Broca and Wernicke are dead, or moving past the classic model of language neurobiology

Is your doctor still using this dead terminology?
http://www.ncbi.nlm.nih.gov/pubmed/27584714

Tremblay P¹, Dick AS².

Author information

• ¹Département de Réadaptation, Faculté de Médecine, Université Laval, Québec City, QC, Canada; Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Québec City, QC, Canada.
• ²Florida International University, Miami, FL, USA. Electronic address: adick@fiu.edu.

Abstract

With the advancement of cognitive neuroscience and neuropsychological research, the field of language neurobiology is at a cross-roads with respect to its framing theories. The central thesis of this article is that the major historical framing model, the Classic "Wernicke-Lichtheim-Geschwind" model, and associated terminology, is no longer adequate for contemporary investigations into the neurobiology of language. We argue that the Classic model (1) is based on an outdated brain anatomy; (2) does not adequately represent the distributed connectivity relevant for language, (3) offers a modular and "language centric" perspective, and (4) focuses on cortical structures, for the most part leaving out subcortical regions and relevant connections. To make our case, we discuss the issue of anatomical specificity with a focus on the contemporary usage of the terms "Broca's and Wernicke's area", including results of a survey that was conducted within the language neurobiology community. We demonstrate that there is no consistent anatomical definition of "Broca's and Wernicke's Areas", and propose to replace these terms with more precise anatomical definitions. We illustrate the distributed nature of the language connectome, which extends far beyond the single-pathway notion of arcuate fasciculus connectivity established in Geschwind's version of the Classic Model. By illustrating the definitional confusion surrounding "Broca's and Wernicke's areas", and by illustrating the difficulty integrating the emerging literature on perisylvian white matter connectivity into this model, we hope to expose the limits of the model, argue for its obsolescence, and suggest a path forward in defining a replacement.
Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Arcuate fasciculus; Broca’s area; Language connectome; Language neurobiology; Wernicke’s area

PMID:

27584714

DOI:

10.1016/j.bandl.2016.08.004