Zhang Jie, Zhong Shuchang, Zhou Liang, Yu Yamei, Tan Xufei, Wu Min, Sun Peng, Zhang Wei, Li Juebao, Cheng Ruidong, Wu Yanfei, Yu Yanmei, Ye Xiangming, Luo Benyan
Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, Peoples Hospital of Hangzhou Medical College, Hangzhou, P. R. China.
Department of Neurology & Brain Medical Centre, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China.
Neuropsychol Rev. 2021 Sep;31(3):402-418. doi: 10.1007/s11065-021-09482-8. Epub 2021 Mar 3.
While converging evidence suggests linguistic roles of white matter tracts, detailed associations between white matter alterations of dual pathways and language abilities remain unknown in aphasic patients. We aimed to verify language functions of dual-pathway tracts from specific domains and investigate the influence of moderators. PubMed, Web of Science, Embase, and CENTRAL were searched for studies published between January 1, 1985 and March 17, 2019. A meta-analysis of 46 studies including 1353 aphasic patients was performed by pooling correlation coefficients between linguistic domains and diffusion metrics of dual-pathway tracts. Among these tracts, the fractional anisotropy (FA) value of the left inferior fronto-occipital fasciculus predominated across most linguistic aspects, showing the strongest correlations with global severity, comprehension, naming and reading ability. The left uncinate fasciculus and inferior longitudinal fasciculus also showed significant FA - comprehension correlations. For syntactic processing, FA values of the left superior longitudinal fasciculus and arcuate fasciculus showed significant positive correlations. Meta-regression revealed no influence of etiology on FA - language correlations, while sex had a moderating effect on the FA - comprehension correlation of the arcuate fasciculus, and age influenced the FA - naming correlation in the superior longitudinal fasciculus. In conclusion, multifunctional characteristics of tracts were revealed in aphasic patients, including broad linguistic associations of the inferior fronto-occipital fasciculus, and repetition and syntactic involvement of the arcuate fasciculus. Language associations of the inferior longitudinal fasciculus and uncinate fasciculus were clarified regarding comprehension subdomains. The insignificant moderating effect of the etiology indicates damage of dual pathways is the common neural mechanism, while sex and age influence the correlation with comprehension and naming ability, respectively, in specific tracts.
虽然越来越多的证据表明白质束具有语言功能，但在失语症患者中，双通路白质改变与语言能力之间的详细关联仍不清楚。我们旨在验证特定领域双通路束的语言功能，并研究调节因素的影响。检索了PubMed、Web of Science、Embase和CENTRAL中1985年1月1日至2019年3月17日发表的研究。通过汇总语言领域与双通路束扩散指标之间的相关系数，对46项研究（包括1353名失语症患者）进行了荟萃分析。在这些束中，左侧额枕下束的分数各向异性（FA）值在大多数语言方面占主导地位，与整体严重程度、理解、命名和阅读能力的相关性最强。左侧钩束和下纵束也显示出显著的FA与理解的相关性。对于句法处理，左侧上纵束和弓状束的FA值显示出显著的正相关。荟萃回归显示病因对FA与语言的相关性没有影响，而性别对弓状束的FA与理解的相关性有调节作用，年龄影响上纵束的FA与命名的相关性。总之，在失语症患者中揭示了束的多功能特征，包括额枕下束广泛的语言关联，以及弓状束的重复和句法参与。关于理解子领域，阐明了下纵束和钩束的语言关联。病因的调节作用不显著表明双通路损伤是常见的神经机制，而性别和年龄分别影响特定束与理解和命名能力的相关性。
