基于语言双流模型的卒中后失语右脑功能网络研究

doi:10.3969/j.issn.1006-9771.2020.05.016

《中国康复理论与实践》 ›› 2020, Vol. 26 ›› Issue (5): 572-578.doi: 10.3969/j.issn.1006-9771.2020.05.016

基于语言双流模型的卒中后失语右脑功能网络研究

樊瑞文,李晓琳,黄幸,徐敏杰,曹云,张丹莉,常静玲()

北京中医药大学东直门医院神经内科,北京市 100700

收稿日期:2019-12-17 修回日期:2020-01-17 出版日期:2020-05-25 发布日期:2020-05-29
通讯作者: 常静玲 E-mail:ear6979@163.com
作者简介:樊瑞文(1991-),女,汉族,江苏镇江市人,博士研究生,主要研究方向：中医药防治脑病的临床与神经影像学实验研究。
基金资助:
1.北京市自然科学基金重点项目(7181005);2.国家自然科学基金项目(81973790);3.北京中医药大学科研创新团队项目(2019-JYB-TD003)

Functional Connectivities in Right Hemisphere for Post-stroke Aphasia: Based on Dual Stream Model

FAN Rui-wen,LI Xiao-lin,HUANG Xing,XU Min-jie,CAO Yun,ZHANG Dan-li,CHANG Jing-ling()

Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China

Received:2019-12-17 Revised:2020-01-17 Published:2020-05-25 Online:2020-05-29
Contact: CHANG Jing-ling E-mail:ear6979@163.com
Supported by:
Beijing Natural Science Foundation(7181005);National Science Foundation of China(81973790);Beijing University of Chinese Medicine Research and Innovation Team(2019-JYB-TD003)

摘要/Abstract

摘要：

目的探究右脑功能网络在左侧脑损伤卒中后失语(PSA)的效应特点。方法 2018年12月至2019年6月,招募左脑半球损伤PSA患者12例(患者组)和匹配的健康成年人12例(对照组),以双流语言模型为参照,应用静息态功能磁共振观察右脑功能网络特征。结果 2例患者脱落。与对照组相比,在语言背侧通路中,患者组缘上回至额中回、三角部额下回功能连接增强,中央后回至岛盖部额下回功能连接降低;在语言腹侧通路中,角回至眶部额下回功能连接增强;在腹、背侧双通路模型中,语言功能皮质至皮质下核团功能连接增强,额、颞叶和边缘系统功能连接减弱。三角部额下回至豆状壳核功能连接增强与复述能力呈负相关(r = -0.720, P < 0.05),岛盖部额下回至尾状核功能连接增强与说和复述能力呈负相关关系( r < -0.696, P < 0.05)。患者组右脑语言关键脑区局部网络指标和全局指标均与对照组有显著性差异(| t| > 2.143, P < 0.05)。结论 PSA患者右脑功能网络在脑卒中后发生功能重组,语言关键皮质与皮质下核团功能连接增强可能是右脑代偿的关键环节。

关键词: 脑卒中, 失语, 双流模型, 脑功能网络, 右脑

Abstract:

Objective To study the effect of right brain language network in post-stroke aphasia (PSA) patients with left hemisphere injury.Methods From December, 2018 to June, 2019, twelve PSA patients with left hemisphere injury, and twelve matched healthy controls were recruited to accept rest-state functional magnetic resonance imaging (f-MRI) scan, and analyzed the characteristics of right brain function network with Dual Stream model.Results There were two patients lost. Compared with the controls, for dorsolateral lingual pathway, the functional connections increased from superior marginal gyrus to middle frontal gyrus and inferior frontal gyrus of trigone in the patients, while those decreased from posterior central gyrus to inferior frontal gyrus of insula. For ventral lingual pathway, the functional connection increased from angular gyrus to orbital inferior frontal gyrus. For ventral and dorsolateral double-pathway, the functional connections increased from temporal lobe to lenticular pallidum and angular gyrus, from caudate nucleus to inferior frontal gyrus of insula, from lenticular putamen nucleus to middle frontal gyrus and trigonometry, while it decreased from superior marginal gyrus and temporal lobe to inferior frontal gyrus of insula. There was a negative correlation between the functional connection from inferior frontal gyrus to lenticular putamen and repeating (r = -0.720, P < 0.05), between the functional connection from inferior frontal gyrus to the caudate nucleus to speaking and repeating ( r < -0.696, P < 0.05). In terms of network index, there were significant differences between the patients and the controls in both local and global indexes for language key brain area in right brain (| t| > 2.143, P < 0.05). Conclusion The functional network has reorganized in right hemisphere of PSA patients. However, the increase of connection between language critical cortex and subcortical nuclei may play a role in improvement of language function.

Key words: stroke, aphasia, dual stream model, brain function network, right brain

中图分类号:

R743.3

樊瑞文,李晓琳,黄幸,徐敏杰,曹云,张丹莉,常静玲. 基于语言双流模型的卒中后失语右脑功能网络研究[J]. 《中国康复理论与实践》, 2020, 26(5): 572-578.

FAN Rui-wen,LI Xiao-lin,HUANG Xing,XU Min-jie,CAO Yun,ZHANG Dan-li,CHANG Jing-ling. Functional Connectivities in Right Hemisphere for Post-stroke Aphasia: Based on Dual Stream Model[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(5): 572-578.

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参考文献 38

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组别	n	性别(男/女, n)	年龄(岁)	教育程度(年)	病程(d)	病灶体积(ml)
对照组	12	10/2	57.08±9.03	13.33±3.06	-	-
患者组	10	6/4	51.10±12.42	12.20±3.58	46.7±40.94	17.01±17.29
χ²/t值		0.552	-1.307	-0.801
P值		0.458	0.206	0.434

网络指标	脑区	对照组(n= 12)	患者组(n= 10)	t值	P值
介数中心性	后扣带回	1.63±1.46	4.85±4.31	2.442	0.024
	眶部额上回	3.82±2.71	7.62±5.41	2.143	0.045
度中心性	额中回	7.00±1.36	8.93±1.42	3.249	0.004
节点集聚系数	颞横回	0.23±0.08	0.14±0.08	-2.689	0.014
节点效率	额中回	0.26±0.02	0.28±0.02	2.926	0.008
	颞下回	0.29±0.02	0.26±0.02	-2.315	0.031
节点局部效率	颞横回	0.26±0.09	0.16±0.09	-2.741	0.013
节点最短路径	额中回	0.65±0.07	0.59±0.04	-2.417	0.025

网络指标		对照组(n= 12)	患者组(n= 10)	t值	P值
同配性	同配性分数	0.04±0.05	0.04±0.06	0.068	0.947
	同配性z分	1.94±0.73	2.21±1.13	0.682	0.503
层级性	层级性分数	0.05±0.04	0.02±0.05	-1.574	0.131
	层级性z分	-0.14±0.30	-0.53±0.50	-2.300	0.032
网络效率	全局效率	0.23±0.01	0.23±0.01	-1.047	0.308
	局部效率	0.29±0.01	0.28±0.01	-1.868	0.077
小世界属性	聚集系数	0.23±0.01	0.23±0.02	-0.047	0.963
	Gamma系数	0.59±0.07	0.52±0.06	-2.558	0.019
	Lambda系数	0.42±0.01	0.42±0.01	-0.084	0.934
	最短路径	0.76±0.05	0.79±0.07	1.260	0.222
	Sigma系数	0.56±0.06	0.49±0.06	-2.493	0.022
同步性	同步性分数	0.02±0.02	0.01±0.01	-0.878	0.390
	同步性z分	-0.47±0.66	-0.37±0.20	0.534	0.602

基于语言双流模型的卒中后失语右脑功能网络研究

Functional Connectivities in Right Hemisphere for Post-stroke Aphasia: Based on Dual Stream Model

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