Belin P, Van Eeckhout P, Zilbovicius M, Remy P, François C, Guillaume S, Chain F, Rancurel G, Samson Y
Service Hospitalier Frédéric Joliot, DRM-CEA, Orsay, France.
Neurology. 1996 Dec;47(6):1504-11. doi: 10.1212/wnl.47.6.1504.
We examined mechanisms of recovery from aphasia in seven nonfluent aphasic patients, who were successfully treated with melodic intonation therapy (MIT) after a lengthy absence of spontaneous recovery. We measured changes in relative cerebral blood flow (CBF) with positron emission tomography (PET) during hearing and repetition of simple words, and during repetition of MIT-loaded words. Without MIT, language tasks abnormally activated right hemisphere regions, homotopic to those activated in the normal subject, and deactivated left hemisphere language zones. In contrast, repeating words with MIT reactivated Broca's area and the left prefrontal cortex, while deactivating the counterpart of Wernicke's area in the right hemisphere. The recovery process induced by MIT in these patients probably coincides with this reactivation of left prefrontal structures. In contrast, the right hemisphere regions abnormally activated during simple language tasks seem to be associated with the initial persistence of the aphasia. This study supports the idea that abnormal activation patterns in the lesioned brain are not necessarily related to the recovery process.
我们研究了7名非流利性失语患者的失语恢复机制，这些患者在长期缺乏自发恢复后成功接受了旋律语调疗法（MIT）治疗。我们用正电子发射断层扫描（PET）测量了在听和重复简单单词以及重复加载MIT的单词过程中相对脑血流量（CBF）的变化。在没有MIT的情况下，语言任务异常激活了与正常受试者激活区域同位的右半球区域，并使左半球语言区失活。相比之下，用MIT重复单词重新激活了布洛卡区和左前额叶皮层，同时使右半球韦尼克区的对应区域失活。这些患者中由MIT诱导的恢复过程可能与左前额叶结构的这种重新激活相吻合。相比之下，在简单语言任务中异常激活的右半球区域似乎与失语的最初持续存在有关。这项研究支持这样一种观点，即受损大脑中的异常激活模式不一定与恢复过程相关。
