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中风患者优势半球失语症的恢复及受损弓状束的变化

Recovery of aphasia and change of injured arcuate fasciculus in the dominant hemisphere in stroke patients.

作者信息

Jang Sung Ho, Cho Ik Tae, Lim Ji Woon

机构信息

Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.

出版信息

NeuroRehabilitation. 2017;41(4):759-764. doi: 10.3233/NRE-172167.

Abstract

OBJECTIVES

We investigated the relation between recovery of aphasia and change of injured fasciculus (AF) in the dominant hemisphere using diffusion tensor tractography (DTT) in stroke patients with aphasia.

METHODS

Sixteen consecutive right-handed stroke patients with aphasia with injury of the left AF were recruited for this study. The Western Aphasia Battery for assessment of aphasia and DTTs of the AF were used within 30 days of stroke onset and again three months after. DTTs of both AFs were reconstructed, and fractional anisotropy (FA) and voxel number of the AF were measured.

RESULTS

A moderate positive correlation was observed between aphasia quotient (AQ) and voxel number of the left AF (r = 0.626, p < 0.01). However, no correlation was observed between AQ and FA of the left AF, and voxel number and FA of the right AF. In addition, the language quotient (LQ) of WAB was not correlated with FA and voxel number of the both AFs.

CONCLUSIONS

We found a relation between recovery of aphasia from early to chronic stage of stroke and recovery of the injured AF in the dominant hemisphere irrespective of change of the AF in the non-dominant hemisphere. Our results suggest that facilitation of the injured AF in the dominant hemisphere could be an important strategy in neuro-rehabilitation for stroke patients with aphasia.

摘要

目的

我们使用弥散张量纤维束成像(DTT)研究了失语症脑卒中患者优势半球损伤的弓状束(AF)恢复与变化之间的关系。

方法

本研究招募了16例连续的左AF损伤的右利手失语症脑卒中患者。在脑卒中发病30天内及3个月后分别使用西方失语成套测验评估失语症,并进行AF的DTT检查。重建双侧AF的DTT,测量AF的分数各向异性(FA)和体素数量。

结果

失语商(AQ)与左侧AF的体素数量之间存在中度正相关(r = 0.626,p < 0.01)。然而,AQ与左侧AF的FA之间、右侧AF的体素数量与FA之间均未观察到相关性。此外,西方失语成套测验的语言商(LQ)与双侧AF的FA和体素数量均无相关性。

结论

我们发现,从中风早期到慢性期失语症的恢复与优势半球损伤的AF恢复之间存在关联,而与非优势半球AF的变化无关。我们的结果表明,促进优势半球损伤的AF可能是失语症脑卒中患者神经康复的一项重要策略。

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