What have we learned from aphasias in the 21st century? Neuroanatomical, cognitive, and diagnostic implications of the ventral language stream

¿Qué hemos aprendido de las afasias en el siglo XXI?: Implicaciones neuroanatómicas, cognitivas y diagnósticas de la red ventral del lenguaje


Our understanding of the neural basis of language has grown enormously over the last 2 decades. However, the classical anatomical-lesional model of aphasias, which began with Paul Broca in the late 18th century and culminated with Geschwind in the 1970s, continues to be widely used both in the academic and the clinical contexts.


We discuss the limitations of the classical model from a neuroanatomical, cognitive, and diagnostic perspective. We address in detail the explanatory models of the last 20 years that focus on linguistic processes and neural correlates, including the ventral stream, and analyse the increase in scientific publications that associate this pathway with language, proposing that it may be part of a multimodal association circuit.


This review of the new cognitive and neuroanatomical models of language shows the deficiencies of the classical classification and suggests that some semantic aphasic disorders may be concealed by these categories. There is a need for an assessment based on cognitive processes; we indicate some specific tests for the detection of verbal semantic alterations and guidelines for their rehabilitation.

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