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Objective:To observe the temporal variability of functional connectivity between the bilateral inferior frontal gyrus and rest of the brain in persons with Broca′s aphasia (BA) and to compare the connectivity between Uygur and Chinese aphasics.Methods:Thirty Chinese and Uygur BA patients (the patient group) and 30 healthy people speaking Uygur and Chinese (the healthy group) were included. rs-fMRI images were acquired, and the patient group was divided then into a Uygur language patient group (9 cases) and a Chinese language patient group (12 cases). The healthy group was divided into a Uygur language healthy group (13 cases) and a Chinese language healthy group (15 cases). Dynamic functional connectivity (dFC) calculations were performed, and a two-factor analysis of covariance was used to obtain the brain regions in which there was an interaction between language and aphasia and to analyze the correlation between the brain regions with abnormal dFCs and linguistic behavior.Results:Interaction between the bilateral inferior frontal gyrus and the left medial and paracentral cingulate gyrus and the right postcentral gyrus dFC was observed to vary. Temporal variability among the Uygur patients was significantly less than among the Uygur healthy and Chinese patient groups. The temporal variability of Broca′s mirror area and the right postcentral gyrus in the Chinese patient group was significantly greater than in the Chinese healthy group or the Uygur patient group. Variability of Broca′s area and the left medial and paracingulate cingulate gyrus in the Uygur patients group correlated positively with oral fluency, reading comprehension and writing.Conclusion:There are differences in the temporal variability of the dFC in the bilateral inferior frontal gyrus between Uygur and Chinese BA patients. The lower variability of Broca′s area with the left medial and paracingulate and cingulate gyrus may help to identify impaired language function in BA patients. The enhanced variability of the Broca′s mirror image area with the right postcentral gyrus may be the result of reorganization of the linguistic network in Chinese BA patients.
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Broca's aphasia is a common type of aphasia after stroke. Its etiology and pathogenes belong to deficient root and excessive superficial. Deficiency of qi and blood, liver and kidney yin is the origin of the disease, and wind, fire, phlegm and blood stasis are the symptoms. Acupuncture therapy aims to refresh the brain, dredge the orifices and amplify the sound, supplemented by benefiting qi and blood, removing phlegm and blood stasis, benefiting tongue. At present, scalp acupuncture, tongue acupuncture, electroacupuncture, characteristic acupuncture and acupuncture combined with other therapies are commonly used to treat the disease. It is observed that acupuncture combined with other therapies have showed advantages in reducing the disability, and realize the optimal principle.
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Objective:To observe the clinical efficacy and safety of transcranial direct current stimulation (tDCS) on post-stroke depression (PSD) with Broca's aphasia. Methods:From January to December, 2018, 60 patients with PSD and Broca's aphasia were randomly divided into control group (n = 30) and trial group (n = 30). Both groups accepted routine medicine and rehabilitation. The trial group accepted tDCS, anode over left dorsal lateral prefrontal cortex, while the control group accepted sham stimulation. They were assessed with Stroke Aphasic Depression Questionnaire Hospital Version (SADQ-H) and Aphasic Depression Rating Scale (ADRS) before treatment and one, two and three weeks after treatment. They were also assessed with modified Barthel Index (MBI) before and three weeks after treatment. The adverse effects were investigated with questionnaire as the patients finished treatment or withdrew. Results:There were three patients withdrawing in the control group, and two in the trial group. The scores of SADQ-H and ADRS decreased with time in both groups (Ftime > 100.643, P < 0.001), and the score of SADQ-H was lower in the trial group than in the control group (Fgroup = 6.891, P = 0.011), but no significant difference was found between two groups in the scores of ADRS (Fgroup = 2.925, P = 0.093). There was significance of interaction between group and time (F > 13.642, P < 0.001). The difference of MBI was more in the trial group than in the control group (t = 7.016, P < 0.001). There was no significant difference in the incidence of adverse effects between the two groups (P = 0.5). Conclusion:tDCS is effective on PSD in patients with Broca's aphasia, without obvious adverse effects.
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Ohjective To explore the impact of constraint-induced aphasia therapy (CIAT) on language function and neural activity in patients with chronic Broca's aphasia.Methods Two chronic aphasics whose use of language was recovering after standard language therapy were selected to receive 1.5 h of CIAT twice daily for two weeks (30 hours in total).Before and after the CIAT they were tested using a block-designed picture-naming task,fMRIs were taken and their use of language was examined.Results The language function assessments showed relatively large improvements in the subjects' use of language after 4 weeks of conventional language training,but not much further change after 8 and 12 weeks.After the two weeks of CIAT,their language function improved further to a certain extent.fMRI showed increased activation in the left inferior frontal gyrus with or without enhanced activation in the left hemisphere,and reduced activation in the right inferior frontal gyrus.Conclusions Functional reorganization induced in the brain by CIAT was associated with up-regulation of the left inferior frontal gyrus or down-regulation of the right inferior frontal gyrus.Even the whole language network may have been modified.
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Using diffusion tensor tractography (DTT), we demonstrated injury of the arcuate fasciculus (AF) in the nondominant hemisphere in two patients who showed subfalcine herniation after intracerebral hemorrhage (ICH) in the dominant hemisphere. Two patients (patient 1 and patient 2) with ICH and six age-matched control patients who have ICH on the left corona radiata and basal ganglia without subfalcine herniation were recruited for this study. DTT was performed at one month after onset in patient 1 and patient 2. AFs of both hemispheres in both patients were disrupted between Wernicke's and Broca's areas. The fractional anisotropy value and tract numbers of the right AFs in both patients were found to be more than two standard deviations lower than those of control patients. In contrast, the apparent diffusion coefficient value was more than two standard deviations higher than those of control patients. Using the configuration and parameters of DTT, we confirmed injury of the AF in the nondominant hemisphere in two patients with subfalcine herniation following ICH in the dominant hemisphere. Therefore, DTT would be a useful tool for detection of underlying injury of the AF in the nondominant hemisphere in patients with subfalcine herniation.
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Humanos , Anisotropía , Ganglios Basales , Hemorragia Cerebral , DifusiónRESUMEN
Objective To investigate effects of transcranial direct current stimulation on picture naming by those with Broca's aphasia recovering from a stroke.Methods Five patients with Broca's aphasia 6-12 months post-stroke served as their own controls.They all had lesions of the left frontal gyms or the basal ganglia.They received either anodic, cathodic or sham stimulation of the left Broca's area.They were then given a picture naming test.Results The average number of correct namings was 13.13 with anodic stimulation, 9.80 with cathodic and 10.15 with the sham stimulation.Compared with cathodic or sham stimulation, anodic stimulation of the left Broca's area can improve the picture-naming ability of aphasic stroke patients significantly more effectively.Conclusions Anodic stimulation of the left Broca's area can improve the picture-naming of cerebral apoplexy patients with Broca's aphasia.Such stimulation may increase the excitability of the left cortex, suggesting that the left Broca's area and its periphery play a very important role in language recovery after stroke.
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Objective To investigate the rehabilitative effect of low frequency repetitive transcranial magnetic stimulation (rTMS) on convalescing patients with Broca's aphasia. MethodsTwenty-eight patients with Broca's aphasia recovering from cerebral infarction were randomly divided into a stimulation group and a control group with 14 subjects in each.Patients in the control group accepted conventional drugs,speech rehabilitation and sham stimulation,while patients in the stimulation group were in given low frequency rTMS in place of the sham stimulation.Their speech performance was evaluated using the China Rehabilitation Research Center's aphasia examination (CRRCAE) pre-stimulation,post-stimulation and 90 days later. ResultsCompared with before treatment and with the controls,the speaking scores of the stimulation group increased significantly after treatment and also 90 days later. ConclusionLow frequency rTMS can not only improve the speech performance of Broca's aphasia sufferers in the short term,but it also plays a lasting role.It may thus have clinical application for patients with Broca's aphasia.
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INTRODUÇÃO: Afasia é uma alteração neurológica decorrente de uma lesão em áreas cerebrais que são responsáveis pela linguagem. Frequentemente, a afasia ocorre como resultado de um acidente vascular cerebral, comprometendo a linguagem de expressão (afasia de Broca), a linguagem de entendimento (afasia de Wernicke) ou ambas (afasia mista). A avaliação otoneurológica corresponde a um grupo de procedimentos para avaliação sequencial do sistema auditivo e vestibular a de suas relações com o sistema nervoso central. O sistema auditivo e vestibular são de grande importância no controle dos mecanismos auditivos centrais, no processamento auditivo central, no controle do senso de movimento e no equilíbrio. OBJETIVO: Nosso objetivo foi apresentar a sequência da avaliação neurológica das vias auditivas (periféricas e centrais) e do sistema vestibular em um paciente com afasia de Broca. MÉTODOS: O paciente foi submetido a avaliação otorrinolaringológica, avaliação auditiva (audiometria tonal limiar convencional), testes de imitância acústica, pesquisa do reflexo acústico, avaliação do processamento auditivo central e do sistema vestibular. CONCLUSÃO: Nossos dados demonstram a importância da avaliação neurofisiológica das vias auditivas e do sistema vestibular em pacientes com afasia de Broca, para aprimorar o diagnóstico, tratamento e o acompanhamento evolutivo.
INTRODUCTION: Aphasia is a neurological disorder that results from damage to areas of the brain that are responsible for language. Often, the aphasia occurs as the result of a stroke, that leads to language expression impairment (Broca's aphasia), language comprehension impairment (Wernicke's aphasia) or the association of both (mixed aphasia). The otoneurologic evaluation is a group of semiologic standardized procedures that evaluates the relationship between the auditory and vestibular system and the central nervous system. The auditory pathways and the vestibular system are very important for the control of the central auditory mechanisms, the central auditory processing and the sense of movement and balance controls. OBJECTIVE: Our aim was to present the neurophysiologic evaluation of the auditory pathways (peripheral and central) and the vestibular system in patients with Broca's aphasia. METHODS: The patient was submitted to otorrinolaringologic evaluation, audiologic evaluation (tonal audiometria conventional), acoustics immittance measurements, research of the acoustic reflex and central auditory processing as well as vestibular system evaluation. CONCLUSIONS: Our data demonstrate the importance of the auditory pathways and the vestibular system neurophysiologic evaluation in patients with Broca's aphasia in order to improve the diagnosis, treatment and the follow-up.
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Humanos , Afasia de Broca , Vías Auditivas , Vestíbulo del LaberintoRESUMEN
OBJECTIVE: To present the case of a 54-year-old man with loss of speech, but with preservation of voluntary facio-lingual motility, language and other cognitive abilities (Broca's aphemia). METHOD: Observation of patient oral communicative abilities and general behavior, neuropsychological assessment and cranial computed tomography. RESULTS: Computed tomography showed a hyperdense lesion in the subcortex of the left precentral gyrus corresponding to Brodmann's area 6 and 44. Neuropsychological assessment confirmed that the major cognitive domains were intact. CONCLUSION: Our patient reiterates the validity of Broca's aphemia as a clinico-anatomic entity allowing us to portray it for the first time in pictures. From a neurobehavioral perspective, aphemia is related to apraxia rather than to aphasia, a fact that may have hampered the full grasp of its far-reaching implications for neurology and aphasiology.
OBJETIVO: Apresentar o caso de um paciente de 54 anos de idade com perda da fala, mas preservação da linguagem, das demais capacidades cognitivas, e da motilidade fácio-lingual voluntária (afemia de Broca). MÉTODO: Observação da capacidade de comunicação oral e do comportamento geral, exame neuropsicológico e tomografia computadorizada do crânio. RESULTADOS: A tomografia computadorizada revelou lesão hiperdensa no subcórtex do giro precentral esquerdo correspondendo às áreas 6 e 44 de Brodmann. O exame neuropsicológico confirmou que os principais domínios cognitivos se encontravam intactos. CONCLUSÃO: Nosso paciente reiterou a validade da afemia de Broca como entidade anátomo-clínico permitindo documentá-la em fotos pela primeira vez. Da perspectiva neurocomportamental, a afemia está vinculada às apraxias e não às afasias, o que pode ter prejudicado a apreensão plena do seu profundo significado para a neurologia e para a afasiologia.
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Humanos , Masculino , Persona de Mediana Edad , Apraxias/diagnóstico , Lóbulo Frontal , Trastornos del Habla/diagnóstico , Lóbulo Frontal/patología , Pruebas Neuropsicológicas , Tomografía Computarizada por Rayos XRESUMEN
@#Objective To explore the effect of early melodic intonation speech training on Broca aphasia. Methods 22 patients with Broca aphasia were trained with the early melodic intonation training program. They were evaluated with China Rehabilitation Research Center aphasia examination before and after the treatment. Results There were significant differences in auditory comprehension, repetition, oral reading, speaking, reading and calculation (P<0.05), but no significant difference in description, copying, and dictation (P>0.05). Conclusion Early melodic intonation speech training can improve the speech and reading in patients with Broca aphasia.
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@#ObjectiveTo study the method about language rehabilitation for Broca aphasis with bucco-facial apraxia in hemiplebies after stroke.Methods55 patients in hemiplegies after stroke who were diagnoised Broca aphasia with bucco-facial-apraxia by Chinese standard language test of aphasia and apraxia test,were randomly divided into two groups:treatment group(30 cases) and control group(25 cases). The trainning about language rehabilitation and occupational therapy(OT)to bucco-facial-apraxia were given in the treatment group, while in the control group the language rehabilitation training were given only. Evaluation was done in pre-treatment and post-treatment respectively.ResultsThe improvement of bucco-facial-apraxia and language expression function(repetition,speech and speech-reading) of treatment group were significant than that of control group (P<0.05).Conclusions The OT for bucco-facial-apraxia may obviously improved bucco-facial-apraxia and language expression function on training of language rehabilitation for Broca aphasia with bucco-facial-apraxia.
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Herpetic meningoencephalitis is a devastating disease with significant morbidity and mortality. One of the most serious clinical sequelae is aphasia, usually of sensory type, whereas, Broca's or motor aphasia is not a common manifestation. We report a case of herpetic meningoencephalitis diagnosed by polymerase chain reaction (PCR) and viral culture with Broca's aphasia as a neurologic sequela. A 35-year old male patient was admitted due to fever and altered mentality for 3 days. He was accompanied by nausea, vomiting, disorientation, and memory defect. Several vesicular eruptions were noted around the lips. Neck stiffness was present, but Kernig's and Brudzinski signs were not observed. Herpetic meningoencephalitis was confirmed with PCR and other diagnostic tests such as EEG, brain MRI, brain CT scan, and viral culture. His overall clinical condition was improved after acyclovir therapy, but Broca's aphasia remained as a sequela.
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Adulto , Humanos , Masculino , Aciclovir , Afasia , Afasia de Broca , Encéfalo , Pruebas Diagnósticas de Rutina , Electroencefalografía , Encefalitis por Herpes Simple , Fiebre , Herpes Simple , Labio , Imagen por Resonancia Magnética , Memoria , Mortalidad , Náusea , Cuello , Reacción en Cadena de la Polimerasa , Tomografía Computarizada por Rayos X , VómitosRESUMEN
Objective To investigate the depression in stroke patients with broca aphasia.Methods Aphasia Depression Rating Scale (ADRS) and Zung's self-rating depression scale (SDS) were applied in patients on the first stroke with broca aphasia (Aphasia group,66 cases).The results were compared with stroke patients without aphasia(control group,66 cases).Results Compared to control group,the incidence of depression in Aphasia group was significantly higher(62.12% vs 25.76%,P