1 The University of Queensland, St Lucia, Queensland, Australia.
2 Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Neurorehabil Neural Repair. 2019 Mar;33(3):167-178. doi: 10.1177/1545968319829454. Epub 2019 Feb 13.
Stroke is the third leading cause of death in the developed world and the primary cause of adult disability. The most common site of stroke is the middle cerebral artery (MCA), an artery that supplies a range of areas involved in both language and motor function. As a consequence, many stroke patients experience a combination of language and motor deficits. Indeed, those suffering from Broca's aphasia have an 80% chance of also suffering hemiplegia. Despite the prevalence of multifaceted disability in patients, the current trend in both clinical trials and clinical practice is toward compartmentalization of dysfunction. In this article, we review evidence that aphasia and hemiplegia do not just coexist, but that they interact. We review a number of clinical reports describing how therapies for one type of deficit can improve recovery in the other and vice versa. We go on to describe how language deficits should be seen as a warning to clinicians that the patient is likely to experience motor impairment and slower motor recovery, aiding clinicians to optimize their choice of therapy. We explore these findings and offer a tentative link between language and arm function through their shared need for sequential action, which we term fluency. We propose that area BA44 (part of Broca's area) acts as a hub for fluency in both movement and language, both in terms of production and comprehension.
中风是发达国家的第三大致死原因，也是成年人残疾的主要原因。中风最常见的部位是大脑中动脉（MCA），该动脉供应一系列涉及语言和运动功能的区域。因此，许多中风患者同时存在语言和运动功能缺陷。事实上，患有布洛卡失语症的患者有 80%的几率同时患有偏瘫。尽管患者存在多方面的残疾，但目前临床试验和临床实践的趋势是将功能障碍分开。在本文中，我们回顾了证据，表明失语症和偏瘫不仅共存，而且相互作用。我们回顾了许多临床报告，描述了一种类型的缺陷的治疗如何改善另一种缺陷的恢复，反之亦然。我们接着描述了语言缺陷如何被视为临床医生的警告，即患者可能会出现运动障碍和较慢的运动恢复，帮助临床医生优化治疗选择。我们探讨了这些发现，并通过它们对连续动作的共同需求，即我们所说的流畅性，提出了语言和手臂功能之间的暂时联系。我们提出，BA44 区（布洛卡区的一部分）作为运动和语言流畅性的枢纽，在生成和理解方面都是如此。
