脑卒中后完全性失语症患者功能连接模式的功能性近红外光谱成像研究

关键词：脑卒中  完全性失语症  功能性近红外光谱技术  功能连接

Keywords:stroke  global aphasia  functional near-infrared spectroscopy  functional connectivity

摘要：

      摘要 目的：采用功能性近红外光谱技术（functional near-infrared spectroscopy，fNIRS）观察脑卒中后完全性失语症患者功能连接模式的特征。 方法：选取脑卒中后完全性失语症患者10例，脑卒中后非失语症患者10例为非失语症对照组，健康中老年人21例为健康对照组。采用fNIRS采集8min的静息态数据，并选择与语言相关的关键脑区，包括背外侧前额叶（dorsolateral prefrontal cortex，DLPFC）、Broca区、颞上回（superior temporal gyrus，STG）、颞中回（middle temporal gyrus，MTG）、Wernicke区、角回、辅助运动区（supplementary motor area，SMA）作为感兴趣区，分别与全脑做相关分析，获得各组的脑功能连接图。 结果：与健康对照组比较，完全性失语症组全脑语言网络功能连通性和连接比下降，其中连接比下降有显著性意义(P<0.05)，同时在左侧DLPFC-右侧SMA、左侧DLPFC-右侧Wernicke、左侧MTG-右侧MTG、左侧SMA-右侧Wernicke、左侧DLPFC-左侧SMA、右侧DLPFC-左侧SMA、左侧SMA-右侧SMA间的功能连接差异有显著性意义(P<0.05)。相较于非失语症组，完全性失语症组表现出左侧MTG-左侧角回间功能连接下降且差异有显著性意义(P<0.05)。 结论：脑卒中后完全性失语症患者全脑语言网络的功能连通性与连接比以及关键语言区之间的功能连接模式存在异常，相关脑区之间的功能连接减弱可能是引起脑卒中后语言功能减弱的原因之一。其中左侧MTG-左侧角回间的功能连接可能为关键功能连接，左侧MTG和角回有望成为针对脑卒中后完全性失语症患者的新的神经调控靶点。

Abstract:

      Abstract Objective： To investigate the functional connectivity patterns in global aphasia by functional near-infrared spectroscopy (fNIRS) and its possible mechanism. Method： Ten patients with global aphasia were enrolled as the case group with 10 patients without aphasia after stroke and 21 healthy elderly people as the control group. The resting state data were collected by fNIRS for 8 minutes and the key language areas including dorsolateral prefrontal cortex (DLPFC)， Broca’s area， Superior temporal gyrus (STG)， Middle temporal gyrus (MTG)， Wernicke’s area， Angular gyrus and Supplementary motor area (SMA) were selected as the regions of interest. The functional connectivity map of each group was obtained and the functional connectivity patterns between the language network were analyzed. Result： Compared with the healthy control group， the intensity and connection ratio of functional connectivity of the whole brain language network decreased in the case group(P<0.05). Compared with the healthy control group， the intensity of functional connectivity in left DLPFC-right SMA、left DLPFC-right Wernicke、left MTG-right MTG 、left SMA-right Wernicke、left DLPFC-left SMA、right DLPFC-left SMA、left SMA-right SMA decreased in global aphasia group(P<0.05). Compared with non-aphasia group， global aphasia group showed a decreased trend in left MTG-left angular gyrus， and there was a significant difference between groups(P<0.05). Conclusion： The functional connectivity pattern and connection ratio between critical language areas and the whole brain are abnormal in aphasia patients after stroke， and the weakening of functional connectivity between related brain areas may be one of the causes of language impairment after stroke. The functional connectivity between the left MTG-left angular gyrus may be critical functional connections. Left MTG may play an important role in the recovery of patients with global aphasia after stroke.