目的:应用静息态功能 MR|的基于局部一致性(regional homogeneity,ReHo)技术,探讨脑梗死后运动性失语的早期恢复发生机制。

方法:选取脑梗死后运动性失语症患者10例作为失语组，同期无失语患者10例作为对照组,均行静息态fMRI检查。应用SPM8软件和DPARSF软件对数据进行处理,利用REST进行2样本t检验。

结果:与对照组相比,失语组患者 ReHO 高于对照组的脑区有左侧小脑(脑成像坐标系 MNIx=-27,y=-60,Z=-18;t=3.33)、左枕叶(脑成像坐标系 MN1:x=-45,y=-69,z=15;t=5.26)和右侧颞叶(脑成像坐标系 MNI:x=51,y=-51,z=9;t=7.49)。失语组患者 ReHO 低于对照组的脑区有左侧前额叶内侧回(脑成像坐标系 MN:x=-24,y=75,z=3;t=-3.75)、左额上回和左额中回(脑成像坐标系 MNI:x=-36,y=9,z=66;t=-4.44)、左角回(脑成像坐标系 MNIx=-66,y=-60,z=42;t-2.67)、左顶叶(脑成像坐标系 MN1:x=-57,y=-84,z=48;t=-3.23)左侧顶上小叶和顶下小叶(脑成像坐标系 MN:x=-21,y=-42,z=87;t=-3.50)、右侧角回(脑成像坐标系 MNI:x=-54,y=-84,z=21;t=-4.00)、右侧缘上回(脑成像坐标系 MNI:x=63,y=-69Z=57;t=-4.16)、右枕叶(脑成像坐标系 MN1:x=9,y=-105,Z=24;t=-4.38)。

结论:在脑梗死后运动性失语症的急性期,左侧小脑、左枕叶和右侧颞叶激活增强,这些脑区可能参与了早期的功能代偿,是急性期恢复机制;而左侧前额叶内侧回、左侧额上回、左额中回、左顶上小叶、顶下小叶和顶叶的激活减少,这些脑区出现激活减低可能是脑梗死后运动性失语症的发生机制。

Objective: To explore the mechanism of early recovery of motor aphasia after cerebral infarction using regional homogeneity(ReHo) based techniques using resting state functional magnetic resonance imaging.

Methods: Ten patients with motor aphasia after cerebral infarction were selected as the aphasia group, and 10 patients without aphasia during the same period were selected as the control group. All patients underwent resting fMRl examination. Apply SPM8 software and DPARSF software to process the data, and use REST for 2-sample t-test.

Results: Compared with the control group, the aphasia group had higher ReH0  in the left cerebellum (MNl: x=-27,y=-60,2=-18;t=3.33), left occipital lobe (MNl: x=-45, y=-692=15; 5.26) and right middle temporal gyrus (MNl: x=51, y=?51,2=9; t=7.49). The brain areas with lower ReHO in the aphasia group compared to the control group were left medial prefrontal gyrus (MNl: x=-24, y=75, 2=3; t=-3.75), left superior frontal gyrus and left middle frontal gyrus (MNl: x=-36, y=9, z=66;t=-4.44), left angular gyrus (MN: x=-66, y=-60,z=42; t=-2.67), left parietal lobe(MNl: x=-57, y=-84, 2=48; t=-3.23), left upper and lower parietal lobules(MNl: x=-21,y=-42,2=87; t=-3.50), right angular gyrus(MNl: x=-54, y=-84, 2=21; t=-4.00)right supramarginal gyrus (MNl: x=63, y=-69, 2=57; t=-4.16) and right occipital lobe (MN!:x9,y=-105,2=24; t--4.38).

Conclusion: In the acute phase of motor aphasia after cerebral infarction, the activation of the left cerebellum, left occipital lobe, and right temporal lobe is enhanced. These brain regions may participate in early functional compensation and are the recovery mechanism of the acute phase; The activation of left medial prefrontal gyrus, left superior frontal gyrus, left middle frontal gyrus, left superior parietal lobule, inferior parietal lobule and parietal lobe is reduced, which may be the mechanism of motor aphasia after cerebral infarction.