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Ann Neurol:卒中后言语康复的关键在大脑背腹侧结构的可塑性

2017-06-20 MedSci MedSci原创

弓状纤维是背侧语言网络中最大的也是最明确的一组纤维束,该区域损伤会导致复述、命名甚至是理解障碍,以及持续的慢性失语。弓状纤维损伤程度可预测言语的整体性。急性期弓状纤维的非对称性消失可以预测脑卒中后 30 天失语表现。不单是弓状纤维还包括腹侧的白质通路(钩回和极囊束)均与会话性言语损伤有关。 腹侧纤维束在语义处理过程中扮演重要角色。腹侧纤维束损伤程度与急性失语的理解能力和语义处理明显相关。

弓状纤维是背侧语言网络中最大的也是最明确的一组纤维束,该区域损伤会导致复述、命名甚至是理解障碍,以及持续的慢性失语。弓状纤维损伤程度可预测言语的整体性。急性期弓状纤维的非对称性消失可以预测脑卒中后 30 天失语表现。不单是弓状纤维还包括腹侧的白质通路(钩回和极囊束)均与会话性言语损伤有关。 

腹侧纤维束在语义处理过程中扮演重要角色。腹侧纤维束损伤程度与急性失语的理解能力和语义处理明显相关。理解能力是失语严重性的决定因素。额枕下束纤维损害可导致语义错语。既往的研究已经证明慢性脑卒中病人失语严重程度与白质交叉通路损毁而非梗死体积密切相关。该交叉通路连接背侧语言纤维束和腹侧语言纤维束。

临床实践中,通过MRI明确哪个脑白质区与失语严重程度密切相关将有助于评估脑卒中后失语患者的总体损伤情况,指导神经康复的临床决策的制定。残留语言网络的强化可能是卒中后失语患者言语康复的关键。

研究人员对8例慢性失语症的患者进行强化言语治疗3周,并在治疗前后用标准化的命名测试和脑MRI检查。使用基于峰度的弥散张量纤维束成像测量部分下纵束(ILF)的平均峰度(MK)。与减少语义学(不是语音错误)相关的治疗与ILF MK的强化(重整化)相关(R = -0.90,P<0.05 校正),提示言语康复与残余语言网络的特定语言组件的结构可塑性相关。

原始出处:

McKinnon ET, Fridriksson J,et al.Structural plasticity of the ventral stream and aphasia recovery.Ann Neurol. 2017 Jun 19. doi: 10.1002/ana.24983. [Epub ahead of print]

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    2017-12-22 yinhl1978
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    2017-06-21 wei834766788

    学习了!!!!!!

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1671297, encodeId=ffdc16e1297a1, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Thu May 17 18:49:00 CST 2018, time=2018-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999993, encodeId=9ed61999993a2, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Fri Dec 22 02:49:00 CST 2017, time=2017-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213625, encodeId=1f9221362566, content=学习了!!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=078f1661649, createdName=wei834766788, createdTime=Wed Jun 21 22:04:59 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213248, encodeId=c9df213248ad, content=学习了解了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Tue Jun 20 22:21:35 CST 2017, time=2017-06-20, status=1, ipAttribution=)]
    2017-06-20 林3301

    学习了解了,谢谢分享

    0

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