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John Hart, Jr, MD; Ronald P. Lesser, MD; Robert S. Fisher, MD, PhD; Pamela Schwerdt; R. Nicholas Bryan, MD, PhD; Barry Gordon, MD, PhD

Arch Neurol. 1991;48(1):55-58.

Abstract
• Abolition of speech production after intracarotid amobarbital injection is generally considered evidence for language laterality. However, complex auditory comprehension may be preserved after injection of the dominant (left) side. The possibility that this sparing may be due to the intracarotid amobarbital injection not adequately deactivating some of the areas responsible for speech comprehension in the posterior part of the hemisphere was tested with a task known to be critically dependent on the left posterotemporal-in-feroparietal region, one assessing visuoverbal semantic relatedness. Even when the intracarotid injection of the left side produced marked deficits of speech production, comprehension of semantic relations was still intact in eight of 15 patients. Ten of these 15 patients also received right carotid injections, none of which affected comprehension of semantic relatedness. These data indicate that the intracarotid amobarbital injection cannot always specify the laterality of all language functions, an important concern when considering surgical procedures in the dominant posterotemporal-inferoparietal region.

Author Affiliations
From the Departments of Neurology (Drs Hart, Lesser, Fisher, and Gordon and Ms Schwerdt), Neurosurgery (Drs Lesser and Fisher), Neuroradiology (Dr Bryan), and Psychology (Dr Gordon), The Johns Hopkins University and School of Medicine, Baltimore, Md.

Footnotes
Accepted for publication April 6, 1990.

Presented, in part, at the 113th annual meeting of the American Neurological Association, Philadelphia, Pa, October 3,1988.

Reprint requests to Cognitive Neurology Division, Department of Neurology, Meyer 222, The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21205 (Dr Hart).

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