Functional re-recruitment of dysfunctional brain areas predicts language recovery in chronic aphasia
Functional re-recruitment of dysfunctional brain areas predicts language recovery in chronic aphasia
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DOI：
10.1016/j.neuroimage.2007.10.008
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发表时间：
2008-02-15
期刊：
影响因子：
5.7
通讯作者：
Rockstroh, Brigitte
中科院分区：
文献类型：
--
作者：
Meinzer, Marcus;Flaisch, Tobias;Rockstroh, Brigitte
脑损伤（如中风）后的功能恢复甚至可以在事件发生数年后发生，并且可以通过有效的康复策略加速。在11例慢性失语症患者中，我们进行了短期强化语言训练，以改善语言功能，并在严格控制的条件下诱导皮层重组。在语言训练之前和之后立即在功能性磁共振成像（fMRI）期间评估公开命名表现。用于统计分析的感兴趣区域（ROI）由具有单独确定的异常高密度慢波发生器（在语言干预之前通过脑磁图识别）的区域构成，这些区域主要聚集在左侧病灶周围区域。另外三个单独定义的区域用于控制所选相应靶区域结果的特异性：个别患者病变的同源区域，右半球和左半球区域中的Δ ROI的镜像，其不产生显著量的慢波活动。fMRI脑激活的诱导变化与训练图片命名的改善高度相关，但选择性地位于训练前功能障碍的病灶周围脑区。我们的研究结果表明，即使在中风后数年，皮质功能的重塑也是可能的。这种行为增益似乎是由最初中风后被部分剥夺输入的大脑区域介导的。因此，我们提供了第一次直接证据的重要性，治疗引起的功能重新整合的病灶周围地区的异质性样本的慢性失语症患者。(C)2007年由Elsevier TNC出版。
Functional recovery in response to a brain lesion, such as a stroke, can even occur years after the incident and may be accelerated by effective rehabilitation strategies. In eleven chronic aphasia patients, we administered a short-term intensive language training to improve language functions and to induce cortical reorganization under rigorously controlled conditions. Overt naming performance was assessed during functional magnetic resonance imaging (fMRI) prior to and immediately after the language training. Regions of interest (ROIs) for statistical analyses were constituted by areas with individually determined abnormally high densities of slow wave generators (identified by magnetoencephalography prior to the language intervention) that clustered mainly in left perilesional areas. Three additional individually defined regions served to control for the specificity of the results for the selected respective target region: the homologue area of the individual patient's lesion, the mirror image of the delta ROI in the right hemisphere and left hemispheric regions that did not produce a significant amount of slow wave activity.Treatment-induced changes of fMRI brain activation were highly correlated with improved naming of the trained pictures, but selectively within the pre-training dysfunctional perilesional brain areas. Our results suggest that remodeling of cortical functions is possible even years after a stroke. The behavioral gain seems to be mediated by brain regions that had been partially deprived from input after the initial stroke. We therefore provide first time direct evidence for the importance of treatment-induced functional reintegration of perilesional areas in a heterogeneous sample of chronic aphasia patients. (C) 2007 Published by Elsevier tnc.