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失语症恢复过程中胼胝体的变化:一例报告。

Changes in the corpus callosum during the recovery of aphasia: A case report.

作者信息

Yu Qiwei, Yang Weixin, Liu Yi, Wang Hong, Chen Zhuoming, Yan Jiajian

机构信息

Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China.

出版信息

Medicine (Baltimore). 2018 Jun;97(24):e11155. doi: 10.1097/MD.0000000000011155.

Abstract

RATIONALE

The corpus callosum, which is the most important fiber pathway linking the bilateral hemispheres, plays a key role in information access, as well as the functional coordination and reorganization between the bilateral hemispheres. However, whether the corpus callosum will undergo structural changes during the recovery of aphasia is still unclear. In the current study, a Chinese aphasic patient with stroke was reported to develop changes in the corpus callosum after speech therapy.

PATIENT CONCERNS

A 33-year-old right-handed male patient had aphasia only without limb paralysis at 14 months after stroke.

DIAGNOSES

Neuroimaging evaluation confirmed a diagnosis of cerebral infarction in the left frontal lobe, insula and basal ganglia.

INTERVENTIONS

He underwent 5-month speech therapy and received language function evaluation and DTI examination before and after speech therapy.

OUTCOMES

The result ABC showed that the language functions in the patient, including spontaneous speech, auditory comprehension, repetition and naming, were improved after the speech therapy. In addition, results of follow-up DTT suggested that the fiber pathway between the splenium of corpus callosum and the left superior temporal gyrus (Wernicke's area) had been established. At the same time, fiber connections between the genu of corpus callosum and the right inferior frontal gyrus (the mirror region of Broca's area) were increased.

LESSONS

The fibrous structure between the corpus callosum and cortical language areas may be reconstructed during the recovery of aphasia. In addition, and the corpus callosum may play an important role in the occurrence and recovery of aphasia after stroke.

摘要

理论依据

胼胝体是连接双侧半球的最重要纤维通路,在信息获取以及双侧半球之间的功能协调与重组中起关键作用。然而,失语恢复过程中胼胝体是否会发生结构变化仍不清楚。在本研究中,报道了一名中国失语症中风患者在言语治疗后胼胝体出现变化。

患者情况

一名33岁右利手男性患者,中风后14个月仅患有失语症,无肢体瘫痪。

诊断

神经影像学评估确诊为左侧额叶、岛叶和基底节区脑梗死。

干预措施

他接受了5个月的言语治疗,并在言语治疗前后接受了语言功能评估和DTI检查。

结果

ABC结果显示,言语治疗后患者的语言功能,包括自发言语、听觉理解、复述和命名,均得到改善。此外,后续DTT结果表明,胼胝体压部与左侧颞上回(韦尼克区)之间的纤维通路已经建立。同时,胼胝体膝部与右侧额下回(布洛卡区的镜像区域)之间的纤维连接增加。

经验教训

失语恢复过程中,胼胝体与皮质语言区之间的纤维结构可能会重建。此外,胼胝体可能在中风后失语的发生和恢复中起重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8e4/6023720/bb40f26cedc6/medi-97-e11155-g001.jpg

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本文引用的文献

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Aphasia due to isolated infarction of the corpus callosum.胼胝体孤立性梗死所致失语症。
BMJ Case Rep. 2014 Jun 12;2014:bcr2014204316. doi: 10.1136/bcr-2014-204316.
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Crossed aphasia following an infarction in the right corpus callosum.右侧胼胝体梗死继发交叉性失语。
Clin Neurol Neurosurg. 2012 Feb;114(2):161-5. doi: 10.1016/j.clineuro.2011.09.009. Epub 2011 Oct 17.

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