The Supplementary Motor Area Responsible for Word Retrieval Decline After Acute Thalamic Stroke Revealed by Coupled SPECT and Near-Infrared Spectroscopy
The Supplementary Motor Area Responsible for Word Retrieval Decline After Acute Thalamic Stroke Revealed by Coupled SPECT and Near-Infrared Spectroscopy
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DOI：
10.3390/brainsci10040247
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发表时间：
2020-04-01
期刊：
影响因子：
3.3
通讯作者：
Obayashi, Shigeru
中科院分区：
文献类型：
--
作者：
Obayashi, Shigeru
丘脑的损伤可能会影响认知和语言，但潜在的机制仍不清楚。特别是，丘脑失语症为什么偶尔会发生，然后大多会在一定程度上恢复，这仍然是一个谜。为了探讨认知和语言受影响的机制，我们使用了两种神经成像技术--单光子发射计算机断层扫描(SPECT)和功能性近红外光谱(f-NIRS)，前者适用于观察急性丘脑中风后受影响的大脑分布，后者侧重于负责语音产生的辅助运动区(SMA)与额斜束(FAT)通路的血流动力学反应。SPECT不仅在额顶小脑环，而且在SMA、IFG和周围语言相关区域也发现了常见的灌注异常。在音素语言流畅性任务的NIRS会话中，我们发现急性丘脑患者的单词提取能力显著低于年龄匹配的健康志愿者。此外，近红外光谱显示，单词提取和后继的SMA反应之间存在很强的相关性。此外，随访的近红外光谱显示，与提高单词检索能力有关的双边SMA反应增加。研究结果表明，认知功能障碍可能与额叶-顶叶-小脑环有关，而语言功能障碍则与SMA、IFG和语言相关的大脑区域有关。SMA可能有助于丘脑卒中后单词提取困难和失语的恢复。
Damage to the thalamus may affect cognition and language, but the underlying mechanism remains unknown. In particular, it remains a riddle why thalamic aphasia occasionally occurs and then mostly recovers to some degree. To explore the mechanism of the affected cognition and language, we used two neuroimaging techniques-single-photon emission computed tomography (SPECT), suitable for viewing the affected brain distribution after acute thalamic stroke, and functional near-infrared spectroscopy (f-NIRS), focusing on hemodynamic responses of the supplementary motor area (SMA) responsible for speech production in conjunction with the frontal aslant tract (FAT) pathway. SPECT yielded common perfusion abnormalities not only in the fronto-parieto-cerebellar loop, but also in the SMA, IFG and surrounding language-relevant regions. In NIRS sessions during a phonemic verbal fluency task, we found significant word retrieval decline in acute thalamic patients relative to age-matched healthy volunteers. Further, NIRS showed strong correlation between word retrieval and posterior SMA responses. In addition, follow-up NIRS exhibited increased bilateral SMA responses linked to improving word retrieval ability. The findings suggest that cognitive dysfunction may be related to the fronto-parieto-cerebellar loop, while language dysfunction is attributed to the SMA, IFG and language-related brain areas. SMA may contribute to the recovery of word retrieval difficulty and aphasia after thalamic stroke.