Department of Rehabilitation, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Department of Radiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Top Stroke Rehabil. 2024 Apr;31(3):301-310. doi: 10.1080/10749357.2023.2253632. Epub 2023 Aug 31.
This study aimed to longitudinally observe the improvement mechanism of semantic fluency in subacute post-stroke aphasia (PSA) patients using resting-state functional magnetic resonance imaging (rs-fMRI).
Twelve PSA patients, about one month after onset, were enrolled in this study and received speech-language therapy (SLT) for one month. Auditory comprehension and semantic fluency were evaluated using the Western Aphasia Battery (WAB) and the Animal Fluency Test. Before and after treatment, rs-fMRI data were collected, and the dice similarity coefficient was used to measure the spatial similarity between each patient's lesion and a reference lesion. The left posterior inferior temporal gyrus (pITG) was used as a seed to calculate the normalized functional connectivity in whole-brain voxel analysis using DPABI software for statistical analysis.
The dice similarity coefficient between each patient's lesion and the reference lesion showed moderate to high intensity (0.57 ± 0.14) in the Montreal Neurological Institute space. After treatment, we found a significant increase in functional connectivity between the left pITG and the right prefrontal lobe convergence area (peak = 8.219, Gaussian random field multiple comparison correction, voxel < 0.001, cluster < 0.05). The increase in functional connectivity was negatively correlated with the improvement in auditory comprehension ( =-0.707, = 0.033) and positively correlated with the improvement in semantic fluency ( = 0.79, = 0.02).
The improvement of semantic fluency in subacute PSA patients may require the participation of the right convergence area of the prefrontal lobe.
本研究旨在通过静息态功能磁共振成像(rs-fMRI)对亚急性卒中后失语症(PSA)患者的语义流畅性改善机制进行纵向观察。
本研究纳入了 12 例 PSA 患者，在发病后约 1 个月接受言语语言治疗(SLT)1 个月。采用西方失语症成套测验(WAB)和动物流畅性测验评估听觉理解和语义流畅性。在治疗前后采集 rs-fMRI 数据，并使用 Dice 相似系数测量每位患者病变与参考病变之间的空间相似性。以左侧后下颞回(pITG)为种子，采用 DPABI 软件进行全脑体素分析，计算归一化功能连接。
每位患者病变与参考病变之间的 Dice 相似系数在蒙特利尔神经学研究所空间中表现出中等至高强度(0.57±0.14)。治疗后，我们发现左侧 pITG 与右侧前额叶汇聚区之间的功能连接显著增加(峰值=8.219，高斯随机场多重比较校正，体素<0.001，簇<0.05)。功能连接的增加与听觉理解的改善呈负相关(r=-0.707，P=0.033)，与语义流畅性的改善呈正相关(r=0.79，P=0.02)。
亚急性 PSA 患者语义流畅性的改善可能需要前额叶右侧汇聚区的参与。
