Recovered vs. not-recovered from post-stroke aphasia: the contributions from the dominant and non-dominant hemispheres.
Recovered vs. not-recovered from post-stroke aphasia: the contributions from the dominant and non-dominant hemispheres.
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DOI：
10.3233/rnn-120267
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发表时间：
2013
影响因子：
2.8
通讯作者：
Holland SK
中科院分区：
文献类型：
--
作者：
Szaflarski JP;Allendorfer JB;Banks C;Vannest J;Holland SK
一些成人研究已经证明了中风周围区域对失语症恢复的重要性。但是，迄今为止，还没有研究检查左大脑中动脉梗死患者（LMCA-R）或未恢复（LMCA-NR）的语言理解中皮质参与模式的差异。在这项研究中，我们比较了语言理解的皮层相关功能磁共振成像和语义决策/音调决策任务在9个LMCA-R和18个LMCA-NR患者在中风时匹配的年龄和利手。我们通过将功能磁共振成像激活和中风量与语言表现的扫描仪内和扫描仪外测量相关联来检查语言表现的皮层相关性。我们的分析表明，LMCA-R中风后至少1年显示返回到典型的功能磁共振成像语言激活模式，并有一个补偿性重组LMCA-NR患者的语言功能转移到右半球的大脑区域。此外，随着左半球功能磁共振成像信号转移强度的增加，标准化语言测量测试的表现也有相关的改善。还观察到笔画的大小与某些语言测试的表现之间存在负相关。作为成年人中风后恢复的机制，这种右半球移位似乎是语言功能恢复的无效模式，随着右半球移位的增加，语言表现下降。因此，中风后语言激活模式的正常化是需要更好的语言表现，而激活模式的非优势（右）半球和/或大的中风大小的移位与中风后语言能力下降。
Several adult studies have documented the importance of the peri-stroke areas to aphasia recovery. But, studies examining the differences in patterns of cortical participation in language comprehension in patients who have (LMCA-R) or have not recovered (LMCA-NR) from left middle cerebral artery infarction have not been performed up to date. In this study, we compare cortical correlates of language comprehension using fMRI and semantic decision/tone decision task in 9 LMCA-R and 18 LMCA-NR patients matched at the time of stroke for age and handedness. We examine the cortical correlates of language performance by correlating intra- and extra-scanner measures of linguistic performance with fMRI activation and stroke volumes. Our analyses show that LMCA-R at least 1 year after stroke show a return to typical fMRI language activation patterns and that there is a compensatory reorganization of language function in LMCA-NR patients with shifts to the right hemispheric brain regions. Further, with increasing strength of the left-hemispheric fMRI signal shift there are associated improvements in performance as tested with standardized linguistic measures. A negative correlation between the size of the stroke and performance on some of the linguistic tests is also observed. This right-hemispheric shift as a mechanism of post-stroke recovery in adults appears to be an ineffective mode of language function recovery with increasing right-hemispheric shift associated with lower language performance. Thus, normalization of the post-stroke language activation patterns is needed for better language performance while shifts of the activation patterns to the non-dominant (right) hemisphere and/or large stroke size are associated with decreased linguistic abilities after stroke.