Radman Narges, Mouthon Michael, Di Pietro Marie, Gaytanidis Chrisovalandou, Leemann Beatrice, Abutalebi Jubin, Annoni Jean-Marie
Neurology Unit, Department of Medicine, Faculty of Sciences, University of Fribourg, Fribourg, Switzerland.
Neurorehabilitation Department, University Hospital, University of Geneva, Geneva, Switzerland.
Neural Plast. 2016;2016:8797086. doi: 10.1155/2016/8797086. Epub 2016 Nov 14.
Aphasia in bilingual patients is a therapeutic challenge since both languages can be impacted by the same lesion. Language control has been suggested to play an important role in the recovery of first (L1) and second (L2) language in bilingual aphasia following stroke. To test this hypothesis, we collected behavioral measures of language production (general aphasia evaluation and picture naming) in each language and language control (linguistic and nonlinguistic switching tasks), as well as fMRI during a naming task at one and four months following stroke in five bilingual patients suffering from poststroke aphasia. We further applied dynamic causal modelling (DCM) analyses to the connections between language and control brain areas. Three patients showed parallel recovery in language production, one patient improved in L1, and one improved in L2 only. Language-control functions improved in two patients. Consistent with the dynamic view of language recovery, DCM analyses showed a higher connectedness between language and control areas in the language with the better recovery. Moreover, similar degrees of connectedness between language and control areas were found in the patients who recovered in both languages. Our data suggest that engagement of the interconnected language-control network is crucial in the recovery of languages.
双语患者的失语症是一项治疗挑战，因为两种语言都可能受到同一损伤的影响。有人提出，语言控制在中风后双语失语症患者的第一语言（L1）和第二语言（L2）恢复中起着重要作用。为了验证这一假设，我们收集了五名患有中风后失语症的双语患者在中风后1个月和4个月时每种语言的语言产出行为指标（一般失语症评估和图片命名）以及语言控制指标（语言和非语言切换任务），同时还进行了功能性磁共振成像（fMRI）。我们进一步对语言和控制脑区之间的连接进行了动态因果模型（DCM）分析。三名患者在语言产出方面呈现平行恢复，一名患者的L1有所改善，一名患者仅L2有所改善。两名患者的语言控制功能得到改善。与语言恢复的动态观点一致，DCM分析显示，恢复较好的语言中语言和控制区域之间的连通性更高。此外，在两种语言都恢复的患者中，语言和控制区域之间的连通程度相似。我们的数据表明，相互连接的语言控制网络的参与对语言恢复至关重要。
