Musso M, Weiller C, Kiebel S, Müller S P, Bülau P, Rijntjes M
Department of Neurology, Friedrich-Schiller-Universität Jena, Waldbreitbach, Germany.
Brain. 1999 Sep;122 ( Pt 9):1781-90. doi: 10.1093/brain/122.9.1781.
It has long been a matter of debate whether recovery from aphasia after left perisylvian lesions is mediated by the preserved left hemispheric language zones or by the homologous right hemisphere regions. Using PET, we investigated the short-term changes in the cortical network involved in language comprehension during recovery from aphasia. In 12 consecutive measurements of regional cerebral blood flow (rCBF), four patients with Wernicke's aphasia, caused by a posterior left middle cerebral artery infarction, were tested with a language comprehension task. Comprehension was estimated directly after each scan with a modified version of the Token Test. In the interval between the scans, the patients participated in brief, intense language comprehension training. A significant improvement in performance was observed in all patients. We correlated changes in blood flow measured during the language comprehension task with the scores achieved in the Token Test. The regions which best correlated with the training-induced improvement in verbal comprehension were the posterior part of the right superior temporal gyrus and the left precuneus. This study supports the role of the right hemisphere in recovery from aphasia and demonstrates that the improvement in auditory comprehension induced by specific training is associated with functional brain reorganization.
长期以来，左侧外侧裂周围病变后失语症的恢复是由保留的左侧半球语言区介导，还是由同源的右侧半球区域介导，一直存在争议。我们使用正电子发射断层扫描（PET）研究了失语症恢复过程中涉及语言理解的皮质网络的短期变化。在对局部脑血流量（rCBF）进行的12次连续测量中，对4名由左侧大脑中动脉后部梗死导致韦尼克失语症的患者进行了语言理解任务测试。每次扫描后，使用改良版的代币测验直接评估理解能力。在扫描间隔期间，患者参加简短而密集的语言理解训练。所有患者的表现均有显著改善。我们将语言理解任务期间测量的血流变化与代币测验中取得的分数进行了关联。与训练引起的言语理解改善相关性最强的区域是右侧颞上回后部和左侧楔前叶。这项研究支持了右侧半球在失语症恢复中的作用，并表明特定训练引起的听觉理解改善与功能性脑重组有关。
