Ischemia in Broca Area Is Associated With Broca Aphasia More Reliably in Acute Than in Chronic Stroke
Ischemia in Broca Area Is Associated With Broca Aphasia More Reliably in Acute Than in Chronic Stroke
复制标题
DOI：
10.1161/strokeaha.109.570374
复制
发表时间：
2010-02-01
期刊：
影响因子：
8.3
通讯作者：
Hillis, Argye E.
中科院分区：
文献类型：
--
作者：
Ochfeld, Elisa;Newhart, Melissa;Hillis, Argye E.
背景和目的：我们的目的是确定在急性或慢性卒中中，Broca区的缺血是否能更可靠地预测Broca失语。方法：我们纳入了连续右手优势的左半球缺血性卒中患者(慢性卒中患者卒中后6个月)。MRI扫描分析Broca区(Brodmann区44和45区)的缺血灶或低灌注区。用西方失语症成套测验对患者进行失语症状分类；用X(2)检验确定有意义的联系。结果急性卒中患者脑梗塞累及任何部位的Broca区和Broca或全面性失语的发生率(chi(2)=38.1；df1；P<；0.0001)明显高于慢性卒中(chi(2)=0.54；df1；P=0.46；无统计学意义)。急性(CHI(2)=35.8；DF1；P<；0.0001)与慢性卒中(CHI(2)=1.2；DF1；P=0.2 7；不显著)Broca或全面性失语的发生与整个Broca区的脑梗塞或低血流灌注之间的相关性明显强于慢性卒中。在一组纵向研究的20例患者中，这种关联只在急性时显著，而不是慢性地(chi(2)=20；df1；P<；0.0001 vs.chi(2)=0；df1；p=1；对于累及Broca区的部分脑缺血不显著，chi(2)=16.4；df1；P<；0.0001 vs.chi(2)=3.2；df1；p=0.08；对于覆盖整个Broca区的缺血不显著)。许多部分或全部Broca区受损的慢性卒中患者既没有Broca区，也没有全面性失语。Broca或全面性失语有时最初出现在这些患者身上，但在6个月后消失。我们的结果表明，急性失语综合征可以让临床医生预测受损的血管区域，即使结构成像只显示一个小的(或没有)梗死。(笔划。2010；41：325-330。)
Background and Purpose-We aimed to determine if ischemia involving Broca area predicts Broca aphasia more reliably in acute or chronic stroke.Methods-We included consecutive right-hand-dominant patients with left hemisphere ischemic stroke (6 months after stroke for chronic stroke). MRI scans were analyzed for ischemic lesions or hypoperfusion in Broca area (Brodmann areas 44 and 45). Patients were scored on the Western Aphasia Battery to classify aphasia syndromes; chi(2) tests were used to identify significant associations.Results-The presence of infarct involving any part of Broca area and the presence of Broca or global aphasia was much stronger in acute (chi(2) = 38.1; df1; P < 0.0001) than in chronic stroke (chi(2) = 0.54; df1; P = 0.46; not significant). The association between infarct or hypoperfusion covering all of Broca area and the presence of Broca or global aphasia was much stronger in acute (chi(2) = 35.8; df1; P < 0.0001) than in chronic stroke (chi(2) = 1.2; df1; p = 0.27; not significant). In a subset of 20 patients studied longitudinally, the associations were significant only acutely, not chronically (chi(2) = 20; df1; P < 0.0001 vs. chi(2) = 0; df1; p = 1; not significant for ischemia involving part of Broca area, and chi(2) = 16.4; df1; P < 0.0001 vs chi(2) = 3.2; df1; p = 0.08; not significant for ischemia covering all of Broca area).Conclusions-Broca aphasia is more reliably associated with infarct/hypoperfusion of Broca area in acute stroke. Many chronic stroke patients with damage to part or all of Broca area had neither Broca nor global aphasia. Broca or global aphasia was sometimes present initially in these patients but resolved by 6 months. Our results indicate that the acute aphasia syndrome may allow the clinician to predict the compromised vascular territory, even when structural imaging shows only a small (or no) infarct. (Stroke. 2010; 41: 325-330.)