Lidzba Karen, Küpper Hanna, Kluger Gerhard, Staudt Martin
Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
Eur J Paediatr Neurol. 2017 Sep;21(5):715-721. doi: 10.1016/j.ejpn.2017.06.001. Epub 2017 Jun 12.
To identify, in a retrospective, observational study, the time window during which successful right-hemispheric language reorganization is possible after left-hemispheric brain damage.
25 patients (10 females; age 6-41 years; ≥12 months after insult; age at insult 0;3-15;11 years) with acute, language-relevant left-hemispheric insults acquired during childhood and adolescence completed questionnaires for self-assessment of language problems. 12 patients of those reporting no (n = 8) or only moderate (n = 4) language problems participated in language fMRI.
Language outcome of lesions occurring before 5 years of age (n = 7) was always favorable, and language was right-lateralized (2 patients: age at lesion < 2 years) or bilateral (3 patients: age at lesion 2-5 years). Following lesions occurring after 5 years of age, language outcome was often unfavorable (11/18 patients: moderate or severe problems), and of the 7 patients without problems, none showed right-hemispheric reorganization (fMRI available in 4).
The combination of normal language outcome and right-hemispheric language reorganization after a left-hemispheric lesion sustained after the neonatal period is extremely rare. Functionally sufficient right-hemispheric language was documented in only two patients with lesions acquired before two years of age.
在一项回顾性观察研究中，确定左脑损伤后成功进行右半球语言重组的时间窗。
25例（10例女性；年龄6 - 41岁；损伤后≥12个月；损伤时年龄0;3 - 15;11岁）在儿童期和青少年期发生急性、与语言相关的左脑损伤的患者完成了语言问题自我评估问卷。其中12例报告无（n = 8）或仅有中度（n = 4）语言问题的患者参与了语言功能磁共振成像（fMRI）检查。
5岁前发生损伤的患者（n = 7）语言结局总是良好，语言为右侧化（2例：损伤时年龄<2岁）或双侧化（3例：损伤时年龄2 - 5岁）。5岁后发生损伤的患者，语言结局通常不佳（11/18例患者：中度或重度问题），在7例无问题的患者中，无一例显示右半球重组（4例可进行fMRI检查）。
新生儿期后发生左脑损伤后，语言结局正常且右半球语言重组的情况极为罕见。仅在2例2岁前发生损伤的患者中记录到功能上足够的右半球语言。
