Naeser M A, Baker E H, Palumbo C L, Nicholas M, Alexander M P, Samaraweera R, Prete M N, Hodge S M, Weissman T
Department of Neurology, Boston University School of Medicine and the Harold Goodglass Aphasia Research Center at the Department of Veterans Affairs Medical Center, Mass, USA.
Arch Neurol. 1998 Nov;55(11):1438-48. doi: 10.1001/archneur.55.11.1438.
To test whether lesion site patterns in patients with chronic, severe aphasia who have no meaningful spontaneous speech are predictive of outcome following treatment with a nonverbal, icon-based computer-assisted visual communication (C-ViC) program.
Retrospective study in which computed tomographic scans performed 3 months after onset of stroke and aphasia test scores obtained before C-ViC therapy were reviewed for patients after receiving C-ViC treatment.
A neurology department and speech pathology service of a Department of Veterans Affairs medical center and a university aphasia research center.
Seventeen patients with stroke and severe aphasia who began treatment with C-ViC from 3 months to 10 years after onset of stroke.
Level of ability to use C-ViC on a personal computer to communicate.
All patients with bilateral lesions failed to learn C-ViC. For patients with unilateral left hemisphere lesion sites, statistical analyses accurately discriminated between those who could initiate communication with C-ViC from those who were only able to answer directed questions. The critical lesion areas involved temporal lobe structures (Wernicke cortical area and the subcortical temporal isthmus), supraventricular frontal lobe structures (supplementary motor area or cingulate gyrus 24), and the subcortical medial subcallosal fasciculus, deep to the Broca area. Specific lesion sites were also identified for appropriate candidacy for C-ViC.
Lesion site patterns on computed tomographic scans are helpful to define candidacy for C-ViC training, and to predict outcome level. A practical method is presented for clinical application of these lesion site results in combination with aphasia test scores.
测试慢性重度失语且无有意义自发言语的患者的病灶部位模式是否能预测非言语、基于图标的计算机辅助视觉交流（C-ViC）程序治疗后的结果。
回顾性研究，对接受C-ViC治疗后的患者，复查其卒中发病3个月后进行的计算机断层扫描以及C-ViC治疗前获得的失语测试分数。
一家退伍军人事务医疗中心的神经内科和言语病理学服务部门以及一所大学的失语研究中心。
17名卒中后出现重度失语的患者，他们在卒中发病3个月至10年后开始接受C-ViC治疗。
在个人电脑上使用C-ViC进行交流的能力水平。
所有双侧病灶患者均未能学会C-ViC。对于单侧左半球病灶部位的患者，统计分析能够准确区分哪些患者可以通过C-ViC开始交流，哪些患者只能回答定向问题。关键病灶区域包括颞叶结构（韦尼克皮质区和皮质下颞峡）、脑室上额叶结构（辅助运动区或扣带回24）以及位于布洛卡区深部的皮质下内侧胼胝体下束。还确定了适合C-ViC治疗的特定病灶部位。
计算机断层扫描上的病灶部位模式有助于确定C-ViC训练的适合性，并预测结果水平。提出了一种将这些病灶部位结果与失语测试分数相结合用于临床的实用方法。
