Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, New Jersey.
Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, New Jersey.
Hum Brain Mapp. 2019 Dec 15;40(18):5301-5314. doi: 10.1002/hbm.24773. Epub 2019 Aug 26.
Better understanding of cerebral blood flow (CBF) perfusion in stroke recovery can help inform decisions about optimal timing and targets of restorative treatments. In this study, we examined the relationship between cerebral perfusion and recovery from stroke-induced reading deficits. Left stroke patients were tested with a noninvasive CBF measure (arterial spin labeling) <5 weeks post-stroke, and a subset had follow up testing >3 months post-stroke. We measured blood flow perfusion within the left and right sides of the brain, in areas surrounding the lesion, and areas belonging to the reading network. Two hypotheses were tested. The first was that recovery of reading function depends on increased perfusion around the stroke lesion. This hypothesis was not supported by our findings. The second hypothesis was that increased perfusion of intact areas within the reading circuit is tightly coupled with recovery. Our findings are consistent with this hypothesis. Specifically, higher perfusion in the left reading network measured during the subacute stroke period predicted better reading ability and phonology competence in the chronic period. In contrast, higher perfusion of the right homologous regions was associated with decreased reading accuracy and phonology competence in the subacute and chronic periods. These findings suggest that recovery of reading and language competence may rely on improved blood flow in the reading network of the language-dominant hemisphere.
更好地了解中风后大脑血流 (CBF) 灌注有助于为最佳治疗时机和目标提供决策依据。在这项研究中，我们研究了脑灌注与中风引起的阅读障碍恢复之间的关系。左脑中风患者在中风后 5 周内接受了非侵入性 CBF 测量（动脉自旋标记），其中一部分患者在中风后 3 个月以上进行了随访测试。我们测量了大脑左右两侧、病变周围区域和阅读网络所属区域的血流灌注。我们检验了两个假设。第一个假设是阅读功能的恢复取决于中风病灶周围的灌注增加。我们的研究结果不支持这一假设。第二个假设是阅读回路未受损区域的灌注增加与恢复密切相关。我们的研究结果与这一假设一致。具体来说，在亚急性期中风期间测量到的左阅读网络中较高的灌注水平预示着慢性期阅读能力和语音能力的提高。相比之下，亚急性期和慢性期右同源区域的灌注较高与阅读准确性和语音能力下降相关。这些发现表明，阅读和语言能力的恢复可能依赖于语言优势半球阅读网络中血流的改善。
