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我们从失语症恢复中能学到什么?

What do we learn from recovery from aphasia?

作者信息

Kertesz A

机构信息

Research Institute, St. Joseph's Hospital, University of Western Ontario, London, Canada.

出版信息

Adv Neurol. 1988;47:277-92.

PMID:3344630
Abstract
  1. Recovery rates are different from outcome measures, and therefore paradoxically positive correlation between the recovery of comprehension and lesion size can be found particularly in Broca's aphasia or in populations that are skewed toward nonfluent aphasics. 2. Outcome, in terms of recovery from aphasia, correlates significantly with lesion size in the expected direction regardless of initial severity for the total aphasic group, but not as much in Wernicke's aphasia. 3. Outcome correlates well with initial test scores, but, particularly in Broca's aphasics, lesion size is as good a predictor as initial severity. 4. The rate of recovery differs in different types of aphasia, and Broca's aphasics recover most. 5. The initial recovery period between 0 and 3 months is significantly steeper than subsequent periods, but it does not correlate as well as outcome with lesion size. 6. Cerebral asymmetry or torque may be less typical in more recovered Broca's aphasics, but this failed to reach statistical significance and seems not be a factor for Wernicke's aphasics. 7. Age and gender are not as significant as lesion size and location. 8. Surrounding intact ipsilateral structures are more important for the recovery of some of the language functions, such as motor output and phonemic assembly, than homologous contralateral structures. Comprehension and semantic processing may have more contralateral or right hemisphere compensation than other language functions.
摘要
  1. 恢复率与结果测量指标不同,因此,尤其在布罗卡失语症或偏向非流畅性失语症患者群体中,可发现理解能力恢复与病变大小之间存在反常的正相关。2. 就失语症恢复情况而言,无论失语症患者总体的初始严重程度如何,结果与病变大小在预期方向上显著相关,但在韦尼克失语症中并非如此。3. 结果与初始测试分数相关性良好,但尤其在布罗卡失语症患者中,病变大小与初始严重程度一样是良好的预测指标。4. 不同类型失语症的恢复率不同,布罗卡失语症患者恢复得最多。5. 0至3个月的初始恢复期比后续时期明显更陡峭,但它与病变大小的相关性不如结果与病变大小的相关性好。6. 在恢复较好的布罗卡失语症患者中,大脑不对称或扭矩可能不太典型,但这未达到统计学显著性,且似乎不是韦尼克失语症患者的一个因素。7. 年龄和性别不如病变大小和位置重要。8. 对于某些语言功能的恢复,如运动输出和音素组合,周围完整的同侧结构比同源对侧结构更重要。与其他语言功能相比,理解和语义处理可能有更多的对侧或右半球代偿。

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