Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1, Daemyungdong, Namku, Taegu 705-717, Republic of Korea.
BMC Neurol. 2014 Mar 8;14:46. doi: 10.1186/1471-2377-14-46.
The role of the arcuate fasciculus (AF) in the dominant hemisphere in stroke patients with aphasia has not been clearly elucidated. We investigated the relation between language function and diffusion tensor tractography (DTT) findings for the left AF in chronic stroke patients with aphasia.
Twenty five consecutive right-handed stroke patients with aphasia following lesions in the left hemisphere were recruited for this study. The aphasia quotient (AQ) of Korean-Western Aphasia Battery was used for assessment of language function. We measured values of fractional anisotropy (FA), apparent diffusion coefficient (ADC), voxel number of the left AF. We classified patients into three groups: type A--the left AF was not reconstructed, type B--the left AF was discontinued between Wernicke's and Broca's areas, and type C--the left AF was preserved around the stroke lesion.
Moderate positive correlation was observed between AQ and voxel number of the left AF (r = 0.471, p < 0.05). However, no correlation was observed between AQ and FA (r = 0.275, p > 0.05) and ADC values (r = -0.286, p > 0.05). Significant differences in AQ scores were observed between the three types (p < 0.05); the AQ score of type C was higher than those of type A and B, and that of type B was also higher than that of type A (p < 0.05).
According to our findings, the remaining volume of the left AF, irrespective of directionality and diffusivity, showed moderate positive correlation with language function in chronic stroke patients with aphasia. Discontinuation or non-construction of the left AF was also an important factor for language function.
左侧弓状束(AF)在优势半球卒中伴失语症患者中的作用尚未明确。我们研究了慢性卒中伴失语症患者左侧 AF 的弥散张量纤维束成像(DTT)发现与语言功能之间的关系。
连续纳入 25 例左侧大脑半球病变后伴失语症的右利手卒中患者。采用韩国-西方失语症成套测验的失语商(AQ)评估语言功能。我们测量了左侧 AF 的各向异性分数(FA)、表观扩散系数(ADC)、体素数。我们将患者分为三组:A 型——左侧 AF 未重建,B 型——左侧 AF 在 Wernicke 区和 Broca 区之间中断,C 型——左侧 AF 在卒中病灶周围保留。
AQ 与左侧 AF 的体素数呈中度正相关(r=0.471,p<0.05)。然而,AQ 与 FA(r=0.275,p>0.05)和 ADC 值(r=0.286,p>0.05)无相关性。三组之间 AQ 评分存在显著差异(p<0.05);C 型 AQ 评分高于 A 型和 B 型,B 型也高于 A 型(p<0.05)。
根据我们的发现,左侧 AF 的剩余体积,无论方向和弥散性如何,与慢性卒中伴失语症患者的语言功能呈中度正相关。左侧 AF 的中断或未重建也是语言功能的重要因素。