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急性和亚急性脑卒中后失语症的静息态连通性:一项近红外功能光谱的初步研究。

Resting-State Connectivity in Acute and Subacute Poststroke Aphasia: A Functional Near-Infrared Spectroscopy Pilot Study.

机构信息

Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA.

Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, USA.

出版信息

Brain Connect. 2023 Oct;13(8):441-452. doi: 10.1089/brain.2022.0065. Epub 2023 May 15.

Abstract

Understanding how brain function and language skills change during early (acute and subacute) stroke phases is critical for maximizing patient recovery, yet functional neuroimaging studies of early aphasia are scarce. In this pilot study, we used functional near-infrared spectroscopy (fNIRS) to investigate how resting-state functional connectivity (rs-FC) in early aphasia differs from neurologically healthy adults and is related to language deficits. Twenty individuals with aphasia (12 acute and 8 subacute phase) and 15 healthy controls underwent rs-fNIRS imaging with a 46-channel montage centered over bilateral perisylvian language areas. FC was computed using a prewhitening, autoregressive Pearson correlation routine applied to preprocessed oxyhemoglobin (HbO) data. Connections were classified as left intra-, right intra-, or interhemispheric. We then compared rs-FC between groups by connection type and examined Spearman correlations between rs-FC averages and language measures within patients. Participants in the acute phase had significantly reduced global rs-FC across all HbO-based connections compared to healthy controls. No significant differences were found in rs-FC between controls and patients in the subacute phase. Controlling for days since stroke, stronger right intra- and interhemispheric rs-FC was related to milder aphasia across all patients. Exploratory correlations revealed that relationships between language measures and rs-FC differed between acute and subacute patient groups. This study provides preliminary evidence that fNIRS-based rs-FC measures may be a viable metric to index the early impacts of stroke in people with aphasia.

摘要

了解大脑功能和语言技能在早期(急性和亚急性)中风阶段的变化对于最大限度地提高患者康复至关重要,但早期失语症的功能神经影像学研究却很少。在这项初步研究中,我们使用功能近红外光谱(fNIRS)来研究早期失语症的静息态功能连接(rs-FC)如何与神经健康成年人不同,以及与语言缺陷的关系。20 名失语症患者(12 名急性和 8 名亚急性)和 15 名健康对照者接受了 rs-fNIRS 成像,采用 46 通道的装置,以双侧大脑语言区为中心。FC 使用预白化、自回归 Pearson 相关程序应用于预处理的氧合血红蛋白(HbO)数据计算。连接被分类为左内、右内或半球间。然后,我们通过连接类型比较了组间的 rs-FC,并在患者内检查了 rs-FC 平均值与语言测量之间的 Spearman 相关性。与健康对照组相比,急性组患者在所有基于 HbO 的连接中,全局 rs-FC 显著降低。在亚急性组中,对照组和患者之间的 rs-FC 没有显著差异。控制中风后的天数,所有患者的右侧内和半球间 rs-FC 越强,失语症越轻。探索性相关性表明,语言测量与 rs-FC 之间的关系在急性和亚急性患者组之间存在差异。这项研究提供了初步证据,表明基于 fNIRS 的 rs-FC 测量可能是一种可行的指标,用于评估失语症患者中风的早期影响。

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