喉癌术后发声重建中语言功能脑区的重组特点研究  

A Study of the Reorganization Characteristics of Linguistic Cortex in the Pronunciation Rebuilding Process of Postoperative Laryngeal Carcinoma Patients

作　　者：尹建忠[1] 薛永刚[1] 林鹏[2] 翁旭初[3] 祁吉[1] 

机构地区：[1]天津市第一中心医院放射科,天津市影像医学研究所,300192 [2]天津市第一中心医院耳鼻喉科 [3]中国科学院心理研究所

出　　处：《临床放射学杂志》2008年第9期1194-1197,共4页Journal of Clinical Radiology

基　　金：天津市自然科学基金资助项目(06YFJMJC09300)

摘　　要：目的运用ER-fMRI对喉癌术后患者进行随访,研究语言功能脑区在不同恢复阶段功能脑区的变化,并比较与正常人的差别。资料与方法18例喉癌全喉切除术的患者参加了实验,根据患者的语言恢复情况分为三组:发音差组(1组);发音中等组(2组);发音良组(3组)。每组分别完成朗读"i"和朗读词任务。刺激采用视觉呈现。结果三组患者和正常人比较,在朗读音节任务时,左侧额中回、左侧SMA和左侧扣带前回区域激活体素和强度变化率2组明显大于其他组;朗读词任务时,左侧额中回、左侧中央前回、左侧中央后回、左侧SMA和右侧梭状回激活体素和强度变化率2组明显大于其他组。此外,岛叶在各患者组的激活频率均大于正常组;豆状核和海马旁回在2组和3组激活频率大于1组和正常组。结论上述功能脑区在语言重建过程中发挥着学习作用,可指导患者更好地发音。Objective To observe the changes of linguistic cortical areas in patients who had undergone total resection of laryngeal carcinoma during their pronunciation rebuilding process with fMRI and identify their differences with healthy in- dividuals. Materials and Methods 18 patients who had undergone total resection of laryngeal carcinoma were collected. We divided all the subjects into three different groups according to the pronouncing evaluation： Group 1 ,bad pronunciation; Group 2,moderate pronunciation; Group 3, good pronunciation. The task for each group was to tone reading and chinese words reading. The occurrence of stimulus turned up in a way of visual presentation. Results There were statistical differ- ences among all the groups in the left middle frontal gyrus,left SMA, and left anterior cingulate gyros while the task of tone reading was being performed ; while the task of reading words was being performed , there were statistical differences in the left middle frontal gyrus,left precentral gyrus, left postcentral gyrus, left SMA, and right fusiform gyrus. There was significant increase in the activated voxel and intensity change of the above areas in group 2 than those of the other groups. Also, the activation rate of insular lobe in group1,2 ,and 3 were bigger than that of the normal group. The activation rate of lenticular nucleus and parabippocampal gyrus in group 2 and 3 were bigger than that of group 1 and the normal group. Conclusion We speculate that these regions play important role in the progress of pronunciation rebuilding process, and can instruct the patients to learn better pronunciation.

关 键 词：功能磁共振成像 语言 喉癌 发声重建 

分 类 号：R739.6[医药卫生—肿瘤]