History of the frontal lobes: Language and language disorders - 03/12/18

Doi : 10.1016/j.neurol.2018.09.006

François Boller, MD, Ph.D. ^⁎ : Clinical Professor of Neurology, Nicoletta Caputi
George Washington University, Washington DC 20037, USA

^⁎Corresponding author.

Résumé

The topic “Language and language disorders” fits well into a meeting dedicated to the history of the frontal lobes because that is where it all began. The ability to communicate is certainly not restricted to humans but language is. Specifically the ability to learn, articulate and use symbolic language, the use of accompanying facial and body gestures, the ability to teach and correct are all unique to humans. They are related to the development of frontal lobe structures, with mirror neurons the likely neuronal basis of these abilities [1, 2, 3].

The birth of neuropsychology in its current meaning occurred in the second part of the 19th century when studies of language and its disorders were linked to lesions of structures located in the frontal lobes. There were several contributors. Broca of course comes to mind but others played a role, some even preceded him. Jean-Baptiste Boullaud had gone as far as offering 500 francs to “anyone who could produce the brain of one who had during life lost speech, and which did not show any frontal lesion”. On April 4th 1861, his son-in-law Ernest Aubertin made a presentation on “the seat of articulated language”. That date is considered “the most important one in the history of aphasiology” by McDonald Critchley (1970, p. 61) [4]. As for Broca, his contribution first formally presented on May 2nd 1861 was crucial, but it must be remembered that this was only a relatively short parenthesis in a life dedicated to surgery and above all to anthropology.

We will conclude with the cri de douleur of Pierre Marie who proclaimed that the third frontal convolution plays no role on language function. This iconoclastic position was later discretely retracted, but we will summarize the fierce debates, particularly those of 1908 when a duel of swords was fortunately cancelled to become a duel of words [5]. We will present the taped voice of two very reduced patients from Henry Hécaen's Unit [6]. In his signature book “Introduction à la Neuropsychologie” (1972), he refers to these two patients as examples of “Aphasie de réalisation phonématique”. To this day the precise definition of Broca's aphasia and aphemia is not entirely agreed upon except mostly for one thing: the lesion is in the frontal lobes [1, 2, 3, 4, 5, 6].