非流利性失语听理解障碍与优势侧弓状纤维损伤的相关性研究

Damage to the dominant arcuate fasciculus degrades auditory comprehension in non-fluent aphasia

目的采用弥散张量成像(DTI)技术探讨优势侧弓状纤维(AF)损伤与脑卒中后失语症患者听理解障碍发生的相关性.方法选取脑卒中后非流利性失语症患者18例设为患者组,另选取9例正常受试者设为正常组.2组受试者均进行DTI检查,测量各向异性分数值(FA),采用两样本t检验,分析比较患者组与正常组双侧AF的FA值差异;另采用汉语失语成套检测(ABC)评估患者组的言语功能,取是/否问题、听辨认、听指令作为观测指标,采用Spearman相关性分析来分析优势侧AF的FA值与ABC言语功能分项评估得分的相关性.结果患者组优势侧AF的FA值为0.313±0.138,显著弱于正常组的0.512±0.025,差异有统计学意义(P<0.01).经Spearman相关性分析,患者组优势侧AF的FA值与听辨认(r=0.513,P=0.029)得分存在显著的相关性.结论脑卒中后失语症患者优势侧AF的损伤可能是导致听理解障碍的原因之一,主要表现为与听辨认相关.

Objective To investigate the correlation between damage to the dominant arcuate fasciculus (AF) and the occurrence of auditory comprehension dysfunction in post-stroke aphasia. Methods Eighteen stroke survivors with non-fluent aphasia were recruited into the observation group, and nine healthy counterparts were chosen for the control group. All received diffusion tensor imaging (DTI) scans and fractional anisotropy (FA) values were measured. A Chinese aphasia battery was used to evaluate the aphasics′ language functioning, with the listening true or false, listening recognition and oral instruction auditory comprehension sub-scales used as the observation indices. Results There were significant differences between the two groups in the FA value of the dominant AF. Spearman correlation showed that the FA value of the dominant AF was positively related to the listening recognition results. Conclusions Damage to the dominant AF may be one of the reasons for auditory comprehension dysfunction in post-stroke aphasia. It is significantly related to listening recognition.