右侧小脑对卒中后失语的潜在作用：基于格兰杰因果分析的初步研究

doi:10.3969/j.issn.1006-9771.2021.12.012

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (12): 1458-1463.doi: 10.3969/j.issn.1006-9771.2021.12.012

右侧小脑对卒中后失语的潜在作用：基于格兰杰因果分析的初步研究

张晓彤^1a,李娜^1a,陈兆聪^1a,梁井凤^1a,喻勇^1a,武惠香^1a,康庄^1b,丘卫红^1a()

1. 中山大学附属第三医院,a.康复医学科；b.放射科,广东广州市 510630

收稿日期:2021-06-21 修回日期:2021-10-25 出版日期:2021-12-25 发布日期:2021-12-29
通讯作者: 丘卫红 E-mail:q-weihong@163.com
作者简介:张晓彤(1996-),女,汉族,广东河源市人,硕士研究生,主要研究方向：神经康复。
基金资助:
1. 国家重点研发计划项目(2020YFC2004201);2. 广东省自然科学基金项目(2016A030313327);3. 广东省科技计划项目(2016A020215226);4. 广州市科技计划项目(201607010185)

Potential Role of Right Cerebellum in Post-stroke Aphasia: A Preliminary Study Based on Granger Causality Analysis

ZHANG Xiao-tong^1a,LI Na^1a,CHEN Zhao-cong^1a,LIANG Jing-feng^1a,YU Yong^1a,WU Hui-xiang^1a,KANG Zhuang^1b,QIU Wei-hong^1a()

1. a. Department of Rehabilitation Medicine; b. Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510630, China

Received:2021-06-21 Revised:2021-10-25 Published:2021-12-25 Online:2021-12-29
Contact: QIU Wei-hong E-mail:q-weihong@163.com
Supported by:
National Key Research and Development Program(2020YFC2004201);Natural Science Foundation of Guangdong Province(2016A030313327);Science and Technology Planning Project of Guangdong Province(2016A020215226);Science and Technology Program of Guangzhou(201607010185)

摘要/Abstract

摘要：

目的基于静息态功能磁共振技术(rs-fMRI),运用格兰杰因果分析(GCA),探讨左侧大脑半球卒中后失语(PSA)患者语言相关脑区的功能重组状况,为PSA语言网络重组提供理论依据。方法 2019年5月至2021年5月,本院康复医学科住院的19例左侧大脑半球PSA患者(病例组)和17例性别、年龄匹配的健康人(对照组)行rs-fMRI扫描,病例组行中文版西方失语症成套检验评估。采用Restplus软件包对fMRI数据进行分析,选择组间对比低频震荡振幅值(ALFF)有明显显著性差异的区域作为感兴趣区(ROI),运用GCA分析有效连接的差异。结果病例组全脑ALFF低于对照组,其中左侧额下回三角部(LIFGtri)及左侧额中回(LMFG)的ALFF值低于对照组(P < 0.05)。与对照组相比,LIFGtri到LMFG以及LMFG到右侧小脑CrusⅠ的有效连接强度降低;右侧小脑CrusⅡ到LIFGtri、右侧小脑CrusⅠ到LMFG的有效连接强度增高。结论 PSA患者LIFGtri和LMFG的ALFF值明显减低,伴随LIFGtri→LMFG的有效连接降低;右侧小脑CrusⅠ、Ⅱ分别对LMFG、LIFGtri的有效连接增强。右侧小脑可能是PSA患者促进语言恢复的潜在调控位点。

关键词: 卒中后失语, 静息态功能磁共振, 小脑, 格兰杰因果分析

Abstract:

Objective To explore the recovery mechanism of language network among post-stroke aphasic patients by investigating the difference of whole-brain amplitude of low frequency fluctuations (ALFF) and the Granger causality analysis (GCA) between the patients and the controls.Methods From May, 2019 to May, 2021, 19 patients with aphasia after left hemispheric stroke and 17 age- and sex- matched healthy controls finished functional magnetic resonance imaging scanning. All the patients assessed with Chinese version of Western Aphasia Battery (WAB). Restplus was used for fMRI data analysis. Regions with significant difference of ALFF between groups were chosen as regions of interests (ROI) for the following GCA analysis.Results ALFF in left inferior frontal gyrus triangle (LIFGtri) and left medial frontal gyrus (LMFG) were significantly lower in the patients than in the controls. Effective connectivity from LIFGtri to LMFG and from LMFG to the right cerebellar Crus I were significantly lower in the patients. Effective connectivity from right cerebellar Crus II to LIFGtri, from right cerebellar Crus I to LMFG were significantly greater in the patients.Conclusion Unidirectional negative regulatory pathway such as LIFGtri→LMFG might be injured in post-stroke aphasia, while, connectivities between right cerebellar Crus II→LIFGtri and right cerebellar Crus I →LMFG enhanced. Right cerebellum might be the potential target for the language recovery.

Key words: post-stroke aphasia, functional magnetic resonance imaging, cerebellum, Granger causality analysis

中图分类号:

R743.3

张晓彤,李娜,陈兆聪,梁井凤,喻勇,武惠香,康庄,丘卫红. 右侧小脑对卒中后失语的潜在作用：基于格兰杰因果分析的初步研究[J]. 《中国康复理论与实践》, 2021, 27(12): 1458-1463.

ZHANG Xiao-tong,LI Na,CHEN Zhao-cong,LIANG Jing-feng,YU Yong,WU Hui-xiang,KANG Zhuang,QIU Wei-hong. Potential Role of Right Cerebellum in Post-stroke Aphasia: A Preliminary Study Based on Granger Causality Analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(12): 1458-1463.

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组别	n	性别(男/女,n)	年龄(岁)	病程(d)
对照组	17	12/5	45.76±7.41	67.05±38.32
病例组	19	15/4	48.63±7.50
χ²/t值			1.151
P值		0.706^a	0.258

差异脑区	MNI坐标			体素	t值
差异脑区	x	y	z	体素	t值
LIFGtri	-36	18	27	50	-7.23
LMFG	-39	21	48	26	-7.01

连接方向	脑区	MNI坐标			体素	t值
连接方向	脑区	x	y	z	体素	t值
LIFGtri→全脑	LMFG	-36	51	12	258	-4.44
全脑→LIFGtri	右侧小脑Crus II	39	-69	-45	198	4.04
LMFG→全脑	右侧小脑Crus I	21	-78	-33	202	-4.09
全脑→LMFG	右侧小脑Crus I	24	-78	-33	127	3.82

右侧小脑对卒中后失语的潜在作用：基于格兰杰因果分析的初步研究

Potential Role of Right Cerebellum in Post-stroke Aphasia: A Preliminary Study Based on Granger Causality Analysis

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