急性期脑梗死引起的运动性失语的功能磁共振研究

The research of BOLD-fMRI in Broca aphasia resulting from acute cerebral infarction

目的:探讨急性脑梗死引起的运动性失语脑内代偿情况。方法:急性脑梗死患者8例,男女比例1.3:1,平均44.5岁;正常健康志愿者20人,男10例,女10例,平均38.5岁,均为右利手。检查者均完成图片命名任务。AFNI软件处理实验数据。统计分析采用SPSS12.0分析软件。同一感兴奋区(ROI)比较采用两样本t检验或非参数统计:Mann-Whitney test。结果:患者组因病灶位置不同分为两组:①病灶位于左侧岛叶及左侧脑室旁白质5例。激活脑区如下:右侧Broca区,右侧BA10区,左侧角回,左侧顶上小叶,辅助运动区等。其中右侧Broca区激活强度和体素具有统计学意义,P<0.05;②病灶位于左侧额下回(Broca区)3例。激活脑区如下:左侧BA46区,右侧顶上小叶,右侧额中回,左侧角回,辅助运动区等。正常对照组激活脑区:双侧岛叶,双侧额下回(Broca区,以左侧为著);双侧额中回,双侧额叶背外侧区,双侧顶上小叶,双侧颞上回,辅助运动区,双侧梭状回等激活。结论:急性脑梗死所致运动性失语,脑内代偿方式因位置不同而有差异。

Objective：To explore the functional compensation and reorganization of the Broca aphasia resulting from acute cerebral infarction.Methods：In patient groups,8 cases male： female=1.3：1,mean ages： 44.5Y;20 cases of normal healthy volunteers,male： 10 cases,female： 10 cases.The mean ages： 38.5Y.The right hand is predominant.The task of picture naming was be done.The same regions in two groups would be compared with the independent t tests or nonparametric tests： Mann-Whitney test.The experiment data were dealed with AFNI soft ware and analysed with SPSS 12.0.Results：The patients were divided into two groups according to the location.① The lesions located in LIG and the white matter by the left lateral ventricle： 5 cases.The activation regions were as following： RIFG,right BA10,LAG,LSPL,SMA and so on.Among them the activation intention and volume of the RIFG had statistical significance.P0.05;② The lesions located in LIFG（Broca region）： 3 cases.the activated regions were： left BA46,RSPL,RMFG,LAG,SMA and so on.In control group,the activated regions were： both insula lobe,both inferior frontal gyrus（IFG,or Broca region）,the left side is obvious,MFG,DLFR,SPG,SMA,fusiform gyrus and so on.Conclusion：The compensation modes of the Broca aphasia were differenciated with different locations of infarction.