脑梗死后运动性失语的发生机制:基于局部一致性的静息态功能MRl研究  

Application of ReHo in motor aphasia in patients with stroke:a BOLD-fMRI study

作　　者：李闯[1] 李爱琴[1] 曹爱华[1] 庞华军 李华[3] LI Chuang;LI Aiqin;CAO Aihua;PANG Huajun;LI Hua(Department of Neurology,Second Affiliated Hospital of Luohe Medical Collage,Luohe 462300,Henan Province,China;Medical Imaging Center,The Third Affliated Hospital of Shihezi University,Shihezi 862300,Xinjiang Uygur Autonomous Region,China;Department of Neurology,The Third Affliated Hospital of Shihezi University,Shihezi 862300,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]漯河医学高等专科学校第二附属医院神经内科,河南漯河462000 [2]石河子大学医学院第三附属医院医学影像中心,新疆维吾尔自治区石河子832000 [3]石河子大学医学院第三附属医院神经医学中心,新疆维吾尔自治区石河子832000

出　　处：《神经病学与神经康复学杂志》2022年第1期15-21,共7页Journal of Neurology and Neurorehabilitation

摘　　要：目的:应用静息态功能MRl的基于局部一致性(regional homogeneity,ReHo)技术,探讨脑梗死后运动性失语的早期恢复发生机制。方法:选取脑梗死后运动性失语症患者10例作为失语组,同期无失语患者10例作为对照组,均行静息态fMRl检查。应用SPM8软件和DPARSF软件对数据进行处理,利用REST进行2样本t检验。结果:与对照组相比,失语组患者ReHO高于对照组的脑区有左侧小脑(脑成像坐标系MNl:x=-27,y=-60,z=-18;t=3.33)、左枕叶(脑成像坐标系MNl:x=-45,y=-69,z=15;t=5.26)和右侧颞叶(脑成像坐标系MNl:x=51,y=-51,z=9;t=7.49)。失语组患者ReHO低于对照组的脑区有左侧前额叶内侧回(脑成像坐标系MNl:x=-24,y=75,z=3;t=-3.75)、左额上回和左额中回(脑成像坐标系MNl:x=-36,y=9,z=66;t=-4.44)、左角回(脑成像坐标系MNl:x=-66,y=-60,z=42;t=-2.67)、左顶叶(脑成像坐标系MNl:x=-57,y=-84,z=48;t=-3.23)、左侧顶上小叶和顶下小叶(脑成像坐标系MNl:x=-21,y=-42,z=87;t=-3.50)、右侧角回(脑成像坐标系MNl:x=-54,y=-84,z=21;t=-4.00)、右侧缘上回(脑成像坐标系MNl:x=63,y=-69,z=57;t=-4.16)、右枕叶(脑成像坐标系MNl:x=9,y=-105,z=24;t=-4.38)。结论:在脑梗死后运动性失语症的急性期,左侧小脑、左枕叶和右侧颞叶激活增强,这些脑区可能参与了早期的功能代偿,是急性期恢复机制;而左侧前额叶内侧回、左侧额上回、左额中回、左顶上小叶、顶下小叶和顶叶的激活减少,这些脑区出现激活减低可能是脑梗死后运动性失语症的发生机制。Objective:To explore the mechanism of early recovery of motor aphasia after cerebral infarction using regional homogeneity(ReHo)based techniques using resting state functional magnetic resonance imaging.Methods:Ten patients with motor aphasia after cerebral infarction were selected as the aphasia group,and 10 patients without aphasia during the same period were selected as the control group.All patients underwent resting fMRI examination.Apply SPM8 software and DPARSF software to process the data,and use REST for 2-sample t-test.Results:Compared with the control group,the aphasia group had higher ReHO in in the left cerebellum(MNI:x=-27,y=-60,z=-18;t=3.33),left occipital lobe(MNI:x=-45,y=-69,z=15;5.26)and right middle temporal gyrus(MNI:x=51,y=?51,z=9;t=7.49).The brain areas with lower ReHO in the aphasia group compared to the control group were left medial prefrontal gyrus(MNI:x=-24,y=75,z=3;t=-3.75),left superior frontal gyrus and left middle frontal gyrus(MNI:x=-36,y=9,z=66;t=-4.44),left angular gyrus(MNI:x=-66,y=-60,z=42;t=-2.67),left parietal lobe(MNI:x=-57,y=-84,z=48;t=-3.23),left upper and lower parietal lobules(MNI:x=-21,y=-42,z=87;t=-3.50),right angular gyrus(MNI:x=-54,y=-84,z=21;t=-4.00),right supramarginal gyrus(MNI:x=63,y=-69,z=57;t=-4.16)and right occipital lobe(MNI:x=9,y=-105,z=24;t=-4.38).Conclusion:In the acute phase of motor aphasia after cerebral infarction,the activation of the left cerebellum,left occipital lobe,and right temporal lobe is enhanced.These brain regions may participate in early functional compensation and are the recovery mechanism of the acute phase;The activation of left medial prefrontal gyrus,left superior frontal gyrus,left middle frontal gyrus,left superior parietal lobule,inferior parietal lobule and parietal lobe is reduced,which may be the mechanism of motor aphasia after cerebral infarction.

关 键 词：脑梗死 运动性失语症 静息态功能MRI 发生机制 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]