Objective To observe therapeutic effects of acupuncture combined with language training on aphasia induced by ischemic apoplexy and investigate the mechanisms. Methods 60 patients were randomly divided into a treatmen...Objective To observe therapeutic effects of acupuncture combined with language training on aphasia induced by ischemic apoplexy and investigate the mechanisms. Methods 60 patients were randomly divided into a treatment group treated by acupuncture associated with language training and a control group treated by simple language training. Tongue-acupuncture was applied as the main therapy, and language training included speech organ training, mouth-shape and voice training, spoken language expression training and practical communication ability training. According to Aphosio Bottery of Chinese （ABC）, language ex- amination evaluation was made, and event related potential （P300） was detected before and after treatment. Results The therapeutic effect in the treatment group was significantly better than that in the control group （P〈O. 05）, and the scores of ABC items including information content, speech fluency, repetition, vocabula- ry denomination, color naming, response denomination, confirmation or negation, acoustic recognition and carrying out instruction in the treatment group were obviously higher than those in the control group （P〈0.05）. After one course of treatment, the latencies of N2 and P3 waves in P300 were significantly short- ened and the amplitude of P3 was significantly elevated in the treatment group, compared with those in the control group （P〈0.05）. Conclusion Acupuncture combined with language training provided remarkable therapeutic effects in treating cerebral infarction-induced motor aphasia, and it was better than simple lan- guage training. The results of enhancing of the ABC scores including information content, speech fluency, repetition, vocabulary denomination, color naming, response denomination, confirmation or negation, acous- tic recognition and carrying out instruction, and shortening of the latencies of N2 and P3 waves in P300 and ele- vation of P3 amplitude may be taken as the indices for evaluating and anticipating clinical therapeutic effects of the therapy for treating the disease, which may also be some of the mechanisms.展开更多
Objective:To evaluate the efficacy of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia.Methods:CNKI,VIP,Wan Fang Database,MEDLINE,Embase,Web of Science and Cochrane Li...Objective:To evaluate the efficacy of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia.Methods:CNKI,VIP,Wan Fang Database,MEDLINE,Embase,Web of Science and Cochrane Library were searched for published researches up to March,2021.Randomized controlled trials RCTs that focused on scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia were included.We managed the data analysis with RevMan 5.3 software.Results:A total of 16 RCTs with 1323 patients were involved.The results of meta-analysis showed that:①The effective rate of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia after stroke was significantly better than that of simple language rehabilitation training[OR=3.94,95%CI(2.73,5.68),P<0.00001];②In the evaluation of language function,compared with the language rehabilitation training,the scalp acupuncture combined with language rehabilitation training can significantly improve the reading ability of the patients with motor aphasia after stroke[MD=7.22,95%CI(3.55,10.89),P=0.0001],writing ability[MD=6.51,95%CI(3.61,9.41),P<0.0001],expressive ability[MD=4.13,95%CI(2.37,5.89),P<0.0001],retelling ability[MD=5.00,95%CI(2.38,7.63),P=0.0002],listening comprehension ability[MD=5.36,95%CI(3.12,7.61),P<0.00001]and naming ability[MD=5.60,95%CI(4.20,7.00),P<0.00001];③Compared with simple language rehabilitation training,scalp acupuncture combined with language rehabilitation can significantly improve the daily life language communication ability of patients with motor aphasia,and the difference was statistically significant[MD=30.01,95%CI(11.30,48.72),P=0.002].Conclusion:Scalp acupuncture combined with language rehabilitation training has a significant effect on motor aphasia.However,due to the small sample size,more RCTs are needed to confirm that.展开更多
To explore the brain default mode network(DMN)in patients with motor aphasia resulting from cerebral infarction,we used resting state functional magnetic resonance imaging(fMRI)to investigate the possible neural mecha...To explore the brain default mode network(DMN)in patients with motor aphasia resulting from cerebral infarction,we used resting state functional magnetic resonance imaging(fMRI)to investigate the possible neural mechanism.Thirteen patients with motor aphasia resulting from cerebral infarction and ten matched controls were selected in this study.All subjects were examined using resting state fMRI.We chose the posterior cingulate cortex as the region of interest and then used functional connectivity analysis to calculate the DMN functional connectivity and analyze differences in the functional connectivity between the two groups.Compared with normal controls,aphasia patient group showed a significantly decreased functional connectivity in bilateral medial frontal gyrus,superior frontal gyrus,middle frontal gyrus,middle temporal gyrus,precuneus and cuneus.The aphasia patient group showed increased functional connectivity mainly in bilateral medial frontal gyrus,middle frontal gyrus,inferior frontal gyrus,precentral gyrus,insula.The DMN in cerebral infarction motor aphasia patients showed significantly decreased functional connectivity in the resting state.The DMN most likely plays an important role in motor aphasia resulting from cerebral infarction.Furthermore,functional connectivity in the brain regions surrounding the left and right Broca’s areas was significantly enhanced due to compensatory mechanisms.This may be helpful for the recovery of language function in cerebral infarction patients with motor aphasia.展开更多
The mirror neuron system consists of a set of brain areas capable of matching action observation with action execution. One core feature of the mirror neuron system is the activation of motor areas by action observati...The mirror neuron system consists of a set of brain areas capable of matching action observation with action execution. One core feature of the mirror neuron system is the activation of motor areas by action observation alone. This unique capacity of the mirror neuron system to match action perception and action execution stimulated the idea that mirror neuron system plays a crucial role in the understanding of the content of observed actions and may participate in procedural learning. These features bear a high potential for neurorehabilitation of motor deficits and of aphasia following stroke. Since the first articles exploring this principle were published, a growing number of follow-up studies have been conducted in the last decade. Though, the combination of action observation with practice of the observed actions seems to constitute the most powerful approach. In the present review, we present the existing studies analyzing the effects of this neurorehabJlitative approach in clinical settings especially in the rehabilitation of stroke associated motor deficits and give a perspective on the ongoing trials by our research group. The data obtained up to date showed significant positive effect of action observation on recovery of motor functions of the upper limbs even in the chronic state after stroke, indicating that our approach might become a new standardized add-on feature of modern neurorehabilitative treatment schemes.展开更多
目的分析阶梯式语言康复训练对老年脑卒中后运动性失语患者言语功能的影响。方法采用随机数字表法将本院2021年10月~2024年10月收治的80例老年脑卒中后运动性失语患者分为对照组与观察组各40例。对照组给予常规语言康复训练,观察组给予...目的分析阶梯式语言康复训练对老年脑卒中后运动性失语患者言语功能的影响。方法采用随机数字表法将本院2021年10月~2024年10月收治的80例老年脑卒中后运动性失语患者分为对照组与观察组各40例。对照组给予常规语言康复训练,观察组给予阶梯式语言康复训练。采用功能性语言沟通能力量表(Chinese functional communication profile,CFCP)、西方失语症成套测验(western aphasia battery,WAB)、日常生活交流能力量表(communication abilities in daily living,CADL)、脑卒中失语症生活质量量表(stroke and aphasia quality of life scale,SAQOL)行临床疗效比较。结果与对照组总有效率(72.50%)对比,观察组(90.00%)显著升高(P<0.05)。两组干预后WAB、CADL、SAQOL量表各维度评分均显著提高(P<0.05),观察组均比对照组显著提高(P<0.05)。结论阶梯式语言康复训练在老年脑卒中后运动性失语患者中应用效果显著,能有效提升言语功能、交流能力及生活质量。展开更多
目的探讨大脑脚非对称性比例(asymmetry rate of cerebral peduncle,ARCP)与中老年优势半球卒中后非优势半球在语言、运动功能等方面代偿潜力的相关性。方法回顾性连续收集2022年10月—2024年10月于上海中医药大学附属市中医医院就诊的...目的探讨大脑脚非对称性比例(asymmetry rate of cerebral peduncle,ARCP)与中老年优势半球卒中后非优势半球在语言、运动功能等方面代偿潜力的相关性。方法回顾性连续收集2022年10月—2024年10月于上海中医药大学附属市中医医院就诊的中老年优势半球卒中后复发卒中患者的临床资料。收集患者复发卒中前后的失语商(aphasia quotient,AQ)、Fugl-Meyer运动功能评定量表(Fugl-Meyer motor assessment scale,FMA)评分及ARCP等指标,观察复发卒中前后上述指标的变化。以ARCP≤0.75和ARCP>0.75为分组标准,分析两组患者AQ、FMA评分在复发卒中前后的变化特点及其与ARCP的相关性。结果17例复发卒中患者中,男性7例,女性10例;年龄为51~80岁;左侧复发卒中6例,右侧复发卒中11例;复发出血性卒中2例,缺血性卒中15例;首次卒中至复发卒中的时间间隔为5~12个月。与复发卒中前相比,9例ARCP≤0.75的右侧复发卒中患者中,AQ下降8.5~59.2分,中位下降值为33.5分;右侧肢体FMA评分下降5~47分,中位下降值为22分;左侧肢体FMA评分下降6~50分,中位下降值为24分。4例ARCP≤0.75的左侧复发卒中患者中,AQ下降0~1.2分,中位下降值为0分;右侧肢体FMA评分下降0~8分,中位下降值为2分;左侧肢体FMA评分下降0~2分,中位下降值为1分。2例ARCP>0.75的右侧复发卒中患者中,左侧肢体FMA评分下降(分别由100分降至86分、96分降至91分)。2例ARCP>0.75的左侧复发卒中患者中,1例AQ无变化,1例由96.0分降至76.4分;右侧肢体FMA评分均出现下降(分别由96分降至81分、95分降至72分)。左侧首次卒中后,AQ与ARCP呈正相关(r=0.767,P=0.003);左侧首次卒中后,右侧肢体FMA评分与ARCP呈正相关(r=0.630,P=0.007);右侧复发卒中后,AQ与ARCP呈正相关(r=0.835,P=0.001);右侧复发卒中后,右侧肢体FMA评分与ARCP呈正相关(r=0.773,P=0.005)。结论中老年优势半球卒中后ARCP≤0.75的患者,其语言及运动功能的恢复与非优势半球代偿密切相关。展开更多
脑卒中后运动性失语(post-stroke motor aphasia,PSMA)通常源于优势半球额下回前部Broca区因脑出血或脑梗死等脑血管疾病受到的损伤。过去关于针刺治疗脑卒中后运动性失语的研究多聚焦于损伤脑区的组织血管与细胞层面的修复,而对语言神...脑卒中后运动性失语(post-stroke motor aphasia,PSMA)通常源于优势半球额下回前部Broca区因脑出血或脑梗死等脑血管疾病受到的损伤。过去关于针刺治疗脑卒中后运动性失语的研究多聚焦于损伤脑区的组织血管与细胞层面的修复,而对语言神经网络的损伤与修复机制则涉猎不多。双流语言模型是一种全面阐述语言产生过程的语言神经网络模型,主要由负责语言理解的腹侧通路与负责语言产生的背侧通路构成。该文基于双流语言模型理论深入分析了针刺治疗脑卒中后运动性失语症的疗效机制。研究显示,针刺治疗能引发以双流语言模型为中心的系列神经网络变化,这些变化包括增强腹侧通路与背侧通路之间功能连接、促进右脑代偿机制以及推动损伤部位的结构重建等3个方面,从而修复脑损伤后中断的白质纤维,缓解失语症状。这一发现为针刺治疗PSMA的临床研究开辟了新的视角和路径。展开更多
文摘Objective To observe therapeutic effects of acupuncture combined with language training on aphasia induced by ischemic apoplexy and investigate the mechanisms. Methods 60 patients were randomly divided into a treatment group treated by acupuncture associated with language training and a control group treated by simple language training. Tongue-acupuncture was applied as the main therapy, and language training included speech organ training, mouth-shape and voice training, spoken language expression training and practical communication ability training. According to Aphosio Bottery of Chinese （ABC）, language ex- amination evaluation was made, and event related potential （P300） was detected before and after treatment. Results The therapeutic effect in the treatment group was significantly better than that in the control group （P〈O. 05）, and the scores of ABC items including information content, speech fluency, repetition, vocabula- ry denomination, color naming, response denomination, confirmation or negation, acoustic recognition and carrying out instruction in the treatment group were obviously higher than those in the control group （P〈0.05）. After one course of treatment, the latencies of N2 and P3 waves in P300 were significantly short- ened and the amplitude of P3 was significantly elevated in the treatment group, compared with those in the control group （P〈0.05）. Conclusion Acupuncture combined with language training provided remarkable therapeutic effects in treating cerebral infarction-induced motor aphasia, and it was better than simple lan- guage training. The results of enhancing of the ABC scores including information content, speech fluency, repetition, vocabulary denomination, color naming, response denomination, confirmation or negation, acous- tic recognition and carrying out instruction, and shortening of the latencies of N2 and P3 waves in P300 and ele- vation of P3 amplitude may be taken as the indices for evaluating and anticipating clinical therapeutic effects of the therapy for treating the disease, which may also be some of the mechanisms.
基金supported by Gansu Natural Science Foundation(No.1610RJZA078)Research Project of Gansu Administration of Traditional Chinese Medicine(No.GZK-2017-19)Key Talent Projects of Gansu Province in 2019(No.Ganzu Tongzi No.39)。
文摘Objective:To evaluate the efficacy of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia.Methods:CNKI,VIP,Wan Fang Database,MEDLINE,Embase,Web of Science and Cochrane Library were searched for published researches up to March,2021.Randomized controlled trials RCTs that focused on scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia were included.We managed the data analysis with RevMan 5.3 software.Results:A total of 16 RCTs with 1323 patients were involved.The results of meta-analysis showed that:①The effective rate of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia after stroke was significantly better than that of simple language rehabilitation training[OR=3.94,95%CI(2.73,5.68),P<0.00001];②In the evaluation of language function,compared with the language rehabilitation training,the scalp acupuncture combined with language rehabilitation training can significantly improve the reading ability of the patients with motor aphasia after stroke[MD=7.22,95%CI(3.55,10.89),P=0.0001],writing ability[MD=6.51,95%CI(3.61,9.41),P<0.0001],expressive ability[MD=4.13,95%CI(2.37,5.89),P<0.0001],retelling ability[MD=5.00,95%CI(2.38,7.63),P=0.0002],listening comprehension ability[MD=5.36,95%CI(3.12,7.61),P<0.00001]and naming ability[MD=5.60,95%CI(4.20,7.00),P<0.00001];③Compared with simple language rehabilitation training,scalp acupuncture combined with language rehabilitation can significantly improve the daily life language communication ability of patients with motor aphasia,and the difference was statistically significant[MD=30.01,95%CI(11.30,48.72),P=0.002].Conclusion:Scalp acupuncture combined with language rehabilitation training has a significant effect on motor aphasia.However,due to the small sample size,more RCTs are needed to confirm that.
文摘To explore the brain default mode network(DMN)in patients with motor aphasia resulting from cerebral infarction,we used resting state functional magnetic resonance imaging(fMRI)to investigate the possible neural mechanism.Thirteen patients with motor aphasia resulting from cerebral infarction and ten matched controls were selected in this study.All subjects were examined using resting state fMRI.We chose the posterior cingulate cortex as the region of interest and then used functional connectivity analysis to calculate the DMN functional connectivity and analyze differences in the functional connectivity between the two groups.Compared with normal controls,aphasia patient group showed a significantly decreased functional connectivity in bilateral medial frontal gyrus,superior frontal gyrus,middle frontal gyrus,middle temporal gyrus,precuneus and cuneus.The aphasia patient group showed increased functional connectivity mainly in bilateral medial frontal gyrus,middle frontal gyrus,inferior frontal gyrus,precentral gyrus,insula.The DMN in cerebral infarction motor aphasia patients showed significantly decreased functional connectivity in the resting state.The DMN most likely plays an important role in motor aphasia resulting from cerebral infarction.Furthermore,functional connectivity in the brain regions surrounding the left and right Broca’s areas was significantly enhanced due to compensatory mechanisms.This may be helpful for the recovery of language function in cerebral infarction patients with motor aphasia.
文摘The mirror neuron system consists of a set of brain areas capable of matching action observation with action execution. One core feature of the mirror neuron system is the activation of motor areas by action observation alone. This unique capacity of the mirror neuron system to match action perception and action execution stimulated the idea that mirror neuron system plays a crucial role in the understanding of the content of observed actions and may participate in procedural learning. These features bear a high potential for neurorehabilitation of motor deficits and of aphasia following stroke. Since the first articles exploring this principle were published, a growing number of follow-up studies have been conducted in the last decade. Though, the combination of action observation with practice of the observed actions seems to constitute the most powerful approach. In the present review, we present the existing studies analyzing the effects of this neurorehabJlitative approach in clinical settings especially in the rehabilitation of stroke associated motor deficits and give a perspective on the ongoing trials by our research group. The data obtained up to date showed significant positive effect of action observation on recovery of motor functions of the upper limbs even in the chronic state after stroke, indicating that our approach might become a new standardized add-on feature of modern neurorehabilitative treatment schemes.
文摘目的分析阶梯式语言康复训练对老年脑卒中后运动性失语患者言语功能的影响。方法采用随机数字表法将本院2021年10月~2024年10月收治的80例老年脑卒中后运动性失语患者分为对照组与观察组各40例。对照组给予常规语言康复训练,观察组给予阶梯式语言康复训练。采用功能性语言沟通能力量表(Chinese functional communication profile,CFCP)、西方失语症成套测验(western aphasia battery,WAB)、日常生活交流能力量表(communication abilities in daily living,CADL)、脑卒中失语症生活质量量表(stroke and aphasia quality of life scale,SAQOL)行临床疗效比较。结果与对照组总有效率(72.50%)对比,观察组(90.00%)显著升高(P<0.05)。两组干预后WAB、CADL、SAQOL量表各维度评分均显著提高(P<0.05),观察组均比对照组显著提高(P<0.05)。结论阶梯式语言康复训练在老年脑卒中后运动性失语患者中应用效果显著,能有效提升言语功能、交流能力及生活质量。
文摘目的探讨大脑脚非对称性比例(asymmetry rate of cerebral peduncle,ARCP)与中老年优势半球卒中后非优势半球在语言、运动功能等方面代偿潜力的相关性。方法回顾性连续收集2022年10月—2024年10月于上海中医药大学附属市中医医院就诊的中老年优势半球卒中后复发卒中患者的临床资料。收集患者复发卒中前后的失语商(aphasia quotient,AQ)、Fugl-Meyer运动功能评定量表(Fugl-Meyer motor assessment scale,FMA)评分及ARCP等指标,观察复发卒中前后上述指标的变化。以ARCP≤0.75和ARCP>0.75为分组标准,分析两组患者AQ、FMA评分在复发卒中前后的变化特点及其与ARCP的相关性。结果17例复发卒中患者中,男性7例,女性10例;年龄为51~80岁;左侧复发卒中6例,右侧复发卒中11例;复发出血性卒中2例,缺血性卒中15例;首次卒中至复发卒中的时间间隔为5~12个月。与复发卒中前相比,9例ARCP≤0.75的右侧复发卒中患者中,AQ下降8.5~59.2分,中位下降值为33.5分;右侧肢体FMA评分下降5~47分,中位下降值为22分;左侧肢体FMA评分下降6~50分,中位下降值为24分。4例ARCP≤0.75的左侧复发卒中患者中,AQ下降0~1.2分,中位下降值为0分;右侧肢体FMA评分下降0~8分,中位下降值为2分;左侧肢体FMA评分下降0~2分,中位下降值为1分。2例ARCP>0.75的右侧复发卒中患者中,左侧肢体FMA评分下降(分别由100分降至86分、96分降至91分)。2例ARCP>0.75的左侧复发卒中患者中,1例AQ无变化,1例由96.0分降至76.4分;右侧肢体FMA评分均出现下降(分别由96分降至81分、95分降至72分)。左侧首次卒中后,AQ与ARCP呈正相关(r=0.767,P=0.003);左侧首次卒中后,右侧肢体FMA评分与ARCP呈正相关(r=0.630,P=0.007);右侧复发卒中后,AQ与ARCP呈正相关(r=0.835,P=0.001);右侧复发卒中后,右侧肢体FMA评分与ARCP呈正相关(r=0.773,P=0.005)。结论中老年优势半球卒中后ARCP≤0.75的患者,其语言及运动功能的恢复与非优势半球代偿密切相关。
文摘脑卒中后运动性失语(post-stroke motor aphasia,PSMA)通常源于优势半球额下回前部Broca区因脑出血或脑梗死等脑血管疾病受到的损伤。过去关于针刺治疗脑卒中后运动性失语的研究多聚焦于损伤脑区的组织血管与细胞层面的修复,而对语言神经网络的损伤与修复机制则涉猎不多。双流语言模型是一种全面阐述语言产生过程的语言神经网络模型,主要由负责语言理解的腹侧通路与负责语言产生的背侧通路构成。该文基于双流语言模型理论深入分析了针刺治疗脑卒中后运动性失语症的疗效机制。研究显示,针刺治疗能引发以双流语言模型为中心的系列神经网络变化,这些变化包括增强腹侧通路与背侧通路之间功能连接、促进右脑代偿机制以及推动损伤部位的结构重建等3个方面,从而修复脑损伤后中断的白质纤维,缓解失语症状。这一发现为针刺治疗PSMA的临床研究开辟了新的视角和路径。
