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[血管性失语的恢复:预后因素及功能脑成像证据]

[Recovery from vascular aphasia: prognostic factors and evidence from functional brain imaging].

作者信息

Kahlaoui K, Ansaldo A I

机构信息

Centre de recherche, institut universitaire de gériatrie de Montréal, 4565, chemin Queen-Mary, Montréal, H3W 1W5 Québec, Canada.

出版信息

Rev Neurol (Paris). 2009 Mar;165(3):233-42. doi: 10.1016/j.neurol.2008.06.014. Epub 2008 Sep 27.

Abstract

INTRODUCTION

Aphasia is a devastating language impairment resulting from acquired brain damage and resulting in severe communication handicap. Aphasia onset is generally followed by some degree of recovery.

STATE OF ART

Prognosis of recovery is considered to depend upon a series of interacting neurobiological and individual factors. Prognosis is better determined based on neurobiological factors, whereas individual factors have a less predictable clinical outcome value. In addition, the results of recent functional neuro-imaging studies allow us to better understand the functional anatomy of the recovery from vascular aphasia. The neuro-imaging literature suggests that recovery from aphasia could depend upon right homologous to language areas, as well as on preserved perilesional left hemisphere regions. The role of either hemisphere seems to be modulated by time elapsed after brain damage, and language processing domain. Further, increasing evidence suggests that intensive and specific language therapy may interact with brain plasticity to promote recovery in chronic and severe aphasia.

PERSPECTIVE AND CONCLUSION

A better understanding of the factors determining recovery from aphasia will contribute to optimizing intervention and, consequently improve the quality of life of people with aphasia.

摘要

引言

失语症是一种由后天脑损伤导致的严重语言障碍,会造成严重的沟通障碍。失语症发作后通常会有一定程度的恢复。

现状

恢复的预后被认为取决于一系列相互作用的神经生物学和个体因素。基于神经生物学因素能更好地判断预后,而个体因素对临床结果的预测价值较小。此外,近期功能神经影像学研究的结果使我们能够更好地理解血管性失语症恢复的功能解剖学。神经影像学文献表明,失语症的恢复可能取决于与语言区域相对应的右侧脑区,以及受损周围的左侧半球保留区域。两个半球的作用似乎都受到脑损伤后经过的时间以及语言处理领域的调节。此外,越来越多的证据表明,强化和特定的语言治疗可能与脑可塑性相互作用,以促进慢性和严重失语症的恢复。

展望与结论

更好地理解决定失语症恢复的因素将有助于优化干预措施,从而提高失语症患者的生活质量。

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