Neuroplasticity of motor aphasia patients with stroke: a resting state BOLD-fMRI study / 中华行为医学与脑科学杂志

ABSTRACT

Objective To investigate the recovery mechanism of brain function in patients with mo-tor aphasia after cerebral infarction by resting-state functional magnetic resonance imaging (fMRI) functional connectivity. Methods 10 patients with aphasia after cerebral infarction (aphasia group),and 10 patients without aphasia (control group)in the same period were enrolled.Both patients underwent resting-state fMRI examination.Patients with aphasia received a second fMRI examination 1 month later.The SPM8 software and DPARSF software were used to process the data.The back of the left middle frontal gyrus ( LFMG) was se-lected as the seed point for functional connectivity analysis.REST was used for pairing and two-sample t-tests. Results Compared with the control group,the brain regions with increased LMFG-ROI functional connectiv-ity were right insula(MNIx,y,z45,12,0,t＝7.98),right inferior frontal gyrus (triangular,ankle,island cap) (MNIx,y,z42,6,27,t＝6.75),right upper temporal gyrus and right middle temporal gyrus( MNIx, y,z48,－45,6,t＝10.57),right superior border gyrus(MNIx,y,z15,－66,60,t＝5.59) and right angle gy-rus(MNIx,y,z54,－50,12,t＝9.55) in the aphasia group (before rehabilitation),and the brain regions with reduced functional connectivity were left posterior cingulate gyrus( MNIx,y,z6,－75,9,t＝－10.05), and left anterior wedge lobe(MNIx,y,z－6,－69,33,t＝－9.07).Compared with the control group,the brain regions with enhanced LMFG-ROI functional connectivity in the aphasia group (after rehabilitation 1 month) included head of left caudate nucleus,left middle frontal gyrus and inferior frontal gyrus,left globus pallidus, left central anterior gyrus,central posterior gyrus,left insula; the brain regions with reduced functional con-nectivity were right hippocampus,left cerebellum,right lingual gyrus,posterior left cingulate gyrus,right oc-cipital lobe and right anterior wedge lobe.Compared with aphasia group before rehabilitation,the brain regions with increased LMFG-ROI functional connectivity after rehabilitation 1 month were the left frontal frontal gy-rus(MNIx,y,z－51,15,24),t＝15.87),left frontal parietal island cover(MNIx,y,z－24,－66,42,t＝5.20),left central anterior gyrus and central posterior gyrus(MNIx,y,z－15,－16,55,t＝6.53); and the reduced brain regions were the right superior temporal gyrus and middle temporal gyrus(MNIx,y,z57,－18,30,t＝－15.21),right insula (MNIx,y,z－24,－66,42,t＝－5.20)and right superior border gyrus (MNIx,y,z15,－66,60,t＝－7.69). Conclusion The functional reorganization of the brain regions around the left hemisphere's injury lingual area may be the main mechanism of brain functional plasticity in patients with aphasia after cerebral infarction,and the right hemisphere is also involved in this process.In both the a-cute and chronic phases of motor aphasia,activation of the posterior left cingulate gyrus is reduced.