Tuesday, April 03, 2007

Comprehending with Your Whole Brain

Just had to share this picture from a recent Mason and Just review looking at Neuroimaging's contributions to our understanding of discourse processing. This is a long way from our neurology clerkship teaching of the Wernicke's area (one of the little green spots on the left side) for language comprehension.

When we have a rich comprehension of a story, we don't just understand the words, we picture the imagery, we put ourselves into a story, we contextualize it, we empathize, and question what doesn't make sense. It makes perfect sense that comprehension is a whole brain activity, it's just that before functional imaging, there wasn't an easy way to show this.

This paper also reminds me of how crude our understanding of brain is with a "pathological" bias of brain function (deduce brain function by studying the results of profound damage). If we only notice the all-or-none qualities of brain function (our patients comprehend or don't), then we will be making errors on both side, missing subtle changes for the worse, and not admiring differences for the better.

I hope that this more nuanced view of brain differences will percolate into the day-to-day world of clinicians and behavioralists, but everyone should best beware - many medical student syllabi for Neurology may still only make scant mention of Language Comprehension, and the old news - that Wernicke's is where language comprehension resides- might be the only information young doctors-to-be might learn.

In this 201 page syllabus from Stanford's Neurology Core Clerkship, language comprehension mentioned only once (on page 114), and you might have guessed it, in association with Wernicke's area.

Neuroimaging and Discourse

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