Sul Bomi, Lee Kyoung Bo, Hong Bo Young, Kim Joon Sung, Kim Jaewon, Hwang Woo Seop, Lim Seong Hoon
Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Front Neurol. 2019 Jul 24;10:776. doi: 10.3389/fneur.2019.00776. eCollection 2019.
Recovery from post-stroke aphasia is important for performing the activities of daily life, returning to work, and quality of life. We investigated the association between specific brain lesions and the long-term outcome of four dimensions of aphasia: fluency, comprehension, naming, and repetition 12 months after onset in patients with stroke. Our retrospective cross-sectional observational study investigated the relationship between the Korean version of the Western Aphasia Battery scores in 31 stroke patients 1 year after the onset of stroke and stroke lesion location. Brain lesions were assessed using voxel-based lesion symptom mapping (VLSM) in conjunction with magnetic resonance imaging. Damage to the Rolandic cortex, Heschl's gyrus, the posterior corona radiata, supramarginal cortex, superior longitudinal fasciculus, superior temporal gyrus, and insula was associated with a low total AQ score. Lesions in the inferior triangularis and inferior operculum of the frontal cortex, supramarginal cortex, and insula were associated with a poor fluency outcome. Damage to the parietal cortex, angular cortex, temporal middle cortex, sagittal stratum, and temporal superior cortex was associated with poor recovery of comprehension skills. Lesions in the angular cortex, supramarginal cortex, posterior corona radiata, superior longitudinal fasciculus, internal capsule, temporal superior cortex, and temporal middle cortex were associated with poor recovery of naming in patients with stroke. Damage to the superior temporal cortex, posterior corona radiata, and superior longitudinal fasciculus was associated with poor recovery of repetition component. We identified specific brain lesions associated with long-term outcomes in four dimensions of aphasia, in patients with post-stroke aphasia. Our findings may be useful for advancing understanding for the pathophysiology of aphasia in stroke patients.
中风后失语症的恢复对于开展日常生活活动、重返工作岗位以及提高生活质量都很重要。我们调查了特定脑损伤与中风患者发病12个月后失语症四个维度(流畅性、理解、命名和复述)的长期预后之间的关联。我们的回顾性横断面观察研究调查了31例中风患者发病1年后西方失语症成套测验韩语版得分与中风损伤部位之间的关系。结合磁共振成像,使用基于体素的损伤症状映射(VLSM)评估脑损伤。中央前回、颞横回、放射冠后部、缘上回、上纵束、颞上回和脑岛受损与失语症总体AQ得分较低有关。额叶下回三角部和额下回岛盖部、缘上回和脑岛的损伤与流畅性预后不良有关。顶叶皮质、角回皮质、颞中皮质、矢状层和颞上皮质受损与理解能力恢复不佳有关。角回、缘上回、放射冠后部、上纵束、内囊、颞上皮质和颞中皮质的损伤与中风患者命名能力恢复不佳有关。颞上皮质、放射冠后部和上纵束受损与复述能力恢复不佳有关。我们确定了与中风后失语症患者失语症四个维度长期预后相关的特定脑损伤。我们的研究结果可能有助于增进对中风患者失语症病理生理学的理解。