Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Department of Physical Medicine & Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
NeuroRehabilitation. 2021;49(1):103-117. doi: 10.3233/NRE-210125.
Mirror therapy (MT) has proven to be beneficial for treating patients suffering from motor aphasia after stroke. However, the impacts of MT on neuroplasticity remain unexplored.
In this paper we conducted a randomized controlled trial to evaluate the treatment using the MT on motor aphasia following acute cerebral infarction.
We randomly assigned 30 patients into test and control groups, with test group patients treated with MT, whereas control group patients were treated with sham MT. At 24 hours prior to and after the intervention, we obtained functional magnetic resonance imaging (fMRI) data from study subjects. At baseline, after treatment and 12-week follow-up, we additionally evaluated patients with the Modified Rankin Scale (mRS), the National Institutes of Health Stroke Scale (NIHSS), and the aphasia quotient (AQ) in the western aphasia test.
After 2 weeks of treatment, the test group demonstrated significant improvements in AQ values, naming, repetition, spontaneous speech, and mRS scores compared to the control group (P < 0.05). Furthermore, in the follow-up time point (12 weeks), we found that the test group exhibited significantly better NIHSS scores and AQ evaluation indicators than the control group (P < 0.05). Specifically, the fMRI study shows that functional connectivity significantly improved in test group patients mainly among frontal, temporal, and parietal lobes of the left hemisphere with each other than controls group. Meanwhile, we found significantly enhanced functional connectivity with the hippocampus (P < 0.01).
Our results indicate that the MT can expedite the recovery of language function during the early phases of stroke recovery. These findings may elucidate the underlying mechanism of MT and the application of this therapy as an adjunct rehabilitation technique in language recovery.
镜像疗法(MT)已被证明对治疗中风后运动性失语症患者有益。然而,其对神经可塑性的影响仍未得到探索。
本研究旨在通过随机对照试验评估 MT 对急性脑梗死后运动性失语症的治疗效果。
我们将 30 名患者随机分为试验组和对照组,试验组接受 MT 治疗,对照组接受假 MT 治疗。在干预前 24 小时和干预后,我们从研究对象中获得功能磁共振成像(fMRI)数据。在基线、治疗后和 12 周随访时,我们还使用改良 Rankin 量表(mRS)、美国国立卫生研究院卒中量表(NIHSS)和西方失语症测试中的失语商(AQ)对患者进行评估。
治疗 2 周后,试验组在 AQ 值、命名、复述、自发言语和 mRS 评分方面的改善明显优于对照组(P < 0.05)。此外,在随访时间点(12 周),我们发现试验组在 NIHSS 评分和 AQ 评估指标方面明显优于对照组(P < 0.05)。具体来说,fMRI 研究表明,与对照组相比,试验组患者的左半球额、颞、顶叶之间的功能连接显著改善,同时与海马的功能连接也显著增强(P < 0.01)。
本研究结果表明,MT 可加速中风后语言功能恢复的早期阶段。这些发现可能阐明了 MT 的潜在机制以及将该治疗方法作为语言康复的辅助康复技术的应用。