Sihvonen Aleksi J, Ripollés Pablo, Rodríguez-Fornells Antoni, Soinila Seppo, Särkämö Teppo
Faculty of Medicine, University of TurkuTurku, Finland.
Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of HelsinkiHelsinki, Finland.
Front Neurosci. 2017 Jul 25;11:426. doi: 10.3389/fnins.2017.00426. eCollection 2017.
Although, acquired amusia is a common deficit following stroke, relatively little is still known about its precise neural basis, let alone to its recovery. Recently, we performed a voxel-based lesion-symptom mapping (VLSM) and morphometry (VBM) study which revealed a right lateralized lesion pattern, and longitudinal gray matter volume (GMV) and white matter volume (WMV) changes that were specifically associated with acquired amusia after stroke. In the present study, using a larger sample of stroke patients ( = 90), we aimed to replicate and extend the previous structural findings as well as to determine the lesion patterns and volumetric changes associated with amusia recovery. Structural MRIs were acquired at acute and 6-month post-stroke stages. Music perception was behaviorally assessed at acute and 3-month post-stroke stages using the Scale and Rhythm subtests of the Montreal Battery of Evaluation of Amusia (MBEA). Using these scores, the patients were classified as non-amusic, recovered amusic, and non-recovered amusic. The results of the acute stage VLSM analyses and the longitudinal VBM analyses converged to show that more severe and persistent (non-recovered) amusia was associated with an extensive pattern of lesions and GMV/WMV decrease in right temporal, frontal, parietal, striatal, and limbic areas. In contrast, less severe and transient (recovered) amusia was linked to lesions specifically in left inferior frontal gyrus as well as to a GMV decrease in right parietal areas. Separate continuous analyses of MBEA Scale and Rhythm scores showed extensively overlapping lesion pattern in right temporal, frontal, and subcortical structures as well as in the right insula. Interestingly, the recovered pitch amusia was related to smaller GMV decreases in the temporoparietal junction whereas the recovered rhythm amusia was associated to smaller GMV decreases in the inferior temporal pole. Overall, the results provide a more comprehensive picture of the lesions and longitudinal structural changes associated with different recovery trajectories of acquired amusia.
尽管获得性失乐感是中风后常见的缺陷，但对其确切的神经基础仍知之甚少，更不用说其恢复情况了。最近，我们进行了一项基于体素的病变-症状映射（VLSM）和形态测量（VBM）研究，该研究揭示了一种右侧化的病变模式，以及与中风后获得性失乐感特异性相关的纵向灰质体积（GMV）和白质体积（WMV）变化。在本研究中，我们使用了更大样本的中风患者（n = 90），旨在重复并扩展先前的结构研究结果，以及确定与失乐感恢复相关的病变模式和体积变化。在中风急性期和中风后6个月阶段采集结构MRI。在中风急性期和中风后3个月阶段，使用蒙特利尔失乐感评估量表（MBEA）的音阶和节奏子测试对音乐感知进行行为评估。根据这些分数，将患者分为非失乐感组、恢复的失乐感组和未恢复的失乐感组。急性期VLSM分析和纵向VBM分析的结果一致表明，更严重和持续（未恢复）的失乐感与右侧颞叶、额叶、顶叶、纹状体和边缘区域广泛的病变模式以及GMV/WMV减少有关。相比之下，不太严重和短暂（恢复）的失乐感与左侧额下回的特异性病变以及右侧顶叶区域的GMV减少有关。对MBEA音阶和节奏分数的单独连续分析显示，在右侧颞叶、额叶和皮质下结构以及右侧岛叶中存在广泛重叠的病变模式。有趣的是，恢复的音高失乐感与颞顶交界区较小的GMV减少有关，而恢复的节奏失乐感与颞下极较小的GMV减少有关。总体而言，这些结果为与获得性失乐感不同恢复轨迹相关的病变和纵向结构变化提供了更全面的图景。
