Table_3_Remote cortical atrophy and language outcomes after chronic left subcortical stroke with aphasia.docx

ObjectiveSubcortical stroke can cause a variety of language deficits. However, the neural mechanisms underlying subcortical aphasia after stroke remain incompletely elucidated. We aimed to determine the effects of distant cortical structures on aphasia outcomes and examine the correlation of cortical thickness measures with connecting tracts integrity after chronic left subcortical stroke.
MethodsThirty-two patients and 30 healthy control subjects underwent MRI scanning and language assessment with the Western Aphasia Battery-Revised (WAB-R) subtests. Among patients, the cortical thickness in brain regions that related to language performance were assessed by the FreeSurfer software. Fiber tracts connecting the identified cortical regions to stroke lesions were reconstructed to determine its correlations with the cortical thickness measures across individual patient.
ResultsCortical thickness in different parts of the left fronto-temporo-parietal (FTP) regions were positively related to auditory-verbal comprehension, spontaneous speech and naming/word finding abilities when controlling for key demographic variables and lesion size. Cortical thickness decline in the identified cortical regions was positively correlated with integrity loss of fiber tracts connected to stroke lesions. Additionally, no significant difference in cortical thickness was found across the left hemisphere between the subgroup of patients with hypoperfusion (HP) and those without HP at stroke onset.
ConclusionsThese findings suggest that remote cortical atrophy independently predicts language outcomes in patients with chronic left subcortical stroke and aphasia and that cortical thinning in these regions might relate to integrity loss of fiber tracts connected to stroke lesions.

研究目的：皮质下卒中可引发多种语言功能缺损，但卒中后皮质下失语症的潜在神经机制尚未完全阐明。本研究旨在明确慢性左侧皮质下卒中后，远端皮质结构对失语症预后的影响，并探讨皮质厚度测量值与连接通路完整性的相关性。
研究方法：本研究纳入32例皮质下卒中患者与30名健康对照受试者，所有受试者均接受磁共振成像（MRI）扫描，并采用西方失语症成套测验修订版（Western Aphasia Battery-Revised, WAB-R）子测验进行语言功能评估。针对患者群体，研究人员通过FreeSurfer软件评估与语言功能相关的脑区皮质厚度。重构与卒中病灶相连的已识别皮质区域的纤维束，以明确其在个体患者层面与皮质厚度测量值的相关性。
研究结果：在控制关键人口学变量与病灶体积的情况下，左侧额颞顶叶（fronto-temporo-parietal, FTP）不同区域的皮质厚度与听觉-语言理解能力、自发言语及命名/找词能力呈正相关。已识别皮质区域的皮质厚度降低与连接卒中病灶的纤维束完整性受损呈正相关。此外，卒中发病时伴低灌注（hypoperfusion, HP）与不伴低灌注的患者亚组间，左侧大脑半球的皮质厚度无显著差异。
研究结论：本研究结果表明，远端皮质萎缩可独立预测慢性左侧皮质下卒中伴失语症患者的语言预后，且上述区域的皮质变薄可能与连接卒中病灶的纤维束完整性受损相关。