THE ROLE OF THE LEFT AND RIGHT THALAMUS IN LANGUAGE ASYMMETRY - DICHOTIC-LISTENING IN PARKINSON PATIENTS UNDERGOING STEREOTAXIC THALAMOTOMY

Fourteen patients with Parkinson's disease (rigidity and unilateral tremor as main symptoms) were treated with stereotactic thalamotomy. The operation was performed in either the left or right ventrolateral thalamus, depending on which hand (or foot) was most affected with tremor. Nine patients were operated on the left side and four on the right side. All patients were tested for asymmetry of language functioning with dichotic presentations of consonant-vowel (CV) syllables. The patients had to indicate which of the two syllables he/she heard on each trial. Dichotic listening was performed before and after the operation, as well as during electrical stimulation of the VL nucleus just before the lesion was carried out. The results revealed essentially three things: an overall reduced right ear advantage (REA) in the patient group compared to what is known from studies of healthy individuals; an increase in REA during left-sided stimulations; and a marked reduction in REA after left-sided lesions. It is concluded that the present data support the notion put forward by Ojemann (e.g., 1975) of a lateralized activating gating mechanism in the left VL nucleus that gates access for language information to the appropriate cortical areas. The gating mechanism seems to be activated by stimulation, and deactivated after lesions. Dichotic listening may thus be a heuristic instrument in assessment of language functions in Parkinson patients. © 1990.