Kapronczay Károly szerk.: Orvostörténeti Közlemények 198-199. (Budapest, 2007)

TANULMÁNYOK — ARTICLES - SZIRMAI, Imre - GOSZTONYI, Georg: Conceps of Localization of Neurological Functions in István Környei 's Oeuvre. - (Az idegműködések helyhez-köthetöségének elméletei Környei István életművében)

lamic tract) an isolate amnesia involving the content of self-awareness have been observed, while the memory concerning famous personalities and events remained relatively preserved (Hodges and McCanty, 1993). Damage to the dorsomedial thalamus is responsible for the "frontal components" of memory, and lesion to the ventral anterior nucleus and the mamillothalamic tract for the learning (Kumral et al., 2001). Környey (1971) analysed the symptom complex of "thalamus dementia". He pointed out that in these cases "high grade inactivity, attention and memory disturbance" develop, and, since the periaqueductal grey matter is not injured, the sleep-wakefulness mechanism remains intact. He was aware of the projection areas of the dorsomedial thalamus, since, quoting Castaigne and coworkers (1966) considered that "within the medial thalamus various areas may have a role in the activity and affectivity"

. He estimated the echolalia, as well as the liberation phenomena resulting from the injuries of the frontal lobe, the consequences of the disinhibition of the acustico-motor reflex. He explained in detail that transcortical aphasia and echolalia are the most frequent inherent characteristics of Pick's disease. Környey interpreted the transcortical aphasia with an analogy of Liepmann's (1913) apraxia mechanism. This sign is going to manifest, when the damage to the posterior fronto-medial areas simultaneously involves the corpus callosum and the descending corticobulbar tracts. The development of the concept of the supplementary area's role in speech is signalized by the fact that now two types of the "extrasylvian aphasia" are differentiated, namely the transcortical and the supplementary motor aphasia. In this context Környey's study (1975) written in French was cited by Rapcsak and Rubens ( 1

994). Környey regarded the semantic disorders as sequelae of dementia, therefore, he did not accept the semantic aphasia as a symptom of independent entity; therefore he stated that the selection of words and the definition of their place within a sentence requires "a cognitive background"

. He added critical notes to the statements regarding disconnections (Geschwind, 1965), "/ explain the lack of expression in transcortical aphasia with loss of initiative instead of with separation from the concept centre ..." "It seems, however that certain categories of action, e.g. speech, require initialing stimuli from definite cortical areas." The "nativistic" concept of Chomsky (1968) means in Környey's interpretation that "behind the grammatical structure a constructional framework must exist, which cannot be considered as something individually learned, namely ... the inherent features of speech might be identical in all languages"

. He quoted Wernicke's "word concept" assumption and Brain's (1961) notion referring to the existence of an acoustic and motor phonema scheme; between these two stands the "central word-scheme", which is based on the association of acoustic and optic stimuli. The Petersen-scheme could be complemented by the inclusion of the supplementary area of the dominant hemisphere, as suggested by Környey. Recent studies (Vogt et al., 2003) elucidated the relation of the supplementary area to the cingular cortex. It was revealed that the loss of speech initiative is only one part of the psycho-organic syndromes, produced by dorso-medial frontal injuries. The rostral part of the cingular cortex has been denoted as an executive region, which has rich interconnections with the motor system. With regard to its function, this structure is not uniform, it can be divided to areas with affective and cognitive operations. The affective areas (Brodmann 25, 33, and the rostral part of Brodmann 24) are connected with the amygdala, the periaquaeductal grey matter, the thalamus and the brain stem nuclei with autonomic function. These areas have a role in learning emotional reactions, in motivation, in the exprès-