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An Analysis Based on (F-18)-Fluorodeoxyglucose, Positron Emission Tomography, and Computed Tomography

E. Jeffrey Metter, MD; Walter H. Riege, PhD; Wayne R. Hanson, PhD; Catherine A. Jackson, MA; Daniel Kempler, PhD; Diana van Lancker, PhD

Arch Neurol. 1988;45(11):1229-1234.

Abstract
• Subcortical structural damage that includes the anterior and posterior internal capsule, caudate, thalamus, lenticular nuclei, and insula has been shown to cause aphasias. A critical question that has not been resolved is whether the role of these structures on behavior is a direct one or whether it is indirect through the cortex. We have used pathway analysis to evaluate computed tomography, glucose metabolic, and language data from 47 aphasic patients to answer this question. For fluency (from the Western Aphasia Battery), subcortical structural damage had direct and indirect (through frontal lobe) effects on the behavior. For a comprehension task (sequential commands), subcortical damage had no direct effect and only a slight indirect effect through the temporal lobe. Thus, both direct and indirect effects of subcortical damage can be demonstrated for specific behavioral measures.

Author Affiliations
From the National Institute of Aging, Gerontology Research Center, Baltimore (Dr Metter); the Veterans Administration Medical Center, Sepulveda, Calif (Drs Riege, Hanson, Kempler, and van Lancker, and Ms Jackson); and the UCLA School of Medicine, Los Angeles (Drs Metter, Riege, and van Lancker).

Footnotes
Accepted for publication May 16, 1988.

Reprint requests to Gerontology Research Center, 4940 Eastern Ave, Baltimore, MD 21224 (Dr Metter).

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