{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T02:06:39Z","timestamp":1790042799522,"version":"4.0.1"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2009,2,4]],"date-time":"2009-02-04T00:00:00Z","timestamp":1233705600000},"content-version":"vor","delay-in-days":34,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2009,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Right\u2010handedness and left\u2010sided language lateralization is an unresolved mystery with unknown cause\/effect relations. Most studies suggest that the language lateralization is related to a fundamental brain asymmetry: right\u2010handedness may be secondary. We analyzed the possibility of an opposite cause\/effect relation: whether asymmetric hand usage (as a cause) can influence language lateralization (as a consequence).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We determined language lateralization by functional magnetic resonance imaging in 15 subjects whose upper limb (UL) had been injured at birth because of unilateral damage of the brachial plexus. These subjects were able to use only one (the noninjured) UL perfectly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found correlation between the severity of right\u2010sided UL injuries and hand usage dysfunction and the degree of left\u2010to\u2010right shift of language lateralization. There was, however, not a complete switch of language lateralization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Right\u2010sided UL injury can induce a left\u2010to\u2010right shift in language lateralization, suggesting that hand usage can influence language lateralization. These findings may contradict the broadly accepted theory that right\u2010handedness is a secondary phenomenon caused by left\u2010sided hemispheric language lateralization. However, the cause\/effect problem between asymmetric hand usage and language lateralization is not resolved in this study. Our findings may support the theory that gestures had a crucial role in human language evolution and is a part of the language system even today. 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