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Subcortical aphasia

The core profile of capsulostriatal infarction

Braintree Hospital (Dr. Alexander), Braintree, MA; the Department of Neurology (Dr. Mega), UCLA School of Medicine, Los Angeles, CA; and the Department of Neurology (Dr. Alexander), Boston University School of Medicine, Boston, MA.

There has been disagreement about the precise characteristics of "subcortical aphasia." We evaluated 14 patients with aphasia after subcortical lesions and controlled for duration, general anatomic site of lesions (capsulostriatal only), and etiology. The clinical profiles of the patients were quite similar, varying in severity in rough proportion to lesion size and varying in quality in proportion to anterior paraventricular extent. Large lesions were associated with impaired "executive" and "generative" language functions. Similar aphasia profiles in patients with deep frontal and paraventricular white matter lesions suggest that damage to a frontal-caudate functional system underlies a "core" aphasia profile in these patients.

Address correspondence and reprint requests to Dr. Michael P. Alexander, Braintree Hospital, 250 Pond Street, Braintree, MA 02185-9020.

Presented in part at the 45th annual meeting of the American Academy of Neurology, New York, NY, April 1993.

Supported in part by grant DC 00081 to the Aphasia Research Center of Boston University.

Received December 27, 1993. Accepted in final form April 13, 1994.

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