交叉性失语语言功能重组的功能磁共振研究

发布时间：2018-03-04 23:18

本文选题：交叉性失语　切入点：功能磁共振　出处：《中国老年学杂志》2017年20期 　论文类型：期刊论文

【摘要】：目的探讨交叉性失语患者语言功能区的动态重组。方法 8例脑卒中后交叉性失语患者在脑卒中发病后第(7±2)天(T1期)、第(30±7)天(T2期)和第(90±7)天(T3期)分别进行3次语言功能测试和功能磁共振检查,健康对照组仅行1次上述各项检查。使用xjview软件呈现脑区激活图。结果病例组在T1期有不同程度的语言功能障碍,其中以自发语流畅度和命名功能受损最为明显。病例组在单因子重复测量的方差分析比较中,T1期、T2期和T3期失语指数的差异均有统计学意义(F=122.96,P0.001)。通过独立样本t检验发现病例组在T1期、T2期和T3期的失语指数和对照组相比差异有统计学意义(P0.05),但T3期自发语流畅度测试和图片命名测试得分和对照组相比差异无统计学意义(t=0.71,1.26;P=0.243,0.487)。在进行图片命名时,健康对照组主要表现为左侧语言区激活,同时在双侧额叶中下回、左侧额上回、左侧颞中回、左侧梭状回、双侧枕中回观察到显著激活。而病例组在T1期表现为激活降低的双侧激活模式,其中左侧额下回后部、左侧中央前回、右侧额叶上中回激活较为显著。在T2期和T3期均表现为激活增强偏左的双侧激活模式,但T3期的激活强度高于T2期。T1期至T2期左侧Broca区的激活增加与失语指数的改善呈正相关(r=0.916,P=0.001),而T2期至T3期左侧颞叶上中回的激活增加与失语指数的改善呈正相关(r=0.873,P=0.005)。结论交叉性失语患者主要表现为非流畅性失语,大部分患者的语言功能在发病后3个月逐渐恢复。交叉性失语患者的语言区重组主要通过左侧大脑半球语言区的功能上调来实现且上调程度与语言能力改善呈正相关,这表明在交叉性失语患者的语言恢复过程中左侧大脑半球发挥了重要作用。
[Abstract]:Objective to investigate the dynamic recombination of language functional areas in patients with intersecting aphasia. Methods 8 patients with intersecting aphasia were treated with T 1, T 1, T 2 (30 卤7) and T 3 (90 卤7) days after stroke, respectively. Language function test and functional magnetic resonance examination, In the healthy control group, only one of the above examinations was performed. The xjview software was used to present the brain activation map. Results the patients had different degrees of language dysfunction at T1 stage. The spontaneous language fluency and nomenclature function were the most obviously impaired. The difference of aphasia index between T 1 and T 3 stage was statistically significant in the single factor repeated measurement in the case group. Through independent sample t test, there were significant differences in the aphasia index of T 1 stage and T 3 stage. The aphasia index of T 1 / T 2 and T 3 stage was significantly different from that of the control group (P 0.05), but there was no significant difference in the scores of spontaneous speech fluency test and picture naming test between the T 3 stage and the control group. When the picture is named, In the healthy control group, the left language area was activated, and the left superior frontal gyrus, the left superior frontal gyrus, the left middle temporal gyrus, the left fusiform gyrus, and the left middle frontal gyrus were activated. Significant activation was observed in the bilateral occipital gyrus, while in the case group, the activation decreased in both sides at T1 stage, in which the posterior part of the left inferior frontal gyrus, the left precentral gyrus, the left prefrontal gyrus, and the left prefrontal gyrus. The activation of the right superior middle frontal gyrus was more significant. In both T2 and T3 phases, the activation was enhanced on both sides of the left side. However, the activation intensity in T3 phase was higher than that in T 2. T1 to T 2 stage. There was a positive correlation between the increase of left Broca area and the improvement of aphasia index, while the increased activation of left superior temporal gyrus from T 2 to T 3 was positively correlated with the improvement of aphasia index. Conclusion the main manifestations of intersecting aphasia are non-fluency aphasia. The language function of most patients gradually recovered 3 months after the onset of the disease. The reorganization of the language area of the patients with intersecting aphasia was mainly achieved by the functional modulation of the left hemisphere language area, and the degree of upregulation was positively correlated with the improvement of language ability. This suggests that the left hemisphere plays an important role in language recovery in patients with intersecting aphasia.
【作者单位】：南方医科大学研究生院;广州军区广州总医院神经内科;广州军区广州总医院磁共振室;
【基金】：国家自然科学基金资助项目(81471172)
【分类号】：R445.2;R743.3

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