Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 200040 Shanghai, China.
Department of Rehabilitation Medicine, Jingan District Central Hospital Affiliated to Fudan University, 200040 Shanghai, China.
J Integr Neurosci. 2023 Jan 17;22(1):24. doi: 10.31083/j.jin2201024.
The left primary motor area (M1) stimulation has recently been revealed to promote post-stroke aphasia (PSA) recovery, of which a plausible mechanism might be the semantic and/or the mirror neuron system reorganization, but the direct evidence is still scarce. The aim of this study was to explore the functional connectivity (FC) alterations induced by the left M1 intermittent theta burst stimulation (iTBS), a new transcranial magnetic stimulation paradigm, in the semantic and mirror neuron systems of PSA patients.
Sixteen PSA patients accepted the left M1 iTBS and underwent a resting-state functional magnetic resonance image (fMRI) scanning before and immediately after the first session of iTBS, of which six underwent another fMRI scanning after twenty sessions of iTBS. Three brain networks covering the semantic and the mirror neuron systems were constructed using the fMRI data, and the FC alterations following one-session iTBS were investigated in the networks. Additional seed-based FC analyses were conducted to explore the longitudinal FC patterns changes during the course of multi-session iTBS. The Aphasia quotient of the Chinese version of the western aphasia battery (WAB-AQ) was used to assess the severity of the language impairments of the participants. The relationship between the longitudinal WAB-AQ and network FC changes was analyzed by Spearman's correlation coefficients in the multi-session iTBS sub-group.
Decreased FCs were noted in the bilateral semantic rather than in the mirror neuron networks following one-session of iTBS ( < 0.05, network based statistical corrected). Longitudinal seed-based FC analyses revealed changing FC ranges along the multi-session iTBS course, extending beyond the semantic networks. No significant relationship was found between the longitudinal WAB-AQ and network FC changes in the multi-session iTBS sub-group.
The left M1 iTBS might induce FC changes in the semantic system of PSA patients.
This research was registered on the Chinese Clinical Trial Registry website (http://www.chictr.org.cn/index.aspx), and the registration number is ChiCTR2100041936.
最近的研究发现，左初级运动区（M1）刺激可促进卒中后失语症（PSA）的恢复，其可能的机制可能是语义和/或镜像神经元系统的重组，但直接证据仍然缺乏。本研究旨在探讨 PSA 患者接受左 M1 间歇性 theta 爆发刺激（iTBS）后，语义和镜像神经元系统的功能连接（FC）变化。
16 名 PSA 患者接受左 M1 iTBS，并在第一次 iTBS 治疗前后进行静息态功能磁共振成像（fMRI）扫描，其中 6 名患者在 20 次 iTBS 治疗后进行了另一次 fMRI 扫描。使用 fMRI 数据构建了覆盖语义和镜像神经元系统的三个脑网络，并在网络中研究了单次 iTBS 后的 FC 变化。还进行了基于种子的 FC 分析，以探索多疗程 iTBS 过程中 FC 模式的纵向变化。使用汉语西方失语症成套测验（WAB-AQ）的失语症商数评估参与者语言障碍的严重程度。在多疗程 iTBS 亚组中，通过 Spearman 相关系数分析纵向 WAB-AQ 和网络 FC 变化之间的关系。
单次 iTBS 后，双侧语义网络而非镜像神经元网络的 FC 降低（<0.05，基于网络的统计校正）。纵向种子 FC 分析显示，随着多疗程 iTBS 疗程的进展，FC 范围发生变化，超出了语义网络。在多疗程 iTBS 亚组中，未发现纵向 WAB-AQ 和网络 FC 变化之间存在显著关系。
左 M1 iTBS 可能会导致 PSA 患者的语义系统 FC 变化。
本研究在中国临床试验注册网站（http://www.chictr.org.cn/index.aspx）注册，注册号为 ChiCTR2100041936。
