结构性网络拓扑与卒中后失语症强化语言治疗后的命名改善相关。
Structural network topology associated with naming improvements following intensive aphasia therapy in post-stroke aphasia.
机构信息
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
出版信息
J Neurol Sci. 2024 Jul 15;462:123065. doi: 10.1016/j.jns.2024.123065. Epub 2024 May 28.
A stroke can disrupt the finely tuned language network resulting in aphasia, a language impairment. Though many stroke survivors with aphasia recover within the first 6 months, a significant proportion have lasting deficits. The factors contributing to optimal treatment response remain unclear. Some evidence suggests that increased modularity or fragmentation of brain networks may underlie post-stroke aphasia severity and the extent of recovery. We examined associations between network organization and aphasia recovery in sixteen chronic stroke survivors with non-fluent aphasia following 35 h of Multi-Modality Aphasia Therapy over 10 days and 20 healthy controls who underwent imaging at a single timepoint. Using diffusion-weighted scans obtained before and after treatment, we constructed whole-brain structural connectomes representing the number of probabilistic streamlines between brain regions. Graph theory metrics were quantified for each connectome using the Brain Connectivity Toolbox. Correlations were examined between graph metrics and speech performance measured using the Boston Naming Test (BNT) at pre-, post- and 3-months post-intervention. Compared to controls, participants with stroke demonstrated higher whole-brain modularity at pre-treatment. Modularity did not differ between pre- and post-treatment. In individuals who responded to therapy, higher pre-treatment modularity was associated with worse performance on the BNT. Moreover, higher pre-treatment participation coefficients (i.e., how well a region is connected outside its own module) for the left IFG, planum temporale, and posterior temporal gyri were associated with greater improvements at post-treatment. These results suggest that pre-treatment network topology may impact therapeutic gains, highlighting the influence of network organization on post-stroke aphasia recovery.
中风可能会破坏精细调节的语言网络,导致失语症,即语言障碍。尽管许多中风后失语症患者在最初的 6 个月内会恢复,但仍有相当一部分患者存在持久的缺陷。导致最佳治疗效果的因素仍不清楚。一些证据表明,大脑网络的模块化或碎片化增加可能是中风后失语症严重程度和恢复程度的基础。我们研究了十六名非流利性失语症慢性中风幸存者在接受 10 天 35 小时多模态失语症治疗和 20 名健康对照者在单次成像后的网络组织与失语症恢复之间的关联。使用治疗前后获得的扩散加权扫描,我们构建了代表大脑区域之间概率流线数量的全脑结构连接组。使用 Brain Connectivity Toolbox 量化了每个连接组的图论指标。使用波士顿命名测试(BNT)在治疗前、治疗后和治疗后 3 个月测量的言语表现与图论指标之间进行了相关性分析。与对照组相比,中风患者在治疗前的全脑模块化程度较高。治疗前和治疗后的模块化程度没有差异。在对治疗有反应的个体中,较高的治疗前模块化程度与 BNT 表现较差相关。此外,左额下回、颞上回和颞后回的较高治疗前参与系数(即一个区域与其自身模块外的连接程度)与治疗后更大的改善相关。这些结果表明,治疗前的网络拓扑结构可能会影响治疗效果,突出了网络组织对中风后失语症恢复的影响。