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Neuroanatomía y fisiología del lenguaje — Transcript

by Sinapsis EMP · 2,174 words · 333 segments · language en · Watch on YouTube

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0:00Language is one of the most important
0:02characteristics that separates us from
0:03the rest of the animal species on the
0:05planet. Of course, this is one of our
0:08greatest abilities because it allows us
0:10to communicate and organize ourselves
0:12with many other people. And essentially
0:15, current civilization depends on our
0:17ability to communicate and the language
0:19we can develop. If we were to analyze
0:23specifically where it originates in the
0:25brain, we would see that, first of all,
0:28in most people, the brain structures in
0:30charge of language are in the dominant
0:32cerebral hemisphere. For most of us who
0:35are right-handed, it will be in the
0:37left cerebral hemisphere, that is,
0:39contralateral. However, we will find
0:43that left-handed people usually have
0:45these structures in the right cerebral
0:47hemisphere. There is a small
0:49subpopulation of people in whom it is
0:51on the same side—that is, if they are
0:53left-handed, it is on the left side,
0:54and if they are right-handed, it is on
0:56the right side. However, in the vast
0:58majority of people, it will be the
1:00contralateral cerebral hemisphere and
1:02the non-dominant hemisphere, that is,
1:05the right hemisphere for right-handed
1:07people and the left hemisphere for
1:09left-handed people. Usually, this is
1:11what provides that person with the
1:14ability to understand the emotional
1:16part of language and, of course, also
1:18to express this language in a more
1:20emotional way. Now, the structures we
1:23are about to see will have close
1:24contact with other parts of the brain.
1:27Of course, for example, the hippocampus
1:29is evidently going to be intimately
1:31related to memory and the ability to
1:33recall. So, of course, it will be
1:36connected to the hippocampus. And as we
1:38discussed, language usually has an
1:40emotional connotation, so it will be
1:42connected to different structures of
1:44the limbic system that we have already
1:46seen in other videos. And although what
1:50we are going to show here is true,
1:52nowadays there are even more complex
1:54models. This is a simplification of how
1:57language functions in the brain, which
1:59involves an entire ventral pathway and
2:01a dorsal pathway that include other
2:03different areas. But the traditional
2:05and simplest explanation is that, of
2:08course, in the motor part of the brain,
2:10there will be a structure in charge of
2:13all the motor aspects of language,
2:15which is, of course, Broca's area. So,
2:19if we want to move the tongue, mouth,
2:21jaw, glottis, etc., it will be Broca's
2:24area that plans the movements that will
2:26be carried out later. On the other hand
2:31, we have, in the temporal lobe, where
2:34we know all auditory information
2:36arrives; so, very close to the primary
2:39auditory cortex, we will find
2:41Wernicke's area, which is essentially
2:44an association area; that is, it allows
2:47the sounds reaching our brain to be
2:49given meaning, or to understand the
2:52meaning of what is being said to us.
2:57Although Wernicke's area is located in
2:59the auditory region, we will see a bit
3:01later that it can also integrate other
3:03types of communication so that they can
3:06be understood later on. And obviously,
3:09these two areas, Wernicke's area and
3:11Broca's area, must be super-connected
3:13because I have to hear what is said to
3:16me, interpret it, of course, and then
3:18generate a motor response in this case.
3:21So, I hear someone speaking to me, they
3:23say, "Hello," my Wernicke's area says,
3:25"Hey, they're greeting you, send the
3:27signal to Broca's area." And Broca's
3:29area makes all the movements so that I
3:31can also say hello. Furthermore, when I
3:34say hello, Wernicke's area can also
3:36hear it and say, "Okay, I said it right
3:38, it's perfect." Or, "You know what?
3:40you messed up because you were very
3:41nervous, because the person intimidates
3:43you or you like them and you said, 'Ol,
3:45' so correct it because you didn't say
3:47it right.""So, Wernicke's area doesn't
3:50just interpret other people's language,
3:52but it also interprets or perceives how
3:54I am producing my own language and
3:56allows me to correct it. This
3:59connection we have between Wernicke's
4:01area and Broca's area is the arcuate
4:02fasciculus. And so you can see that it
4:05basically arches around the lateral
4:08fissure, or also the Sylvian fissure or
4:10Sylvian sulcus, and it goes around it
4:13to communicate directly with Broca's
4:15area. And you can notice here, right
4:19next to this arcuate fasciculus,
4:20something called the angular gyrus,
4:22which we will talk about in a moment,
4:24but which essentially allows more
4:25flexibility to this system regarding
4:27the modalities it understands or
4:29integrates into our language
4:30comprehension. So, here we have our
4:33brain once again. Around here would be
4:35Wernicke's area, around here would be
4:37Broca's area, and here would be the
4:38arcuate fasciculus. Just as we
4:40mentioned, going around this lateral
4:42fissure or sulcus. And so when someone
4:46speaks to us, Wernicke's area, which is
4:49Brodmann area 22—it usually
4:51corresponds to that—allows us to hear
4:53and understand that auditory
4:55information, in this case, for starters
4:57, that we are perceiving. Once we
5:01perceive it, we communicate through the
5:04arcuate fasciculus with Broca's area,
5:06which is usually Brodmann area 44 and
5:0945, which allows us to produce the
5:11sounds, of course, that we need to give
5:14to respond, or in addition to sounds,
5:16other types of movements to respond to
5:19what we are hearing or what we are
5:21perceiving. In other words, this
5:24Broca's area 44/45, which is, uh, 44/45
5:27again, is the Brodmann area. It can
5:30communicate with the primary motor
5:32cortices, again, so that I move my
5:34mouth, tongue, diaphragm, etc., and I
5:36speak. Or it could also send motor
5:39information to the hand so that I could
5:41write what it is that I now want to be
5:43answering to the person who is speaking
5:45to me. And just as I can, through
5:49Broca's area and the other areas of the
5:51motor cortex, write, speak, and so on,
5:54of course, I will also be able to read.
5:58And evidently, the visual information
6:00will reach the occipital cortex, and
6:02usually the Brodmann 17, 18, and 19
6:03cortices, or Brodmann areas 17, 18, and
6:0619. This allows me to read, to
6:09interpret, to have all these visual
6:11stimuli. And this will be sent to the
6:14gyrus we were just discussing, which is
6:16the angular gyrus. to this Wernicke's
6:19area so that what I am reading is
6:21understood and can, again, trigger an
6:23appropriate motor response to what I am
6:26reading. For example, if I were reading
6:29aloud, the visual information reaches
6:31the occipital cortex; from there, it is
6:33sent through the angular gyrus to
6:34Wernicke's area, what I am reading is
6:36interpreted, and from Wernicke's, it is
6:38sent via the arcuate fasciculus to
6:39Broca's area, and Broca's area makes me
6:41read aloud. Again, this is a simplified
6:46model; there are many more components
6:48and often more interactions, but this
6:50is the simplified version of how our
6:52language works. And this leads us, of
6:56course, to, uh, when we have a lesion
6:58in these areas, we will have a process
7:00known as aphasia. And this aphasia,
7:04which is an alteration in language, can
7:06be from any of the structures we have
7:08involved in language. So, when I have,
7:11for example, a cerebral infarction in
7:13the left hemisphere, in Broca's area,
7:15that is to say, this area here will
7:17disappear. What will happen when I, uh,
7:21hear something? Of course, I will
7:23understand it well. So, I can
7:25comprehend language because the
7:27comprehension area is intact. I can
7:29send what response I want to give.
7:31However, the part in charge of giving
7:33the response is not working. So, I
7:36cannot produce language. I will have
7:39non-fluent speech. The words hardly
7:41come out of me. It is very hard for me
7:43to make the movements, whether written,
7:45spoken, or otherwise, to answer. This
7:48patient, of course, does not repeat.
7:50That is, if I tell him to say" dog, "he
7:52understands that I want him to say" dog
7:54, "but he is not able to say" dog. "
7:56This, uh, is again Broca's aphasia, or
7:58also motor aphasia or expressive
8:01aphasia. This patient cannot read out
8:03loud. That is, if I tell him, read this
8:07text and these words, he can understand
8:09the words, but again he cannot emit the
8:11words or generate the words he is
8:13reading, and he cannot write, he cannot
8:15generate the movement to be able to
8:17write what he would like. Meaning, all
8:20other processes, as you can see, are
8:23preserved in a patient who has Broca's
8:25aphasia, or motor aphasia, or
8:26expressive aphasia. Number two,
8:29Wernicke's aphasia. That is, now this
8:32area here, right in the temporal lobe,
8:35an auditory association area, will be
8:37damaged. What happens here? When I
8:40speak to that patient, that patient
8:42does not comprehend language, that is,
8:44he is not understanding what I am
8:45saying to him because there is no part
8:47of the brain that interprets the words
8:49and sounds that person hears. Of course
8:52, he does not repeat. That is, if I
8:54tell him to say" dog, "he is not even
8:56understanding the instruction to say"
8:57dog. "He cannot repeat, he cannot read,
8:59and he cannot write. And here, he
9:02cannot even understand what he is
9:04reading or writing, because the part
9:06that gave meaning to language is not
9:08working. Now, the patient can produce
9:11language. Often, these patients talk
9:13and talk and talk; they have fluent
9:14speech. However, this language is
9:17incorrect, a thing known as paralalia,
9:20that is, he will be throwing words out
9:22as if into the air; it means nothing or
9:25has almost no meaning. But the patient
9:28cannot hear what they are saying or
9:30interpret it; although the sound, of
9:32course, reaches their ear and brain,
9:34they do not understand what they are
9:36saying themselves, so the words coming
9:38from the patient lack meaning once
9:40again. So they have paraphasia in this
9:43Wernicke's aphasia, or sensory aphasia,
9:46again because the part of the brain
9:48that gives meaning to language when the
9:50patient hears it is exactly what is
9:52impaired. We can also have conduction
9:57aphasia; that is, Wernicke's area is
9:59fine, Broca's area is fine, but the
10:01problem is what connects one to the
10:03other, which is, of course, the arcuate
10:05fasciculus. So, when we have
10:08destruction of the arcuate fasciculus,
10:10the patient, of course, understands
10:11language. If I speak to them, they know
10:14that, uh, I am Dr. Marco, that I am
10:16going to examine them, or whatever else
10:18. The patient can produce language, and
10:23again, all the language they need is
10:24coming out of their mouth and motor
10:26areas. The big problem is that, once
10:29again, they have paraphasia because the
10:31language they produce cannot be
10:33communicated from Wernicke's to Broca's
10:36. That is to say, even though they can
10:38understand what they are saying, they
10:40cannot establish or have a relationship
10:42between what they hear themselves
10:44saying and what they are actually
10:45saying. Of course, it is also a patient
10:49who cannot repeat; no matter how much
10:51they understand what I say, the signal
10:53of what I am saying is not reaching the
10:55part that must generate the sound. The
10:58patient cannot read aloud and cannot
11:01write because, once again, they do not
11:03understand what they are emitting or
11:05what they are saying. Finally, we have
11:10global aphasia, which is, of course, a
11:12much larger lesion that can encompass
11:13—or must encompass—the frontal and
11:15temporal areas, as well as where the
11:17arcuate fasciculus passes. And here we
11:20have a destruction of all the
11:22structures: Wernicke's area, the
11:23arcuate fasciculus, and Broca's area.
11:26And this is a patient, of course, who
11:27cannot do anything. They cannot produce
11:30language, they do not understand
11:31language, they cannot repeat, read, or
11:33write. It is, of course, the most
11:36complete aphasia, in the sense that
11:38more brain structures are lost, leaving
11:41the patient even more isolated. Uh,
11:44again, this is a version that is quite,
11:46quite simplified, but it allows us to
11:48begin understanding how language
11:50operates within our brain and, of
11:52course, from here to study it in much
11:54greater depth, using in part the
11:56references I leave here for you to
11:58study in more detail. And of course, I
12:00also want to dedicate this video to
12:02some of the channel members who support
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12:05two dollars to make these types of
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12:09members can watch the videos early
12:11without commercials and can decide what
12:13topics we will cover on the channel. So
12:16, this video in particular was
12:18dedicated to Carlos Prince, Ferdinand
12:20Fernández, Yami Pasco, Olga Hernández
12:22, Gelacio García, Dora Milí, Laura
12:25Elena Barojas, Alex Cas, Bonnie Araf,
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12:34Cindia Magaña Bobadilla, Luis Ernesto
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12:38, Grevy Núñez and María Isabel.
12:40Thank you very much for the support you
12:42provide us each month. With this we are
12:44now finished and as always, help us
12:45change the world.

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