弥散张量成像对皮质下失语症发病机制的研究  

Mechanism of Subcortical Aphasia: A Diffusion Tensor Imaging Study

作　　者：姚婧璠[1] 陈红燕[2] 张玉梅[1] YAO Jing-fan;CHEN Hong-yan;ZHANG Yu-mei(Department of Neurology,Beijing Tiantan Hospital,Capital Medical University;China National Clinical Research Center for Neurological Diseases;Institute of Stroke,Beijing Institute for Brain Disorders;Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases,Bejing 100050,Chi;Department of Imaging,Beijing Tiantan Hospital,Capital Medical University,Bejing 100050,China)

机构地区：[1]首都医科大学附属北京天坛医院神经病学中心,国家神经系统疾病临床医学研究中心,北京脑重大疾病研究院脑卒中研究所,脑血管病转化医学北京市重点实验室,北京市100050 [2]首都医科大学附属北京天坛医院影像科,北京市100050

出　　处：《中国康复理论与实践》2018年第8期869-879,共11页Chinese Journal of Rehabilitation Theory and Practice

基　　金：1.国家自然科学基金面上项目(No.81371201);2.首都医科大学基础与临床合作重点项目(No.16JL03);3.北京市医院管理局临床医学发展专项经费资助项目(No.ZYLX201836)。

摘　　要：目的应用弥散张量成像(DTI)和纤维束示踪技术(DT-FT),探讨正常人语言功能区纤维连接特点以及皮质下失语症可能的发病机制。方法 2016年6月至2017年5月,选择正常被试20例和经MRI证实病变位于皮质下结构并表现为失语的脑卒中患者3例,根据西部失语成套测验评定标准,运动性失语2例,传导性失语1例。采用DTI及DT-FT观察语言功能区、对侧镜像区的各向异性(FA)以及纤维束的数量、走形等。结果正常被试语言功能区神经纤维走行十分复杂,与其他部位皮质和皮质下结构发生广泛联系,个体间差异不大。3例失语症患者中,语言功能区或弓状纤维束FA较对侧镜像区降低,纤维束破坏、数量减少、变形或移位。结论语言功能相关结构十分复杂,除皮质外,多种白质纤维束、皮质下结构也参与其中。语言功能区纤维受损、变形或移位,可能是皮质下失语症的发病机制。Objective To explore the connection of fibers among functional language areas in the normals and the patients with subcortical aphasia using diffusion tensor imaging(DTI)and diffusion tensor fiber tractography(DT-FT).Methods From June,2016 to May,2017,20 healthy subjects and three stroke patients whose lesion located in subcortical structures were included.There were two patients with Broca's aphasia and one with conductive aphasia from the Western Aphasia Battery.They were scanned with DTI and DT-FT,while the fractional anisotropy(FA)of functional language areas and contralateral mirror areas were measured,and the relevant fibers were observed.Results The structures of functional language areas were complicated and extensively connected with other cortex and subcortical structures in healthy subjects,with few differences among individuals.FA was lower in the functional language areas and arcuate fasciculus than in the mirror regions in patients,and the fibers were damaged,distorted or shifted.Conclusion Structures related to language are very complicated,which involve cortex,lots of white matter tracts,subcortical structure and others.The damage,transformation or transposition of fibers in functional language areas may be the mechanism of subcortical aphasia.

关 键 词：皮质下失语症 弥散张量成像 发病机制 

分 类 号：R743.3[医药卫生—神经病学与精神病学]