言语激活SPECT脑血流显像对失语恢复机制的研究  

A study of the mechanisms of recovery from aphasia by speech-activated SPECT brain imaging

作　　者：王红[1] 陈卓铭[1] 陈健[2] 徐浩[2] 

机构地区：[1]暨南大学附属第一医院康复科,广州510632 [2]暨南大学附属第一医院核医学科,广州510632

出　　处：《中华物理医学与康复杂志》2007年第9期602-606,共5页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：广东省自然科学基金(04010435);广州市重大攻关项目(200323-E0271)

摘　　要：目的对脑损伤后已有恢复的汉语失语症患者进行言语激活单光子发射计算机断层扫描(SPECT)脑血流显像研究,探讨失语症恢复的脑机制。方法用隔日法对7例失语症患者字、词朗读前、后分别行SPECT脑血流显像检查,运用感兴趣区(ROI)模型分析法对双侧大脑的局部脑血流(rCBF)进行半定量研究,并分别比较各患者朗读时双侧大脑rCBF的变化,分析左、右大脑半球在失语恢复中的作用。结果朗读功能较好的5例患者以左侧大脑激活为主,其他2例患者则以右侧大脑激活为主,朗读作业完成较差。结论左脑损伤后,言语功能的恢复可能主要依靠左半球受损言语网络的结构修补和重建;当左侧言语网络完全损伤而无法重新激活时,右脑的某些部位将参与代偿,而这种代偿不能达到较好的恢复程度。Objective To explore the mechanisms of recovery from aphasia by using speech-activated single photon emission computed tomography （SPECT） brain imaging. Methods The SPECT brain imaging of 7 aphasic patients caused by various brain disorders were performed while they were at rest and performing oral reading, respectively, with an one-clay interval. A semi-quantitative analysis of regional cerebral blood flow （rCBF） was conducted using region of interesting （ROI）. The change of rCBF before and after reading was calculated and compared to analyze the role of both hemispheres in the recovery from aphasia. Results It was found that the activation pattern of brain region was associated with the speech performance of the patients. The activated brain regions were mainly located at the left hemisphere in 5 patients whose reading capacity was relatively better, and mainly at the right hemisphere in the other 2 patients who had poor performance in reading. Conclusion After a focal lesion of the left hemisphere, the recovery of speech function might be mainly attributed to the repair of the damaged left hemisphere language network. When the left-hemispheric centers were permanently impaired, the brain would recruit some righthemisphere regions for speech processing, but this strategy was less effective than the repair of the original speech-relevant network.

关 键 词：失语症 单光子发射计算机断层扫描 局部脑血流 朗读 恢复机制 

分 类 号：R817.4[医药卫生—影像医学与核医学]