Griffis Joseph C, Nenert Rodolphe, Allendorfer Jane B, Szaflarski Jerzy P
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294-0021, USA.
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL 35294-0021, USA.
Neural Plast. 2016;2016:4796906. doi: 10.1155/2016/4796906. Epub 2016 Jan 10.
The effects of noninvasive neurostimulation on brain structure and function in chronic poststroke aphasia are poorly understood. We investigated the effects of intermittent theta burst stimulation (iTBS) applied to residual language-responsive cortex in chronic patients using functional and anatomical MRI data acquired before and after iTBS. Lateralization index (LI) analyses, along with comparisons of inferior frontal gyrus (IFG) activation and connectivity during covert verb generation, were used to assess changes in cortical language function. Voxel-based morphometry (VBM) was used to assess effects on regional grey matter (GM). LI analyses revealed a leftward shift in IFG activity after treatment. While left IFG activation increased, right IFG activation decreased. Changes in right to left IFG connectivity during covert verb generation also decreased after iTBS. Behavioral correlations revealed a negative relationship between changes in right IFG activation and improvements in fluency. While anatomical analyses did not reveal statistically significant changes in grey matter volume, the fMRI results provide evidence for changes in right and left IFG function after iTBS. The negative relationship between post-iTBS changes in right IFG activity during covert verb generation and improvements in fluency suggests that iTBS applied to residual left-hemispheric language areas may reduce contralateral responses related to language production and facilitate recruitment of residual language areas after stroke.
无创神经刺激对慢性中风后失语症患者脑结构和功能的影响目前了解甚少。我们利用间歇性θ波爆发刺激(iTBS)前后采集的功能和解剖磁共振成像(MRI)数据,研究了iTBS应用于慢性患者残余语言反应性皮层的效果。采用偏利指数(LI)分析,以及在隐蔽动词生成过程中对额下回(IFG)激活和连接性的比较,来评估皮层语言功能的变化。基于体素的形态测量学(VBM)用于评估对局部灰质(GM)的影响。LI分析显示治疗后IFG活动向左偏移。左侧IFG激活增加,而右侧IFG激活减少。iTBS后,在隐蔽动词生成过程中右侧到左侧IFG连接性的变化也减少了。行为相关性分析显示,右侧IFG激活的变化与流畅性改善之间呈负相关。虽然解剖学分析未发现灰质体积有统计学意义的变化,但功能磁共振成像(fMRI)结果为iTBS后左右侧IFG功能的变化提供了证据。隐蔽动词生成过程中iTBS后右侧IFG活动的变化与流畅性改善之间的负相关表明,应用于残余左半球语言区域的iTBS可能会减少与语言产生相关的对侧反应,并促进中风后残余语言区域的重新激活。