弥散张量成像对皮质下失语症发病机制的研究

doi:10.3969/j.issn.1006-9771.2018.08.001

《中国康复理论与实践》 ›› 2018, Vol. 24 ›› Issue (8): 869-879.doi: 10.3969/j.issn.1006-9771.2018.08.001

• 专题卒中后失语症的机制与康复 • 下一篇

弥散张量成像对皮质下失语症发病机制的研究

姚婧璠¹, 陈红燕², 张玉梅¹

1.首都医科大学附属北京天坛医院神经病学中心,国家神经系统疾病临床医学研究中心,北京脑重大疾病研究院脑卒中研究所,脑血管病转化医学北京市重点实验室,北京市 100050;
2.首都医科大学附属北京天坛医院影像科,北京市 100050

收稿日期:2017-11-20 修回日期:2018-04-09 出版日期:2018-08-25 发布日期:2018-08-20
通讯作者: 张玉梅。E-mail: zhangyumei95@aliyun.com
作者简介:姚婧璠(1988-),女,汉族,河北保定市人,博士研究生,医师,主要研究方向：脑血管病、失语症。通讯作者：张玉梅(1967-),女,汉族,黑龙江佳木斯市人,主任医师,博士研究生导师,主要研究方向：脑血管病、失语症、认知障碍。
基金资助:
1.国家自然科学基金面上项目(No. 81371201); 2.首都医科大学基础与临床合作重点项目(No. 16JL03); 3.北京市医院管理局临床医学发展专项经费资助项目(No. ZYLX201836)

Mechanism of Subcortical Aphasia: A Diffusion Tensor Imaging Study

YAO Jing-fan¹, CHEN Hong-yan², ZHANG Yu-mei¹

1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Institute of Stroke, Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Bejing 100050, China;
2. Department of Imaging, Beijing Tiantan Hospital, Capital Medical University, Bejing 100050, China

Received:2017-11-20 Revised:2018-04-09 Published:2018-08-25 Online:2018-08-20
Contact: ZHANG Yu-mei. E-mail: zhangyumei95@aliyun.com
Supported by:
Supported by National Natural Science Foundation of China (General) (No. 81371201), Capital Medical University Research Project for Basic and Clinical Cooperation (Key) (No. 16JL03) and Beijing Municipal Administration of Hospitals Special Funding for Clinical Medicine Development (No. ZYLX201836)

摘要/Abstract

摘要： 目的应用弥散张量成像(DTI)和纤维束示踪技术(DT-FT),探讨正常人语言功能区纤维连接特点以及皮质下失语症可能的发病机制。方法 2016年6月至2017年5月,选择正常被试20例和经MRI证实病变位于皮质下结构并表现为失语的脑卒中患者3例,根据西部失语成套测验评定标准,运动性失语2例,传导性失语1例。采用DTI及DT-FT观察语言功能区、对侧镜像区的各向异性(FA)以及纤维束的数量、走形等。结果正常被试语言功能区神经纤维走行十分复杂,与其他部位皮质和皮质下结构发生广泛联系,个体间差异不大。3例失语症患者中,语言功能区或弓状纤维束FA较对侧镜像区降低,纤维束破坏、数量减少、变形或移位。结论语言功能相关结构十分复杂,除皮质外,多种白质纤维束、皮质下结构也参与其中。语言功能区纤维受损、变形或移位,可能是皮质下失语症的发病机制。

关键词: 皮质下失语症, 弥散张量成像, 发病机制

Abstract: Objective To explore the connection of fibers among functional language areas in the normals and the patients with subcortical aphasia using diffusion tensor imaging (DTI) and diffusion tensor fiber tractography (DT-FT). Methods From June, 2016 to May, 2017, 20 healthy subjects and three stroke patients whose lesion located in subcortical structures were included. There were two patients with Broca's aphasia and one with conductive aphasia from the Western Aphasia Battery. They were scanned with DTI and DT-FT, while the fractional anisotropy (FA) of functional language areas and contralateral mirror areas were measured, and the relevant fibers were observed. Results The structures of functional language areas were complicated and extensively connected with other cortex and subcortical structures in healthy subjects, with few differences among individuals. FA was lower in the functional language areas and arcuate fasciculus than in the mirror regions in patients, and the fibers were damaged, distorted or shifted.Conclusion Structures related to language are very complicated, which involve cortex, lots of white matter tracts, subcortical structure and others. The damage, transformation or transposition of fibers in functional language areas may be the mechanism of subcortical aphasia.

Key words: subcortical aphasia, diffusion tensor imaging, pathogenesis

中图分类号:

R743.3

姚婧璠, 陈红燕, 张玉梅. 弥散张量成像对皮质下失语症发病机制的研究[J]. 《中国康复理论与实践》, 2018, 24(8): 869-879.

YAO Jing-fan, CHEN Hong-yan, ZHANG Yu-mei. Mechanism of Subcortical Aphasia: A Diffusion Tensor Imaging Study[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2018, 24(8): 869-879.

参考文献

[1] 汪洁,吴东宇. 经颅磁刺激与言语产生和感知[J]. 中国康复医学杂志, 2008, 23(10): 950-955.
[2] Vigneau M, Beaucousin V, Herve PY, et al.What is right-hemisphere contribution to phonological, lexico-semantic, and sentence processing? Insights from a meta-analysis[J]. Neuroimage, 2011, 54(1): 577-593.
[3] Cherney LR, Babbitt EM, Hurwitz R, et al.Transcranial direct current stimulation and aphasia: the case of Mr. C[J]. Top Stroke Rehabil, 2013, 20(1): 5-21.
[4] Liu Z, Zhang Y, Yan H, et al.Altered topological patterns of brain networks in mild cognitive impairment and Alzheimer's disease: a resting-state fMRI study[J]. Psychiatry Res, 2012, 202(2): 118-125.
[5] 高素荣. 论汉语失语检查法标准化[J]. 临床神经病学杂志, 1992, 5(4): 193-195.
[6] Bonelli RM, Cummings JL.Frontal-subcortical circuitry and behavior[J]. Dialogues Clin Neurosci, 2007, 9(2): 141-151.
[7] Crescentini C, Lunardelli A, Mussoni A, et al.A left basal ganglia case of dynamic aphasia or impairment of extra-language cognitive processes?[J]. Neurocase, 2008, 14(2): 184-203.
[8] Yehene E, Meiran N, Soroker N.Basal ganglia play a unique role in task switching within the frontal-subcortical circuits: evidence from patients with focal lesions[J]. J Cogn Neurosci, 2008, 20(6): 1079-1093.
[9] Thakkar KN, van den Heiligenberg FM, Kahn RS, et al. Frontal-subcortical circuits involved in reactive control and monitoring of gaze[J]. J Neurosci, 2014, 34(26): 8918-8929.
[10] Klostermann F, Krugel LK, Ehlen F.Functional roles of the thalamus for language capacities[J]. Front Syst Neurosci, 2013, 7: 32.
[11] Hebb AO, Ojemann GA.The thalamus and language revisited[J]. Brain Lang, 2013, 126(1): 99-108.
[12] Ullman MT.Is Broca's area part of a basal ganglia thalamocortical circuit?[J]. Cortex, 2006, 42(4): 480-485.
[13] Friederici AD.Pathways to language: fiber tracts in the human brain[J]. Trends Cogn Sci, 2009, 13(4): 175-181.
[14] Friederici AD, Gierhan SM.The language network[J]. Curr Opin Neurobiol, 2013, 23(2): 250-254.
[15] Friederici AD.The brain basis of language processing: from structure to function[J]. Physiol Rev, 2011, 91(4): 1357-1392.
[16] Frey S, Campbell J, Pike G, et al.Dissociating the human language pathways with high angular resolution diffusion fiber tractography[J]. J Neurosci, 2008, 28(45): 11435-11444.
[17] Glasser MF, Rilling JK.DTI tractography of the human brain's language pathways[J]. Cereb Cortex, 2008, 18(11): 2471-2482.
[18] Martino J, Hamer PCD, Vergani F, et al.Cortex-sparing fiber dissection: an improved method for the study of white matter anatomy in the human brain[J]. J Anat, 2011, 219(4): 531-541.
[19] Sarubbo S, De Benedictis A, Maldonado IL, et al.Frontal terminations for the inferior fronto-occipital fascicle: anatomical dissection, DTI study and functional considerations on a multi-component bundle[J]. Brain Sturct Funct, 2013, 218(1): 21-37.
[20] Smits M, Jiskoot LC, Papma JM.White matter tracts of speech and language[J]. Semin Ultrasound CT MR, 2014, 35(5): 504-516.
[21] Lemaire JJ, Golby A, Wells WM 3rd, et al. Extended Broca's area in the functional connectome of language in adults: combined cortical and subcortical single-subject analysis using fMRI and DTI tractography[J]. Brain Topogr, 2013, 26(3): 428-441.
[22] Nair VA, Young BM, La C, et al.Functional connectivity changes in the language network during stroke recovery[J]. Ann Clin Transl Neurol, 2015, 2(2): 185-195.
[23] Flinker A, Korzeniewska A, Shestyuk AY, et al.Redefining the role of Broca's area in speech[J]. Proc Natl Acad Sci U S A, 2015, 112(9): 2871-2875.
[24] Wang J, Fan L, Wang Y, et al.Determination of the posterior boundary of Wernicke's area based on multimodal connectivity profiles[J]. Hum Brain Mapp, 2015, 36(5): 1908-1924.
[25] Kummerer D, Hartwigsen G, Kellmeyer P, et al.Damage to ventral and dorsal language pathways in acute aphasia[J]. Brain, 2013, 136(2): 619-629.
[26] Nadeau SE, Crosson B.Subcortical aphasia[J]. Brain Lang, 1997, 58(3): 355-402.
[27] Hana A, Dooms G, Boecher-Schwarz H, et al.Diffusion tensor imaging–arcuate fasciculus and the importance for the neurosurgeon[J]. Clin Neurol Neurosurg, 2015, 132: 61-67.
[28] Kim SH, Lee DG, You H, et al.The clinical application of the arcuate fasciculus for stroke patients with aphasia: a diffusion tensor tractography study[J]. NeuroRehabilitation, 2011, 29(3): 305-310.
[29] Breier JI, Juranek J, Papanicolaou AC.Changes in maps of language function and the integrity of the arcuate fasciculus after therapy for chronic aphasia[J]. Neurocase, 2011, 17(6): 506-517.

弥散张量成像对皮质下失语症发病机制的研究

Mechanism of Subcortical Aphasia: A Diffusion Tensor Imaging Study

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