Department of Neurology, Beijing Tiantan Hospital, Capital Medical University , Beijing, China.
Department of Neurology, Tianjin First Central Hospital , Tianjin, China.
Neurol Res. 2020 Aug;42(8):640-648. doi: 10.1080/01616412.2020.1795578. Epub 2020 Jul 22.
Post-stroke aphasia (PSA) often have non-linguistic cognitive impairment. We aimed to ascertain its characteristics of non-linguistic cognitive impairment and the corresponding changes in white matter microstructures.
Ten patients with PSA and 17 healthy controls (HCs) were enrolled. Loewenstein occupational therapy cognitive assessment (LOTCA) were used to assess non-linguistic cognitive function. Summary T-test was performed to compare the LOTCA scores between PSA and the Chinese norm. Tract-based spatial statistics (TBSS) was used to calculate fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) after collecting diffusion tensor imaging data. Correlation analysis was performed between these metrics and LOTCA scores.
The days after stroke onset of PSA was 428.0±52.0. The total LOTCA score of PSA (78.20±22.63) was lower than the Chinese norm (97.65±16.24, =0.003), as well as the scores of orientation, spatial perception (SP), motor praxis (MP), and attention (<0.05). Lower FA and higher MD/RD in bilateral inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), and left superior longitudinal fasciculus (SLF) were found in PSA compared with HCs. The MD and RD of the right uncinate fasciculus (UF) was negatively correlated with SP and MP scores (=-0.787, =-0.733, =-0.726; <0.05). The FA of left UF was negatively correlated with orientation score (=-0.690, =0.04).
Patients with PSA have non-linguistic cognitive impairment. The integrity of the white matter microstructures can be extensively damaged. Impaired SP and MP in patients with PSA are related to UF damage.
脑卒中后失语症（PSA）常伴有非语言认知障碍。本研究旨在确定 PSA 患者非语言认知障碍的特点及其对应的白质微观结构的变化。
共纳入 10 例 PSA 患者和 17 例健康对照者（HCs）。采用洛文斯顿作业疗法认知评定量表（LOTCA）评估非语言认知功能。采用单样本 t 检验比较 PSA 患者与中国常模的 LOTCA 评分。收集扩散张量成像数据后，采用基于体素的空间统计学（TBSS）计算各向异性分数（FA）、平均扩散系数（MD）和径向扩散系数（RD）。并对这些指标与 LOTCA 评分进行相关性分析。
PSA 患者的发病后天数为 428.0±52.0。PSA 患者的 LOTCA 总分（78.20±22.63）低于中国常模（97.65±16.24，=0.003），以及定向力、空间感知（SP）、运动执行（MP）和注意力得分（<0.05）。与 HCs 相比，PSA 患者双侧下额枕束（IFOF）、下纵束（ILF）和左侧上纵束（SLF）的 FA 值降低，MD 和 RD 值升高。右侧钩束（UF）的 MD 和 RD 值与 SP 和 MP 评分呈负相关（=-0.787，=-0.733，=-0.726；<0.05）。左侧 UF 的 FA 值与定向力评分呈负相关（=-0.690，=0.04）。
PSA 患者存在非语言认知障碍，白质微观结构的完整性可能广泛受损。PSA 患者的 SP 和 MP 受损与 UF 损伤有关。
