Table_1_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.

【背景】探索与语言恢复相关的脑重组模式，将有助于推动完全性失语症（global aphasia）的临床治疗。尽管功能性近红外光谱技术（functional near-infrared spectroscopy, fNIRS）已被广泛应用于言语语言障碍的相关研究，但其在完全性失语症领域的应用仍较为有限。
【研究目的】本研究旨在明确完全性失语症患者在命名与复述任务中的皮层激活模式。
【研究对象与方法】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完全性失语症且无认知功能障碍。同时从上海全市范围内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，随后比较两组在上述两项语言任务中的皮层激活模式。
【研究结果】本研究共纳入9例完全性失语症患者与14例健康对照者。在图片命名任务中，与健康受试者相比，完全性失语症患者在左侧布洛卡区（Broca's area）、颞中回（middle temporal gyrus, MTG）、颞上回（superior temporal gyrus, STG）以及前运动皮层与辅助运动皮层（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，患者左侧SMA与SMG的激活程度较对照组显著降低（P<0.05）。
【结论】左侧缘上回（SMG）在完全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应用前景的检测手段，我们相信其将有助于加深对完全性失语症神经机制的理解，并为该疾病的新型治疗方案构建提供理论支撑。