Association between therapy outcome and right-hemispheric activation in chronic aphasia
Association between therapy outcome and right-hemispheric activation in chronic aphasia
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DOI：
10.1093/brain/awn043
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发表时间：
2008-05-01
期刊：
影响因子：
14.5
通讯作者：
Straube, Thomas
中科院分区：
文献类型：
--
作者：
Richter, Maria;Miltner, Wolfgang H. R.;Straube, Thomas
右半球在失语症患者语言处理和成功治疗干预中的作用是一个有争议的问题。本研究探讨了慢性非流利性失语症患者在强制性失语症治疗（CIAT）前后，右半球和左半球病灶周围区域对语言任务的大脑激活。特别是，我们分析了大脑反应和治疗结果之间的关系。采用功能磁共振成像（fMRI）技术，对16名慢性非流利性失语症患者和8名健康人进行了单词阅读（REA）和词干补全（COM）过程中的脑激活检测。治疗前，失语症患者的右额下回/额下回（IFG/IC）在REA期间的激活强于对照组，在COM期间的中央前回（PCG）的激活强于对照组。在所有失语症受试者中，治疗干预本身并没有改变任何一项任务的大脑激活。然而，治疗成功与右半球区域（包括IFG/IC）激活的相对减少相关。最重要的是，右侧IFG/IC和其他右半球区域的初始激活与随后的治疗成功呈正相关。因此，失语症治疗前右半球激活强烈预测治疗成功，这表明慢性失语症的大脑激活表明患者有进一步改善语言的潜力。
The role of the right hemisphere for language processing and successful therapeutic interventions in aphasic patients is a matter of debate. This study explored brain activation in right-hemispheric areas and left-hemispheric perilesional areas in response to language tasks in chronic non-fluent aphasic patients before and after constraint-induced aphasia therapy (CIAT). In particular, we analysed the relation between brain responses and therapy outcome. Using functional magnetic resonance imaging (fMRI), brain activation was measured during word-reading (REA) and word-stem completion (COM) in 16 chronic non-fluent aphasic and 8 healthy subjects. Before therapy, activation in right inferior frontal gyrus/insula (IFG/IC) was stronger in aphasics compared to controls during REA and in precentral gyrus (PCG) during COM. Therapeutic intervention per se did not change brain activation for either task across all aphasic subjects. However, therapeutic success correlated with a relative decrease of activation in right-hemispheric areas, including the IFG/IC. Most importantly, initial activation in right IFG/IC and other right-hemispheric areas correlated positively with subsequent therapy success. Thus, right-hemispheric activation prior to aphasia therapy strongly predicts therapeutic success, suggesting that brain activation in chronic aphasia indicates the patients potential for further language improvement.