基于语言双流模型的卒中后失语右脑功能网络研究  

Functional Connectivities in Right Hemisphere for Post-stroke Aphasia:Based on Dual Stream Model

作　　者：樊瑞文 李晓琳[1] 黄幸[1] 徐敏杰 曹云 张丹莉 常静玲[1] FAN Rui-wen;LI Xiao-lin;HUANG Xing;XU Min-jie;CAO Yun;ZHANG Dan-li;CHANG Jing-ling(Department of Neurology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院神经内科,北京市100700

出　　处：《中国康复理论与实践》2020年第5期572-578,共7页Chinese Journal of Rehabilitation Theory and Practice

基　　金：北京市自然科学基金重点项目(No.7181005);国家自然科学基金项目(No.81973790);北京中医药大学科研创新团队项目(No.2019-JYB-TD003)。

摘　　要：目的探究右脑功能网络在左侧脑损伤卒中后失语(PSA)的效应特点。方法2018年12月至2019年6月,招募左脑半球损伤PSA患者12例(患者组)和匹配的健康成年人12例(对照组),以双流语言模型为参照,应用静息态功能磁共振观察右脑功能网络特征。结果2例患者脱落。与对照组相比,在语言背侧通路中,患者组缘上回至额中回、三角部额下回功能连接增强,中央后回至岛盖部额下回功能连接降低;在语言腹侧通路中,角回至眶部额下回功能连接增强;在腹、背侧双通路模型中,语言功能皮质至皮质下核团功能连接增强,额、颞叶和边缘系统功能连接减弱。三角部额下回至豆状壳核功能连接增强与复述能力呈负相关(r=-0.720,P<0.05),岛盖部额下回至尾状核功能连接增强与说和复述能力呈负相关关系(r<-0.696,P<0.05)。患者组右脑语言关键脑区局部网络指标和全局指标均与对照组有显著性差异(|t|>2.143,P<0.05)。结论PSA患者右脑功能网络在脑卒中后发生功能重组,语言关键皮质与皮质下核团功能连接增强可能是右脑代偿的关键环节。Objective To study the effect of right brain language network in post-stroke aphasia(PSA)patients with left hemisphere injury.Methods From December,2018 to June,2019,twelve PSA patients with left hemisphere injury,and twelve matched healthy controls were recruited to accept rest-state functional magnetic resonance imaging(f-MRI)scan,and analyzed the characteristics of right brain function network with Dual Stream model.Results There were two patients lost.Compared with the controls,for dorsolateral lingual pathway,the functional connections increased from superior marginal gyrus to middle frontal gyrus and inferior frontal gyrus of trigone in the patients,while those decreased from posterior central gyrus to inferior frontal gyrus of insula.For ventral lingual pathway,the functional connection increased from angular gyrus to orbital inferior frontal gyrus.For ventral and dorsolateral double-pathway,the functional connections increased from temporal lobe to lenticular pallidum and angular gyrus,from caudate nucleus to inferior frontal gyrus of insula,from lenticular putamen nucleus to middle frontal gyrus and trigonometry,while it decreased from superior marginal gyrus and temporal lobe to inferior frontal gyrus of insula.There was a negative correlation between the functional connection from inferior frontal gyrus to lenticular putamen and repeating(r=-0.720,P<0.05),between the functional connection from inferior frontal gyrus to the caudate nucleus to speaking and repeating(r<-0.696,P<0.05).In terms of network index,there were significant differences between the patients and the controls in both local and global indexes for language key brain area in right brain(|t|>2.143,P<0.05).Conclusion The functional network has reorganized in right hemisphere of PSA patients.However,the increase of connection between language critical cortex and subcortical nuclei may play a role in improvement of language function.

关 键 词：脑卒中 失语 双流模型 脑功能网络 右脑 

分 类 号：R743.3[医药卫生—神经病学与精神病学]