Table_6_Language reorganization patterns in global aphasia–evidence from fNIRS.DOCX

BackgroundExploring the brain reorganization patterns associated with language recovery would promote the treatment of global aphasia. While functional near-infrared spectroscopy (fNIRS) has been widely used in the study of speech and language impairment, its application in the field of global aphasia is still limited. AimsWe aimed to identify cortical activation patterns of patients with global aphasia during naming and repetition tasks. Methods and proceduresWe recruited patients with post-stroke aphasia from the Department of Rehabilitation Medicine at Huashan Hospital. These individuals were diagnosed with global aphasia without cognitive impairments, as assessed by speech-language pathology evaluations. Age- and sex-matched healthy controls were recruited from the greater Shanghai area. During fNIRS measurement, patients and healthy controls completed the picture-naming and phrase repetition task. Cortical activation patterns on each of these language tasks were then compared between groups. Outcomes and resultsA total of nine patients with global aphasia and 14 healthy controls were included in this study. Compared with the healthy subjects, patients with global aphasia showed increased activation in the left Broca's area, middle temporal gyrus (MTG), superior temporal gyrus (STG), and pre-motor and supplementary motor cortex (SMA) (p < 0.05) in the picture-naming task. Furthermore, the latency of the oxyhemoglobin (HbO) concentration in the left supramarginal gyrus (SMG) region had a strong negative correlation with their score of the naming task (p < 0.01). In the phrase repetition task, decreased activation was detected in the left SMA and SMG (p < 0.05) of patients relative to controls. ConclusionThe left SMG plays a critical role in the language function of patients with global aphasia, especially in their abilities to name and repeat. fNIRS is a promising approach to revealing the changes in brain activities in patients with aphasia, and we believe it will contribute to a deeper understanding of the neurological mechanisms and the establishment of a novel treatment approach for global aphasia.研究背景：探索与语言恢复相关的脑重塑模式，将有助于全面性失语症（global aphasia）的临床治疗。尽管功能性近红外光谱（functional near-infrared spectroscopy, fNIRS）已被广泛应用于言语语言障碍研究，但其在全面性失语症领域的应用仍较为有限。 研究目的：本研究旨在明确全面性失语症患者在命名与复述任务中的皮层激活模式。 方法与步骤：本研究从华山医院康复医学科招募卒中后失语症患者，经言语语言病理学评估确诊为全面性失语症且无认知障碍。同时从上海地区招募年龄与性别相匹配的健康对照者。在fNIRS检测过程中，患者与健康对照者均完成图片命名与短语复述任务，随后对比两组在上述两项语言任务中的皮层激活模式。 结果与分析：本研究共纳入9例全面性失语症患者与14例健康对照者。在图片命名任务中，与健康受试者相比，全面性失语症患者在左侧Broca区（Broca's area）、颞中回（middle temporal gyrus, MTG）、颞上回（superior temporal gyrus, STG）、运动前区及补充运动皮层（supplementary motor cortex, SMA）的激活程度显著升高（p < 0.05）。此外，左侧缘上回（supramarginal gyrus, SMG）区域的氧合血红蛋白（oxyhemoglobin, HbO）浓度潜伏期与患者的命名任务得分呈显著负相关（p < 0.01）。在短语复述任务中，患者组在左侧SMA与SMG的激活程度较对照组显著降低（p < 0.05）。 研究结论：左侧缘上回（SMG）在全面性失语症患者的语言功能中发挥关键作用，尤其体现在命名与复述能力方面。fNIRS是揭示失语症患者脑活动变化的极具潜力的手段，本研究认为其将有助于深入理解全面性失语症的神经生物学机制，并为新型治疗方案的建立提供依据。