摘要
目的探讨脑卒中后运动性失语患者语言功能区变化机制。方法应用3T磁共振成像(magneticresonance image,MRI)扫描仪对15例右利手健康志愿者(正常对照组),分别在执行图片命名及词语联想任务时进行血氧水平依赖(blood oxygenation level dependent,BOLD)功能性磁共振成像(functional magnetic resonance imaging,fMRI)扫描,所得原始图像数据经神经功能影像分析软件处理,生成两种任务的脑激活图;应用3T MRI扫描仪对6例脑卒中患者(脑卒中组)失语后及治疗后分别进行图片命名任务及动词联想的BOLD fMRI扫描,生成两种任务的脑激活图,分别与正常对照组比较研究,并对其在发病1周内及发病1个月后,分别行脑功能成像,对大脑内的激活部位及强度进行研究。结果在正常对照组中,多个脑区均见激活,在脑卒中组发病早期,6例患者均出现左侧Broca区激活减少或未见激活,发病1个月后,在Broca镜像区有3例(50.0%)出现明显激活,左侧Broca区周围区域有3例(50.0%)激活强度及范围明显增加。结论高级语言中枢为广泛皮层共同参与,组成复杂网络而完成语言功能。脑卒中后运动性失语患者早期表现为在经典Broca区激活程度减低或消失,当语言中枢受损时,左侧Broca周围区域及其镜像区在语言功能重塑起到了重要作用。
Objective To explore the mechanism of changes of cerebral language area in patients with motor aphasia after stroke. Methods Fifteen right handed healthy volunteers were examined with 3T MRI machine. By blood oxygenation level dependent （BOLD）, functional magnetic resonance imaging （fMRI） scans were done when the volunteers were executing picture naming and words association assignments. The raw image materials were processed with neurological functional image analysis software and brain activation maps of the two assignments were generated as the control group. Six stroke patients were also examined with 3T MRI machine. BOLD fMRI scans were done when the patients were executing picture naming and words association assignments after they got aphasia and after they were treated. The brain activation maps of the patients were set as the patient group. The patients were given fMRI scans respectively within a week and one month after stroke onset to study brain activation spots and strength. Results In the control group, multiple brain areas were activated. In the early phase of the patient group of stroke, six patients （100 % ） showed significantly lowered or no activation of the left Broca area. One month after stroke onset, three patients （50.0%） showed significant activation of the left Broca area＇s mirror zone while the other three （50.0%） showed significantly elevated intensity and range of activation of brain area around the left Broca area. Conclusion Wide range of brain eortexes are involved in the advanced language center. They form complex networks to fulfill language function. Patients with motor aphasia after stroke have diminished Broca area activation or even no activation in early period. When the language center is damaged, the brain areas around left Broca area and its mirror zone have an important role in language function remodeling.
出处
《临床荟萃》
CAS
2013年第3期261-265,269,F0002,共7页
Clinical Focus
基金
国家重点基础研究发展计划(973计划)[2012CB720700]
关键词
脑血管意外
磁共振成像
失语
经皮质运动性
cerebrovascular accident
magnetic resonance imaging
aphasia, broca
