Sebastian Rajani, Long Charltien, Purcell Jeremy J, Faria Andreia V, Lindquist Martin, Jarso Samson, Race David, Davis Cameron, Posner Joseph, Wright Amy, Hillis Argye E
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA.
Restor Neurol Neurosci. 2016 May 11;34(4):473-89. doi: 10.3233/RNN-150621.
The neural mechanisms that support aphasia recovery are not yet fully understood. Our goal was to evaluate longitudinal changes in naming recovery in participants with posterior cerebral artery (PCA) stroke using a case-by-case analysis.
Using task based and resting state functional magnetic resonance imaging (fMRI) and detailed language testing, we longitudinally studied the recovery of the naming network in four participants with PCA stroke with naming deficits at the acute (0 week), sub acute (3-5 weeks), and chronic time point (5-7 months) post stroke. Behavioral and imaging analyses (task related and resting state functional connectivity) were carried out to elucidate longitudinal changes in naming recovery.
Behavioral and imaging analysis revealed that an improvement in naming accuracy from the acute to the chronic stage was reflected by increased connectivity within and between left and right hemisphere "language" regions. One participant who had persistent moderate naming deficit showed weak and decreasing connectivity longitudinally within and between left and right hemisphere language regions.
These findings emphasize a network view of aphasia recovery, and show that the degree of inter- and intra- hemispheric balance between the language-specific regions is necessary for optimal recovery of naming, at least in participants with PCA stroke.
支持失语症恢复的神经机制尚未完全明确。我们的目标是通过逐例分析，评估大脑后动脉（PCA）卒中患者命名恢复的纵向变化。
我们利用基于任务和静息态功能磁共振成像（fMRI）以及详细的语言测试，对4例PCA卒中且在卒中后急性（0周）、亚急性（3 - 5周）和慢性时间点（5 - 7个月）存在命名缺陷的患者的命名网络恢复情况进行了纵向研究。进行了行为和成像分析（任务相关和静息态功能连接）以阐明命名恢复的纵向变化。
行为和成像分析显示，从急性期到慢性期命名准确性的提高表现为左右半球“语言”区域内及区域间连接性增加。一名持续存在中度命名缺陷的患者，其左右半球语言区域内及区域间的连接性纵向显示较弱且逐渐下降。
这些发现强调了失语症恢复的网络观点，并表明至少在PCA卒中患者中，语言特定区域之间半球间和半球内平衡的程度对于命名的最佳恢复是必要的。
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