Lee Jae Sung, Lee Dong Soo, Oh Seung Ha, Kim Chong Sun, Kim Jeong-Whun, Hwang Chan Ho, Koo Jawon, Kang Eunjoo, Chung June-Key, Lee Myung Chul
Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea.
J Nucl Med. 2003 Sep;44(9):1435-9.
Controversy regarding functional reorganization in the adult brain remains. To investigate whether neuroplasticity is present in adults with postlingual deafness, we examined the pattern of cerebral glucose metabolism on (18)F-FDG brain PET images of postlingually deaf patients by comparing the auditory cortical activation pattern with those of age- and sex-matched healthy control subjects. We also correlated the cerebral glucose metabolism in deaf patients with the duration of deafness using statistical parametric mapping.
In the resting state (eye closed, ears unoccluded in a dark and quiet environment), (18)F-FDG brain PET scans were performed on 9 postlingually deaf patients and 9 age- and sex-matched healthy volunteers. Significant increases and decreases of regional cerebral metabolism in the patient group were estimated by comparing their PET images with those of the healthy volunteers using t statistics at every voxel. To reveal regions in which metabolism was significantly correlated with the duration of deafness, the general linear model with the duration of deafness as a covariate was tested at each voxel.
When we compared (18)F-FDG brain PET images of postlingually deaf patients with those of age- and sex-matched healthy control subjects by performing a t test at every voxel, the glucose metabolism of deaf patients was significantly (P < 0.001) lower than that of the control subjects in both anterior cingulate gyri (Brodmann area 24 [BA24]) and superior temporal cortices (BA41, BA42) and in the right parahippocampal gyrus. No area showed a significant increase of metabolism in deaf patients with the same threshold. When we correlated glucose metabolism of deaf patients with the duration of deafness after total deprivation of hearing capability using a general linear model with the duration of deafness as a covariate at every voxel, metabolism in both anterior cingulate gyri (BA24) and superior temporal cortices (BA41, BA42) showed a significant (P < 0.005) positive correlation with the duration of deafness.
This study suggests that plasticity is present in adult brains of postlingually deaf patients. In the mature brain, auditory deprivation decreased neuronal activity transiently in primary auditory and auditory-related cortices, and, over time, functional reorganization likely takes place in the auditory cortex. Plasticity was prominent in superior temporal and anterior cingulate gyri in the sensory-deprived mature brain and militated against postimplantation improvement in patients with cochlear implants.
关于成人大脑功能重组的争议仍然存在。为了研究语后聋成年人是否存在神经可塑性,我们通过比较语后聋患者与年龄和性别匹配的健康对照者的听觉皮层激活模式,检查了(18)F-FDG脑PET图像上的脑葡萄糖代谢模式。我们还使用统计参数映射将聋患者的脑葡萄糖代谢与耳聋持续时间进行了关联。
在静息状态下(闭眼,在黑暗安静的环境中不堵塞耳朵),对9名语后聋患者和9名年龄和性别匹配的健康志愿者进行了(18)F-FDG脑PET扫描。通过在每个体素处使用t统计量将患者组的PET图像与健康志愿者的图像进行比较,估计患者组区域脑代谢的显著增加和减少。为了揭示代谢与耳聋持续时间显著相关的区域,在每个体素处测试以耳聋持续时间为协变量的一般线性模型。
当我们通过在每个体素处进行t检验,将语后聋患者的(18)F-FDG脑PET图像与年龄和性别匹配的健康对照者的图像进行比较时,聋患者在前扣带回(Brodmann区24 [BA24])、颞上叶皮质(BA41、BA42)和右侧海马旁回的葡萄糖代谢显著低于对照组(P < 0.001)。在相同阈值下,没有区域显示聋患者的代谢显著增加。当我们使用以耳聋持续时间为协变量的一般线性模型,在每个体素处将聋患者的葡萄糖代谢与听力完全丧失后的耳聋持续时间进行关联时,前扣带回(BA24)和颞上叶皮质(BA41、BA42)的代谢与耳聋持续时间均呈显著正相关(P < 0.005)。
本研究表明语后聋患者的成人大脑中存在可塑性。在成熟大脑中,听觉剥夺会使初级听觉和听觉相关皮质中的神经元活动暂时减少,并且随着时间的推移,听觉皮层可能会发生功能重组。在感觉剥夺的成熟大脑中,可塑性在颞上叶和前扣带回中很突出,这不利于人工耳蜗植入患者术后的改善。