Center for Clinical Neurosciences in the Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX, USA.
Arch Phys Med Rehabil. 2009 Dec;90(12):2026-33. doi: 10.1016/j.apmr.2009.08.144.
Breier JI, Juranek J, Maher LM, Schmadeke S, Men D, Papanicolaou AC. Behavioral and neurophysiologic response to therapy for chronic aphasia.
To characterize the relationship between neurophysiologic changes in the brain and behavioral response to constraint-induced language therapy (CILT) by using magnetoencephalography (MEG).
Case series.
Medical school.
Patients (N=23) with chronic aphasia after first-time unilateral stroke in the left hemisphere.
Constraint-induced language therapy administered for 3 hours 4 times per week for 3 weeks. Language testing and functional imaging during a language comprehension task using MEG before, immediately after, and 3 months after CILT with a subgroup of patients undergoing additional MEG scanning and language testing 3 weeks before CILT.
The percent of correct information units and the number of late dipoles normalized to total activation.
Three patterns of behavioral and neurophysiologic response to CILT were identified. Patients with significant improvement in language immediately after CILT who lost these gains at follow-up had greater right hemisphere activation than other patients at all MEG scanning sessions. Patients with significant improvement in language immediately after CILT who maintained these gains at follow-up exhibited an increase in left temporal activation after CILT, whereas patients who did not exhibit significant improvement in language after CILT exhibited comparably greater activation in left parietal areas.
Results suggest that although the right hemisphere may support recovery of language function in response to therapy, this recovery may not be stable, and some participation of perilesional areas of the left hemisphere may be necessary for a stable behavioral response.
Breier JI、Juranek J、Maher LM、Schmadeke S、Men D、Papanicolaou AC。慢性失语症治疗的行为和神经生理反应。
通过使用脑磁图（MEG）来描述大脑神经生理变化与约束诱导语言治疗（CILT）行为反应之间的关系。
病例系列。
医学院。
首次左侧半球卒中后慢性失语症患者（N=23）。
每周 4 次，每次 3 小时，进行 3 周的 CILT。在 CILT 之前、之后即刻和之后 3 个月，对患者进行语言理解任务的语言测试和功能成像，并用 MEG 对亚组患者进行额外的 MEG 扫描和语言测试，在 CILT 前 3 周进行。
正确信息单位的百分比和正常化至总激活的迟极数。
确定了 3 种对 CILT 的行为和神经生理反应模式。在 CILT 后语言立即显著改善但在随访中失去这些改善的患者，在所有 MEG 扫描过程中，右半球的激活均大于其他患者。在 CILT 后语言立即显著改善且保持这些改善的患者，在 CILT 后左侧颞叶的激活增加，而在 CILT 后语言没有显著改善的患者，左侧顶叶区域的激活相对较大。
结果表明，尽管右半球可能支持治疗后语言功能的恢复，但这种恢复可能不稳定，左侧病变区域的某些参与可能是稳定行为反应所必需的。
