基于功能连接探索卒中后失语患者的脑电脑功能网络特征

doi:10.3969/j.issn.1006-9771.2025.11.011

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (11): 1342-1353.doi: 10.3969/j.issn.1006-9771.2025.11.011

基于功能连接探索卒中后失语患者的脑电脑功能网络特征

张梓寒¹, 张家成¹, 刘婧訸¹, 陈宇航¹, 吴丹¹, 王荟荧¹, 黄幸², 常静玲¹()

1.北京中医药大学东直门医院，北京市 100070
2.北京中医药大学第三附属医院，北京市 100029

收稿日期:2025-06-03 修回日期:2025-10-05 出版日期:2025-11-25 发布日期:2025-11-26
通讯作者: 常静玲 E-mail:ear6979@163.com
作者简介:张梓寒(1996-)，女，汉族，重庆市人，博士研究生，主要研究方向：中医药防治脑病的临床与神经电生理研究。
基金资助:
1.北京市自然科学基金面上项目(7242243);2.北京中医药大学东直门医院临床研究和成果转化能力提升试点项目(DZMG-XZYY-23008);3.北京中医药大学东直门医院人才培养计划(DZMG-LJRC0016)

Characteristics of brain functional network based on electroencephalogram in post-stroke aphasia patients based on functional connectivity

ZHANG Zihan¹, ZHANG Jiacheng¹, LIU Jinghe¹, CHEN Yuhang¹, WU Dan¹, WANG Huiying¹, HUANG Xing², CHANG Jingling¹()

1. Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100070, China
2. Beijing Universitity of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China

Received:2025-06-03 Revised:2025-10-05 Published:2025-11-25 Online:2025-11-26
Contact: CHANG Jingling E-mail:ear6979@163.com
Supported by:
Beijing Natural Science Foundation (General)(7242243);Pilot Project for Enhancing Clinical Research and Transformation Capacity of Dongzhimen Hospital, Beijing University of Chinese Medicine(DZMG-XZYY-23008);Dongzhimen Hospital, Beijing University of Chinese Medicine Talent Cultivation Program(DZMG-LJRC0016)

摘要/Abstract

摘要：

目的分析卒中后失语(PSA)患者在词图匹配任务下脑电脑功能网络特征。

方法选取2018年1月至2021年12月东直门医院PSA患者18例(PSA组)，并招募性别、年龄和受教育程度相匹配的健康受试者9例(对照组)，采用汉语标准失语症检查法(CRRCAE)评估，采集基于汉语词图匹配的任务态脑电数据。对脑电信号进行溯源分析，构建功能连接矩阵，采用图论分析全局属性，并利用基于网络的统计分析(NBS)识别组间差异子网络，对全局属性与CRRCAE进行相关性分析。

结果对照组不匹配条件下各频带全局属性显著高于PSA组和对照组(匹配条件)(P < 0.01)。PSA组在α频带存在额颞顶枕叶及边缘系统连接增强(23节点，31边，P < 0.05)和额颞边缘系统及基底节区连接降低(20节点，26边，P < 0.01)的子网络；β频带存在额颞叶、基底节及边缘系统连接增强的子网络(15节点，23边，P < 0.01)；θ频带存在左侧额颞叶连接减弱(10节点，11边，P < 0.05)与右侧额颞叶连接增强(7节点，7边，P < 0.05)并存的子网络。匹配条件下，PSA组α频带和β频带全局属性均与阅读正相关(r = 0.511~0.650，均P < 0.05)，θ频带局部效率和平均集群系数与复述呈负相关(r = -0.500~-0.505，均P < 0.05)；不匹配条件下，PSA组α频带和β频带局部效率、平均集群系数均与阅读呈正相关(r = 0.522~0.642，均P < 0.05)，α频带全局效率、局部效率与听理解呈正相关(r = 0.486~0.496，均P < 0.05)。任务态与静息态对比进一步揭示了PSA患者在α频带额叶及边缘系统(6节点，5边，P < 0.05)和β频带额颞顶枕叶及边缘系统(38节点，52边，P < 0.01)存在代偿性连接增强。

结论 PSA患者核心网络损伤特征为多频带全局属性异常降低和频带特异性网络异常重组，提示脑网络整体效能下降与局部代偿并存，为PSA的神经电生理评估及靶向干预提供了客观依据。

关键词: 卒中后失语, 功能连接, 脑电, 脑功能网络, 图论分析

Abstract:

Objective To analyze the characteristics of brain functional networks in patients with post-stroke aphasia (PSA) during a Chinese word-picture matching task.

Methods A total of 18 PSA patients in Dongzhimen Hospital from January, 2018 to December, 2021 were enrolled as PSA group, and nine healthy controls matched for sex, age and education were included as the control group. The Chinese Rehabilitation Research Center Aphasia Examination (CRRCAE) and task-state electroencephalogram (EEG) data based on a Chinese word-picture matching paradigm were collected. Source-space reconstruction was applied to EEG signals to construct functional connectivity matrices. Graph-theoretical analysis was used to compute global network properties, and network-based statistics were used to identify subnetwork differences between groups. Correlations between global network properties and CRRCAE subscales were further analyzed.

Results The global properties of each frequency band were higher in the control group (unmatched) than in PSA group and the control group (matched) (P < 0.01). Subnetworks connections enhanced in the alpha band in the frontal, temporal, parietal, occipital lobes and limbic system (23 nodes, 31 edges, P < 0.05), and weakened connections in the frontal, temporal, limbic system and basal ganglia (20 nodes, 26 edges, P < 0.01) in PSA group; in the beta band, subnetwork connections enhanced in the frontal, temporal lobes, basal ganglia and limbic system (15 nodes, 23 edges, P < 0.01); in the theta band, subnetwork connections weakened in the left frontal and temporal lobes (10 nodes, 11 edges, P < 0.05), and enhanced in the right frontal and temporal lobes (7 nodes, 7 edges, P < 0.05). Under the matched condition, the global properties of the alpha and beta bands in PSA group were positively correlated with reading (r = 0.511 to 0.650, all P < 0.05), and the local efficiency and average clustering coefficient of the theta band were negatively correlated with repetition (r = -0.500 to -0.505, all P < 0.05); under the unmatched condition, the local efficiency and average clustering coefficient of the alpha and beta bands in PSA group were positively correlated with reading (r = 0.522 to 0.642, all P < 0.05), and the global efficiency and local efficiency of the alpha band were positively correlated with auditory comprehension (r = 0.486 to 0.496, all P < 0.05). The comparison between the task state and the resting state further revealed that compensatory connection enhanced in the alpha band in the frontal lobe and limbic system (6 nodes, 5 edges, P < 0.05) and in the beta band in the frontal, temporal, parietal, occipital lobes and limbic system (38 nodes, 52 edges, P < 0.01) in PSA patients.

Conclusion The core network damage characteristics of PSA patients are abnormally decreased global properties across multiple frequency bands and frequency-specific abnormal network reorganization, suggesting the overall brain network efficiency decline coexists with local compensation. This provides an objective basis for the neuroelectrophysiological evaluation and targeted intervention of PSA.

Key words: post-stroke aphasia, functional connectivity, electroencephalogram, brain functional network, graph theory analysis

中图分类号:

R743.3

张梓寒, 张家成, 刘婧訸, 陈宇航, 吴丹, 王荟荧, 黄幸, 常静玲. 基于功能连接探索卒中后失语患者的脑电脑功能网络特征[J]. 《中国康复理论与实践》, 2025, 31(11): 1342-1353.

ZHANG Zihan, ZHANG Jiacheng, LIU Jinghe, CHEN Yuhang, WU Dan, WANG Huiying, HUANG Xing, CHANG Jingling. Characteristics of brain functional network based on electroencephalogram in post-stroke aphasia patients based on functional connectivity[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(11): 1342-1353.

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组别	n	性别(男/女)/n	年龄/岁	受教育年限/年
对照组	9	6/3	52.00±5.60	12.00(7.5, 12.0)
PSA组	18	13/5	54.45±10.18	12.00(11.3, 16.0)
t/Z值			0.652	-1.457
P值			0.521	0.145

分项	评分
听理解	25.94±11.41
复述	19.00±8.87
说	11.83±11.96
出声读	14.72±9.89
阅读	25.72±10.69
抄写	6.89±4.90
描写	6.61±8.60
听写	4.22±5.47
计算	10.22±5.64

频带	对照组匹配	对照组不匹配	PSA组匹配	PSA组不匹配	F值	P值
α	0.15±0.01	0.16±0.04	0.15±0.01	0.15±0.01	335.057	< 0.001
β	0.15±0.01	0.24±0.01	0.15±0.01	0.16±0.01	187.889	< 0.001
δ	0.15±0.01	0.25±0.01	0.16±0.01	0.15±0.01	23.919	< 0.001
γ	0.16±0.01	0.24±0.01	0.16±0.01	0.16±0.01	22.289	< 0.001
θ	0.15±0.01	0.24±0.01	0.15±0.01	0.15±0.01	287.066	< 0.001

频带	对照组匹配	对照组不匹配	PSA组匹配	PSA组不匹配	F值	P值
α	0.23±0.01	0.35±0.01	0.23±0.01	0.23±0.02	22.226	< 0.001
β	0.24±0.02	0.34±0.01	0.23±0.02	0.24±0.02	95.089	< 0.001
δ	0.23±0.02	0.35±0.01	0.24±0.02	0.23±0.02	23.709	< 0.001
γ	0.24±0.01	0.35±0.01	0.24±0.02	0.25±0.02	136.412	< 0.001
θ	0.23±0.02	0.35±0.01	0.23±0.02	0.22±0.02	146.919	< 0.001

频带	对照组匹配	对照组不匹配	PSA组匹配	PSA组不匹配	F值	P值
α	0.19±0.02	0.28±0.01	0.19±0.02	0.18±0.01	117.944	< 0.001
β	0.20±0.02	0.28±0.01	0.19±0.02	0.20±0.02	69.851	< 0.001
δ	0.19±0.02	0.29±0.01	0.20±0.02	0.19±0.02	23.557	< 0.001
γ	0.20±0.01	0.29±0.01	0.20±0.02	0.20±0.02	92.498	< 0.001
θ	0.18±0.01	0.28±0.01	0.18±0.02	0.18±0.02	113.326	< 0.001

基于功能连接探索卒中后失语患者的脑电脑功能网络特征

Characteristics of brain functional network based on electroencephalogram in post-stroke aphasia patients based on functional connectivity

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全局属性	条件	频带	听理解	复述	阅读
全局效率	匹配	α	0.479^a	-0.307	0.643^b
		β	0.379	-0.421	0.511^a
		δ	0.340	-0.073	0.525^a
		γ	0.249	-0.340	0.444
		θ	0.232	-0.330	0.369
	不匹配	α	0.496^a	-0.336	0.628^b
		β	0.385	-0.425	0.448
		δ	0.023	-0.186	0.244
		γ	0.311	-0.362	0.219
		θ	0.198	-0.401	0.428
局部效率	匹配	α	0.431	-0.382	0.650^b
		β	0.382	-0.381	0.580^a
		δ	0.311	-0.028	0.474^a
		γ	0.261	-0.382	0.486^a
		θ	0.260	-0.500^a	0.360
	不匹配	α	0.486^a	-0.327	0.642^b
		β	0.367	-0.385	0.522^a
		δ	0.124	-0.202	0.320
		γ	0.249	-0.419	0.216
		θ	0.334	-0.381	0.455
平均集群系数	匹配	α	0.382	-0.318	0.636^a
平均集群系数		β	0.297	-0.400	0.547^a
		δ	0.220	0.046	0.373
		γ	0.224	-0.406	0.454
		θ	0.229	-0.505^a	0.359^a
	不匹配	α	0.418	-0.350	0.555^a
		β	0.367	-0.441	0.534^a
		δ	0.035	-0.166	0.256
		γ	0.025	-0.326	0.108
		θ	0.319	-0.418	0.413

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