971, 2017
 Basal nucleus in language

• Producing language 
Selection and temporal
ordering of speech
movements
• Sentence Construction:
grammar

12. Dick AS, Bernal B and Tremblay P. The language connectome: new pathways, new concepts. The Neuroscientist 2014, Vol. 20(5) 453–467.
14. Papito G, Friederici AD and Zaccarella E. NeuroImage 206 (2020) 116321 14
15. Silveri MC. Contribution of the cerebellum and the basal ganglia to language production. The Cerebellum (2021) 20:282–294.
 Corticostriatal regulation of
language functions

16. Copland DA, Brownsett S, Iyer K and Angwin AJ. Neuropsychology Review (2021) 31:472–494. 15
 Cerebellum in language
Control of motor 
automatization and
optimization of speech
• Prosody: the melody of
speech
• Verbal fluency
• Sentence Construction:
grammar

12. Dick AS, Bernal B and Tremblay P. The language connectome: new pathways, new concepts. The Neuroscientist 2014, Vol. 20(5) 453–467.
15. Silveri MC. Contribution of the cerebellum and the basal ganglia to language production. The Cerebellum (2021) 20:282–294. 16
17. D´Mello AM, Centanni TM, Gabrieli JDE and Christodoulou JA. Brain and Language 208 (2020) 104828.
 Descending pathways: anatomy
and function
• M1: area controlling the
face and larynx
• PMCV y SMA
• Chewing muscles and
proprioception
• Facial expressions
• Innervation of laryngeal and
supralaryngeal muscles
• Innervation of tongue

8. Friederici AD. The brain basis of language processing: from structure to function. Physiol Rev 91: 1357–1392, 2011
12. Dick AS, Bernal B and Tremblay P. The language connectome: new pathways, new concepts. The Neuroscientist 2014, Vol. 20(5) 453–467. 17
 Process specific neural netwoks
• Acoustic-phonological analysis • Integration and interpretation
• Initial syntactic processes • Prosodic processes
• Computation of semantic and • Interaction of syntax and
syntactic relations: prosody:
• Processing semantic and verb- • Prosody-syntax interaction during
argument relations phrase structure building
• Processing grammatical relations • Prosody-syntax interaction during
verb argument structure
assignment

8. Friederici AD. The brain basis of language processing: from structure to function. Physiol Rev 91: 1357–1392, 2011
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 Language comprehension

8. Friederici AD. The brain basis of language processing: from structure to function. Physiol Rev 91: 1357–1392, 2011 19
 Language processing

18. Matchin WG. A neuronal retuning hypothesis of sentence-specificity in Broca’s area. Psychon Bull Rev (2018) 25:1682–1694 20
 Clinical relevance
• Aphasia is a selective impairment of language or the cognitive
processes that underlie language.
• Dysarthria is an acquired disorder of speech production due to
weakness, slowness, reduced range of movement, or impaired timing
and coordination of the muscles of the jaw, lips, tongue, palate, vocal
folds, and/or respiratory muscles (the speech articulators).
• Apraxia of speech is an impairment in the motor planning and
programming of the speech articulators that cannot be attributed to
dysarthria.

1. Fustinoni O. Semiología del sistema nervioso, 15a ed., 1a reimp. Cap 14: Palabra y funciones cerebrales superiores: lenguaje, praxia, gnosia, memoria. Pág
335-352. Ciudad Autónoma de Buenos Aires. Editorial El Ateneo, 2016. 21
 Aphasia syndromes

1. Fustinoni O. Semiología del sistema nervioso, 15a ed., 1a reimp. Cap 14: Palabra y funciones cerebrales superiores: lenguaje, praxia, gnosia, memoria. Pág
335-352. Ciudad Autónoma de Buenos Aires. Editorial El Ateneo, 2016. 22
 Dysarthria
• Hypertonic dysarthria • Bradykinized or hypokinetic
• Hypotonic dysarthria dysarthria
• Ataxic dysarthria • Hyperkinetic dysarthria

1. Fustinoni O. Semiología del sistema nervioso, 15a ed., 1a reimp. Cap 14: Palabra y funciones cerebrales superiores: lenguaje, praxia, gnosia, memoria. Pág
335-352. Ciudad Autónoma de Buenos Aires. Editorial El Ateneo, 2016. 23
Historical perspective of the brain-
language relationship
• From the Middle Ages to the • Hierarchical model: John
18th century Hughlings Jackson
• Phrenology: Franz Joseph Gall • Global models: Pierre Marie, Karl
and Jean-Baptiste Bouillaud Lashley and Kurt Goldstein
• Localizationism: Pierre Paul • Linguistic perspective of aphasia:
Broca Roman Jakobson
• Connectionism: Carl Wernicke • Process model: Alexander
Romanovich Luria
• Classical connectionist model:
Ludwig Lichtheim • Current scenario:
Neurolinguistics/fIRM?
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"Beautiful is what we see. More
beautiful is what we know. But
much more beautiful is what we do
not know"
Niels Steensen

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