Stilling Joan, Kim Ji Hyun, Cust Sarah, Keser Zafer, Murter Jamie L, Tippet Donna C, Hillis Argye E, Sebastian Rajani
Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, New York, USA.
Brain Connect. 2025 Feb;15(1):40-54. doi: 10.1089/brain.2023.0087. Epub 2024 Nov 12.
The influence of the cerebellum in poststroke aphasia recovery is poorly understood. Despite the right cerebellum being identified as a critical region involved in both language and cognitive functions, little is known about functional connections between the cerebellum and bilateral cortical hemispheres following stroke. This study investigated the relationship between chronic poststroke naming deficits and cerebello-cerebral resting-state functional connectivity (FC). Twenty-five cognitively normal participants and 42 participants with chronic poststroke aphasia underwent resting-state functional magnetic resonance imaging. Participants with aphasia also underwent language assessment. We conducted regions of interest (ROI)-to-ROI analyses to investigate the FC between the right cerebellar Crus I/II (seed ROI; Cereb1r/Cereb2r) and bilateral cortical language regions and compared these results to cognitively normal controls. Single-subject connectivity parameters were extracted and used as independent variables in a stepwise multiple linear regression model associating Boston Naming Test (BNT) score with FC measures. FC analyses demonstrated correlations between the right cerebellar Crus I/II and both left and right cortical regions for both cognitively normal controls and stroke participants. Additionally, aphasia severity and lesion load had an effect on the cerebello-cerebral network connectivity in participants with aphasia. In a stepwise multiple linear regression, controlling for aphasia severity, time poststroke and lesion load, FC between the right Cereb2-left Cereb1 (standardized beta [std B]= -0.255, < 0.004), right Cereb2-right anterior MTG (std B = 0.259, < 0.004), and the right Cereb2-left anterior STG (std = -0.208, < 0.018) were significant predictors of BNT score. The overall model fit was = 0.786 ( = 0.001). Functional connections between the right cerebellum and residual bilateral cerebral hemisphere regions may play a role in predicting naming ability in poststroke aphasia.
小脑在中风后失语症恢复中的影响尚不清楚。尽管右侧小脑被确定为参与语言和认知功能的关键区域,但对于中风后小脑与双侧皮质半球之间的功能连接却知之甚少。本研究调查了慢性中风后命名缺陷与小脑 - 大脑静息态功能连接(FC)之间的关系。25名认知正常的参与者和42名患有慢性中风后失语症的参与者接受了静息态功能磁共振成像检查。失语症参与者还接受了语言评估。我们进行了感兴趣区域(ROI)到ROI的分析,以研究右侧小脑 Crus I/II(种子ROI;Cereb1r/Cereb2r)与双侧皮质语言区域之间的FC,并将这些结果与认知正常的对照组进行比较。提取单受试者连接参数,并将其用作逐步多元线性回归模型中的自变量,该模型将波士顿命名测试(BNT)分数与FC测量值相关联。FC分析表明,认知正常的对照组和中风参与者的右侧小脑 Crus I/II与左右皮质区域之间均存在相关性。此外,失语症严重程度和病变负荷对失语症参与者的小脑 - 大脑网络连接有影响。在逐步多元线性回归中,控制失语症严重程度、中风后时间和病变负荷,右侧Cereb2 - 左侧Cereb1之间的FC(标准化β[std B]= -0.255,<0.004)、右侧Cereb2 -右侧前颞中回(std B = 0.259,<0.004)以及右侧Cereb2 - 左侧前颞上回(std = -0.208,<0.018)是BNT分数的显著预测因子。总体模型拟合度为 = 0.786( = 0.001)。右侧小脑与残余双侧大脑半球区域之间的功能连接可能在预测中风后失语症的命名能力中起作用。