注意训练对非流畅性失语患者双任务范式干扰效应影响的功能磁共振研究

Effects of Attention Training on Interference Effect of Dual-task Paradigm in Poststroke Nonfluent Aphasiacs: A Functional Magnetic Resonnce Imaging Study

目的考察注意训练对非流畅性失语患者汉字加工任务中双任务范式干扰效应的激活区及偏侧化指数的影响。方法将20例脑卒中后非流畅性失语患者分成实验组及对照组各10例,分别给予注意训练和认知训练,每次30 min,每周5次,共4周。训练前后分别采用组块设计对患者汉字加工任务进行功能磁共振扫描,比较训练前后双任务范式干扰效应的激活区及偏侧化指数。结果训练前两组患者均为右侧额下回、双侧顶叶、双侧小脑显著激活;训练后,实验组各激活区更加显著,而对照组各激活区未见显著变化;训练前两组患者均呈右半球优势;训练后实验组呈左半球优势,而对照组仍呈右半球优势。结论在双任务范式干扰效应中,右侧额下回、双侧顶叶、双侧小脑可能在知觉注意阶段对解决双重任务干扰非常重要;注意训练后激活更加显著;注意训练可能使失语症患者语义加工产生了功能重组。

Objective To investigate the effect of attention training on cortical activation area and lateralization index in interference effect of dual-task paradigm as the poststroke nonfluent aphasiacs processing the Chinese character tasks. Methods 20 cases with nonfluent aphasia after stroke were divided into the training group and the control group, who accepted attention training and cognitive training respectively, 30 min a time, 5 times a week, for 4 weeks. They were investigated the cortical activation area and lateralization index caused by interference effect of dual-task paradigm under block design. Results The right inferior frontal gyrus, bilateral parietal and cerebellar cortex were activated before training in both groups, and more activated after attention training, but no change after cognitive training. Lateralization index suggested that the right brain was more activated before training, while the left side was activated after attention training, but no change after cognitive training. Conclusion The right inferior frontal gyrus, bilateral parietal and cerebellar cortex are very important in solving the dual task interference in the attention stage, and they are activated after attention training. It indicates that attention training makes a significant functional reorganization on Chinese character processing in poststroke nonfluent aphasiacs.