亚急性期脑出血引起的运动性失语功能MRI研究

The research of BOLD-fMRI in broca's aphasia resulting from subacute cerebral hemorrhage

目的探讨亚急性期脑出血引起的运动性失语脑内代偿情况。方法亚急性期脑出血患者6例,男女比例2:1,平均41.5岁;正常的健康志愿者20例,男10例,女10例,平均年龄38.5岁,右利手。检查者均需完成图片的命名任务。用AFNI软件处理实验数据。统计分析用SPSS 20.0。同一感兴奋区域(ROI)的比较用单样本的t检验。结果病灶位于左侧岛叶及左侧脑室旁白质:6例。激活脑区如下:左侧额下回(BA44/45区),激活体素较正常对照组减少明显,激活强度增大。右侧额下回(BA44/45区)激活,激活强度及体素均较正常对照组显著,且有统计学意义。另右侧额中回、双颞上回、顶上小叶及辅助运动区等脑区激活。结论右侧额下回(BA44/45区)在亚急性期脑出血所致运动性失语的功能代偿中起重要作用。

Objective To explore the functional compensation and reorganization of the Broca’s aphasia resulting from subacute cerebral hemorrhage .Methods In patients’group ,there were 6 cases ,male ：female = 2 ：1 ,mean ages ：41 .5Y ;20 cases of normal healthy volunteers ,male ：10 cases ,female ：10 cases .The mean ages ：38 .5 Y .The right hand was predominant .The task of picture naming was be done .The same regions in two groups would be compared with the inde‐pendent t tests .The experiment data were dealed with AFNI soft ware and analysed with SPSS 20 .0 .Results The lesions located in left insula lobe and the white matter near the left lateral ventricle were found in 6 cases .The activated regions were as following ：left inferior frontal gyrus （BA44/45 region） ,compared with the normal group ,the number of acti‐vatated voxels decreased ,while the activatated intensity increased obviously ;right inferior frontal gyrus （RIFG） ,the acti‐vated intensity and the number of voxels of the RIFG had statistical significance compared with the normal group ,P 〈0.05 ;activated regions were also be seen in right middle frontal gyrus ,superior temporal gyrus and inferior parietal lobe of both sides ,accessory movement region and so on .Conclusion The RIFG （BA44/45） played an important role in the compensation of the Broca’s aphasia resulting from subacute cerebral hemorrhage .