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额斜束在言语和语言处理中的独特作用。

The unique role of the frontal aslant tract in speech and language processing.

机构信息

School of Medicine, New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA; Center for Language, Imaging, Mind & Brain, VA Northern California Healthcare System, Martinez, CA, USA.

Center for Language, Imaging, Mind & Brain, VA Northern California Healthcare System, Martinez, CA, USA.

出版信息

Neuroimage Clin. 2022;34:103020. doi: 10.1016/j.nicl.2022.103020. Epub 2022 Apr 26.

Abstract

The frontal aslant tract (FAT) is a recently described intralobar tract that connects the superior and inferior frontal gyri. The FAT has been implicated in various speech and language processes and disorders, including motor speech impairments, stuttering disorders, opercular syndrome, and verbal fluency, but the specific function(s) of the FAT have yet to be elucidated. In the current study, we aimed to address this knowledge gap by investigating the underlying role that the FAT plays in motor aspects of speech and language abilities in post-stroke aphasia. Our goals were three-fold: 1) To identify which specific motor speech or language abilities are impacted by FAT damage by utilizing a powerful imaging analysis method, High Angular Resolution Diffusion Imaging (HARDI) tractography; 2) To determine whether damage to the FAT is associated with functional deficits on a range of motor speech and language tasks even when accounting for cortical damage to adjacent cortical regions; and 3) To explore whether subsections of the FAT (lateral and medial segments) play distinct roles in motor speech performance. We hypothesized that damage to the FAT would be most strongly associated with motor speech performance in comparison to language tasks. We analyzed HARDI data from thirty-three people with aphasia (PWA) with a history of chronic left hemisphere stroke. FAT metrics were related to scores on several speech and language tests: the Motor Speech Evaluation (MSE), the Western Aphasia Battery (WAB) aphasia quotient and subtests, and the Boston Naming Test (BNT). Our results indicated that the integrity of the FAT was strongly associated with the MSE as predicted, and weakly negatively associated with WAB subtest scores including Naming, Comprehension, and Repetition, likely reflecting the fact that performance on these WAB subtests is associated with damage to posterior areas of the brain that are unlikely to be damaged with a frontal lesion. We also performed hierarchical stepwise regressions to predict language function based on FAT properties and lesion load to surrounding cortical areas. After accounting for the contributions of the inferior frontal gyrus, the ventral precentral gyrus, and the superior precentral gyrus of the insula, the FAT still remained a significant predictor of MSE apraxia scores. Our results further showed that the medial and lateral subsections of the FAT did not appear to play distinct roles but rather may indicate normal anatomical variations of the FAT. Overall, current results indicate that the FAT plays a specific and unique role in motor speech. These results further our understanding of the role that white matter tracts play in speech and language.

摘要

额斜裂束(FAT)是最近描述的一种连接额上回和额下回的叶内束。FAT 与各种言语和语言过程及障碍有关,包括运动性言语障碍、口吃障碍、外侧裂综合征和言语流畅性,但 FAT 的具体功能尚未阐明。在目前的研究中,我们旨在通过研究 FAT 在中风后失语症的言语和语言运动方面的作用来填补这一知识空白。我们的目标有三个:1)利用强大的成像分析方法——高角度分辨率扩散成像(HARDI)束追踪术,确定哪些特定的运动言语或语言能力受到 FAT 损伤的影响;2)确定即使考虑到相邻皮质区域的皮质损伤,FAT 损伤是否与一系列运动言语和语言任务的功能缺陷相关;3)探讨 FAT 的各个部分(外侧和内侧部分)在运动言语表现中是否发挥不同的作用。我们假设与语言任务相比,FAT 的损伤与运动言语表现的相关性最强。我们分析了 33 名有中风病史的慢性左侧大脑半球失语症患者的 HARDI 数据。FAT 指标与多项言语和语言测试的得分相关:言语运动评估(MSE)、西方失语症成套测验(WAB)失语商和子测验,以及波士顿命名测验(BNT)。我们的结果表明,正如预测的那样,FAT 的完整性与 MSE 高度相关,与 WAB 子测验的得分呈弱负相关,包括命名、理解和复述,这可能反映了这样一个事实,即这些 WAB 子测验的表现与大脑后部区域的损伤有关,而这些区域不太可能因额叶损伤而受损。我们还进行了分层逐步回归分析,以根据 FAT 特性和对周围皮质区域的损伤负荷来预测语言功能。在考虑了额下回、腹侧中央前回和岛叶上中央前回的贡献后,FAT 仍然是 MSE 失用评分的重要预测因子。我们的结果还表明,FAT 的内侧和外侧部分似乎没有发挥不同的作用,而是可能表明 FAT 的正常解剖变异。总的来说,目前的结果表明 FAT 在运动性言语中起着特定和独特的作用。这些结果进一步加深了我们对白质束在言语和语言中的作用的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ea5/9095886/b4c45d43e418/gr1.jpg

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