Unité de neuroimagerie fonctionnelle, Research Centre Institut Universitaire de Gériatrie de Montréal, 4565 Queen-Mary Road, Montreal, Quebec, Canada.
Neuropsychologia. 2012 Jul;50(8):1776-86. doi: 10.1016/j.neuropsychologia.2012.04.001. Epub 2012 Apr 30.
Research on the neural substrate of aphasia recovery has consistently increased since the advent of functional neuroimaging. The evidence from therapy-induced aphasia recovery studies shows that better recovery results from the reactivation of left hemisphere function; still, the specific left hemisphere key areas that sign successful outcome with a specific therapy approach remain to be identified. Nine participants suffering from aphasia received brief and intensive therapy with Semantic Feature Analysis (SFA). Behavioural and neuroimaging data during overt picture naming were obtained prior to and after therapy. This paper reports on a group of participants having benefited from SFA, and two distinct patterns of improvement. Correlational analysis showed that differences in outcome were not related to lesion size, but were negatively correlated with damage to Broca's area (BA45). Moreover, a group analysis showed that therapy-induced recovery following SFA was characterized by (a) a significant correlation between improvement and activation in the left precentral gyrus (BA4/6) before therapy, and (b) the recruitment of the left inferior parietal lobule, an area known for its role in semantic integration, following therapy with SFA. Individual fMRI analyses showed that although adaptive brain plasticity appeared to operate differently in each patient, best responders to SFA therapy recruited less areas after training compared to participants having shown less recovery who showed a larger number of activated areas sustaining recovery. The results of the present study suggest that a significant activation of BA4/6 could indicate the use of SFA to achieve successful outcome. Also our results suggest that greater SFA improvement in chronic aphasia is associated with recruitment of areas in the left hemisphere.
自从功能神经影像学问世以来，对失语症恢复的神经基础的研究一直在不断增加。来自治疗诱导的失语症恢复研究的证据表明，更好的恢复结果来自于左半球功能的重新激活；尽管如此，特定的左半球关键区域仍然需要确定，这些区域与特定的治疗方法一起可以产生成功的结果。九名患有失语症的参与者接受了短暂而密集的语义特征分析（SFA）治疗。在治疗前后，进行了显性图片命名时的行为和神经影像学数据采集。本文报告了一组从 SFA 中受益的参与者，并展示了两种不同的改善模式。相关性分析表明，结果的差异与损伤大小无关，但与布罗卡区（BA45）的损伤呈负相关。此外，组分析表明，SFA 治疗后，失语症的恢复特征为：（a）治疗前左中央前回（BA4/6）的改善与激活之间存在显著相关性；（b）治疗后左顶下小叶的招募，该区域已知在语义整合中起作用。个体 fMRI 分析表明，尽管适应性大脑可塑性似乎在每个患者中表现不同，但与 SFA 治疗后恢复较差的患者相比，对 SFA 治疗反应最佳的患者在训练后招募的区域较少，而恢复较差的患者则保持恢复的激活区域较多。本研究的结果表明，BA4/6 的显著激活可能表明使用 SFA 可以取得成功的结果。此外，我们的结果表明，慢性失语症中 SFA 的改善越大，与左半球区域的招募相关。
