脑卒中后汉语失语症患者的言语和空间工作记忆障碍  

Verbal and Spatial Working Memory Impairments in Chinese Speakers with Post-Stroke Aphasia

作　　者：范舒涵 牛星阳 古锦敏 唐蕙嘉 邢世会[1] FAN Shu-han;NIU Xing-yang;GU Jin-min;TANG Hui-jia;XING Shi-hui(Department of Neurology,The First Affiliated Hospital,Sun Yat-sen University//Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases//National Key Clinical Department and Key Discipline of Neu rology,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院神经科//广东省重大神经系统疾病诊治研究重点实验室//国家临床重点专科和国家重点学科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2021年第5期738-745,共8页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(81971118);广东省自然科学基金(2021A1515010094);广州市科技计划项目(201904010313);华南神经疾病早期干预及功能修复研究国际合作基地项目(2015B050501003)。

摘　　要：【目的】探讨脑卒中后汉语失语症患者言语和空间工作记忆的损伤模式及其与语言损害的关系。【方法】研究纳入2012年10月至2018年6月期间中山大学附属第一医院收治的42例左侧半球卒中慢性期失语症患者,对照组选取42例人口学资料匹配的健康人群。收集受试者临床和影像学资料,采用数字广度顺向(DSF)和逆向(DSB)任务、空间广度顺向(SSF)和逆向(SSB)任务量表评估言语和空间工作记忆;西部失语症成套量表-修订版(WAB-R)评估语言功能并计算失语商(AQ)。采用组间、组内比较和线性混合效应模型分析患者的言语和空间工作记忆损害情况;利用偏相关分析控制人口学、病灶体积和认知功能因素,分析患者的言语和空间工作记忆与语言功能的相关性。【结果】患者组DSF、DSB、SSF和SSB任务分值低于对照组,差异有统计学意义(P<0.05)。线性混合效应模型分析结果显示,数字广度较空间广度任务受分组和任务版本的影响更大(P<0.001)。患者DSF、DSB和SSF评分与AQ分值呈正相关并有统计学意义(DSF:r=0.62,P<0.001;DSB:r=0.57,P<0.001;SSF:r=0.49,P=0.002)。进一步排除不同工作记忆任务的影响,患者DSF和DSB任务与AQ分值的相关性仍有统计学意义(DSF:r=0.53,P=0.001;DSB:r=0.42,P=0.01)。【结论】脑卒中后汉语失语症患者的言语和空间工作记忆均明显受损,言语工作记忆损害更为明显;工作记忆与语言功能残疾程度密切相关。该研究表明促进工作记忆恢复是改善脑卒中后语言功能的潜在途径。【Objective】To explore the patterns of verbal and spatial working memory impairments and their relationships with language impairment in Chinese speakers with post-stroke aphasia.【Methods】The study recruited 42 chronic left hemisphere stroke patients with Chinese aphasia from the First Affiliated Hospital of Sun Yat-sen University between October 2012 and June 2018.Another 42 demography-matched healthy participants formed the control group.The clinical and radiographic data were collected.The verbal and spatial working memory were assessed by digit span forward(DSF),digit span backward(DSB),spatial span forward(SSF)and spatial span backward(SSB)tasks.The Western Aphasia Battery-Revised(WAB-R)was used to calculate the aphasia quotient(AQ)and measure the language function.The inter-and intra-group comparisons and linear mixed-effect analysis were conducted to test the verbal and spatial working memory impairments.The associations between working memory and language performance were determined by partial correlation analyses controlling for demographic factors,lesion size and related cognitive functions.【Results】The mean scores on DSF,DSB,SSF and SSB tasks in patient group were significantly lower than those in the control group(P<0.05).The linear mixed-effect analysis showed that scores on digit span tasks were more affected by group and version than those on spatial span tasks(P<0.001).Partial correlation analyses showed that scores on DSF,DSB and SSF tasks were positively correlated with AQ values in aphasia(DSF:r=0.62,P<0.001;DSB:r=0.57,P<0.001;SSF:r=0.49,P=0.002).Additionally,controlling for different working memory tasks,the correlations of DSF and DSB scores with AQ values remained statistically significant(DSF:r=0.53,P=0.001;DSB:r=0.42,P=0.01).【Conclusions】Verbal and spatial working memory are significantly impaired in Chinese speakers with post-stroke aphasia,and verbal working memory deficit is more predominant.Working memory closely relates to the language function and modulation of working

关 键 词：脑卒中 失语症 言语工作记忆 空间工作记忆 

分 类 号：R743[医药卫生—神经病学与精神病学] R767.92[医药卫生—临床医学]