Preservation and modulation of specific left hemisphere regions is vital for treated recovery from anomia in stroke.
Preservation and modulation of specific left hemisphere regions is vital for treated recovery from anomia in stroke.
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DOI：
10.1523/jneurosci.2227-10.2010
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发表时间：
2010-09-01
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影响因子：
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通讯作者：
Fridriksson J
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作者：
Fridriksson J
支持慢性中风恢复的大脑变化的位置和程度可能与剩余皮层的结构完整性有关。然而，对这种关系的具体情况知之甚少，同样重要的是，它如何影响慢性中风的治疗结果。为了研究这个问题，目前的研究检查了脑损伤和皮层激活变化作为中风引起的慢性失语症患者语言治疗结果的预测因素。26名患者在针对命名普通物体的能力受损的失语症治疗前后30小时接受了多次MRI检查。命名能力的提高与左半球前部和后部大脑活动的增加有关，而左颞叶后部、中颞叶以及颞枕交界处的损伤对治疗结果有特别负面的影响。具体来说，脑损伤包括通常与词汇检索和语音处理相关的区域（例如Brodmann 's区37和39）的患者，与相同区域完好无损的患者相比，在正确命名方面不太可能显示出治疗相关的改善。这些发现表明，与慢性失语症患者命名能力提高相关的大脑变化依赖于左半球雄辩皮层的保存和补充。总的来说，皮层保存和再招募之间的类似关系可能也适用于慢性中风中其他功能损伤的恢复。
The location and extent of brain changes that support recovery in chronic stroke is probably related to the structural integrity of the remaining cortex. However, little is known about the specifics of this relationship and, as importantly, how it influences treatment outcome in chronic stroke. To examine this issue, the current study examined frank brain damage and changes in cortical activation as predictors of language treatment outcome in patients with chronic aphasia caused by stroke. Twenty-six patients received multiple MRI sessions before and after 30 hours of aphasia treatment targeting anomia, an impairment in the ability to name common objects. Improved naming was associated with increased brain activation in the anterior and posterior regions of the left hemisphere whereas damage to the posterior portion of the left, middle temporal lobe as well as the temporal-occipital junction had a particularly negative effect on treatment outcome. Specifically, patients whose brain damage included regions commonly associated with lexical retrieval and phonological processing (e.g. Brodmann’s areas 37 and 39) were less likely to show treatment related improvement in correct naming compared to cases where the same areas were intact. These findings suggest that brain changes associated with improved naming ability in chronic aphasia rely on preservation and recruitment of eloquent cortex in the left hemisphere. In general, it seems likely that a similar relationship between cortical preservation and recruitment may also pertain to recovery from other functional impairments in chronic stroke.