Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
J Korean Med Sci. 2010 Jan;25(1):123-7. doi: 10.3346/jkms.2010.25.1.123. Epub 2009 Dec 26.
To determine the relations between post-stroke aphasia severity and aphasia type and lesion location, a retrospective review was undertaken using the medical records of 97 Korean patients, treated within 90 days of onset, for aphasia caused by unilateral left hemispheric stroke. Types of aphasia were classified according to the validated Korean version of the Western Aphasia Battery (K-WAB), and severities of aphasia were quantified using WAB Aphasia Quotients (AQ). Lesion locations were classified as cortical or subcortical, and were determined by magnetic resonance imaging. Two-step cluster analysis was performed using AQ values to classify aphasia severity by aphasia type and lesion location. Cluster analysis resulted in four severity clusters: 1) mild; anomic type, 2) moderate; Wernicke's, transcortical motor, transcortical sensory, conduction, and mixed transcortical types, 3) moderately severe; Broca's aphasia, and 4) severe; global aphasia, and also in three lesion location clusters: 1) mild; subcortical 2) moderate; cortical lesions involving Broca's and/or Wernicke's areas, and 3) severe; insular and cortical lesions not in Broca's or Wernicke's areas. These results revealed that within 3 months of stroke, global aphasia was the more severely affected type and cortical lesions were more likely to affect language function than subcortical lesions.
为了确定脑卒中后失语症严重程度与失语症类型和病变位置之间的关系，对 97 例韩国患者的病历进行了回顾性分析，这些患者均在发病后 90 天内接受治疗，且患有单侧左半球脑卒中引起的失语症。根据经验证的韩国版西方失语症成套测验（K-WAB）对失语症类型进行分类，并使用 WAB 失语症商数（AQ）对失语症严重程度进行量化。病变位置分为皮质或皮质下，并通过磁共振成像确定。使用 AQ 值进行两步聚类分析，根据失语症类型和病变位置对失语症严重程度进行分类。聚类分析产生了四个严重程度聚类：1）轻度；命名性失语症类型，2）中度；Wernicke 失语症、皮质下运动性失语症、皮质下感觉性失语症、传导性失语症和混合性皮质下失语症类型，3）中度严重；Broca 失语症，和 4）重度；全面性失语症，以及三个病变位置聚类：1）轻度；皮质下，2）中度；皮质病变累及 Broca 区和/或 Wernicke 区，和 3）重度；岛叶和皮质病变不在 Broca 区或 Wernicke 区。这些结果表明，在脑卒中后 3 个月内，全面性失语症是受影响更严重的类型，皮质病变比皮质下病变更有可能影响语言功能。
