摘要
目的探讨脑卒中后运动性失语患者言语功能区变化机制。方法选取右利手健康志愿者15例作为正常对照组,应用3T磁共振(magnetic resonance,MR)扫描仪分别在其执行图片命名及动词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。同时选取脑卒中6例(脑卒中组),在其失语及治疗后应用3T磁共振扫描仪行动词联想的BOLD fMRI扫描,生成其脑激活图,分别与正常对照组比较分析;并在脑卒中发病1周内及1个月分别行脑功能成像,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。脑卒中组发病早期与正常对照组比较,左侧Broca区激活减少或未见激活6例;发病1个月,在Broca镜像区出现明显激活3例(50%),左侧Broca区周围激活强度及范围明显增加3例(50%)。结论高级言语中枢为广泛皮层共同参与,组成复杂网络而完成言语功能;脑卒中后运动性失语患者早期表现为经典Broca区激活程度减低或消失,当语言中枢受损时,左侧Broca区周围及其镜像区在语言功能重塑上起到了重要作用。
Objective To discuss 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 machines.BOLD 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 machines.BOLD fMRI scans were done when the patients were executing picture naming and words association assignments after they got aphasia and were treated.The brain activation maps of the patients were set as the patient group.The patients were given fMRI scans within a week and one month after stroke onset to study brain activation spots and strength,respectively. Results In the control group,multiple brain areas were activated.In the patient group,in the early phase of stroke,six patients(100%)showed significantly lowered or no activation of the left Broca's area.One month after stroke onset,three patients(50%)showed significant activation of the left Broca's area mirror zone while the other three(50%)showed significantly elevated intensity and range of activation of brain area around the left Broca's area. Conclusions Wide range of brain cortexes are involved in the advanced language center.They form complex networks to fulfill language function.Patients with motor aphasia after stroke have diminished Broca's area activation or even no activation in early period.When the language center is damaged,the brain around left Broca's area and its mirror zone plays an important role in language function remodeling.
出处
《总装备部医学学报》
2013年第4期187-191,253,共6页
Medical Journal of General Equipment Headquarters
基金
解放军306医院院级课题(KT-0059)
关键词
脑血管意外
磁共振成像
运动性失语
cerebrovascular accident
magnetic resonance imaging
aphasia
broca
