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Zhou Y, Dai A, Feng S, Zhu T, Liu M, Shi J, Wang D. Immediate neural effects of acupuncture manipulation time for stroke with motor dysfunction: a fMRI pilot study. Front Neurosci 2024; 17:1297149. [PMID: 38249582 PMCID: PMC10796520 DOI: 10.3389/fnins.2023.1297149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Acupuncture is widely utilized as a beneficial intervention for the treatment of motor dysfunction after stroke, and its effectiveness depends on the stimulation dose. Manipulation time is an important factor affecting the dose. This trial aimed use fMRI to explore the immediate neural effects in stroke patients with motor dysfunction by different acupuncture manipulation times, to reveal the neural mechanism of acupuncture manipulation. Methods Thirty participants were divided into three groups according to different acupuncture times. Each group received the same acupoint prescription, although the continuous manipulation time of each acupoint in three groups was 1-min, 2-min, and 3-min, respectively. The NIHSS, FMA and fMRI-BOLD in each participant we obtained before and after acupuncture manipulation. Then, we used the regional homogeneity (ReHo) algorithm to analyze the changes of brain function and to compare the neural effects at different acupuncture manipulation times. Results There were no significant differences in NIHSS and FMA scores between and within groups. Longitudinal analysis of ReHo values indicated that the right inferior frontal gyrus was activated in the 1-min group, the right insula in the 2-min group, and the right inferior temporal gyrus in the 3-min group. Compared with the 1-min group, the 2-min group showed the ReHo values of the right precentral gyrus was decreased, and the 3-min group showed the left cerebellum posterior lobe was increased, the right posterior cingulate gyrus and the right anterior cingulate gyrus were decreased. Compared with the 2-min group, the 3-min group showed the ReHo values of the right cerebellum anterior lobe was increased. Conclusion Our findings suggest that acupuncture at different manipulation times caused different changes of the neural effects in stroke patients, and the volume of activated voxel clusters is positively correlated with the manipulation time. Longer acupuncture manipulation could drive SMN and DMN in stroke patients, which may be the potential neurological mechanism of acupuncture manipulation affecting the recovery of motor dysfunction.
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Affiliation(s)
- Yihao Zhou
- Heilongjiang University of Chinese Medicine, Harbin, China
- The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Anhong Dai
- Yan’an Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Sifeng Feng
- The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Tao Zhu
- The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Meifang Liu
- The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Jing Shi
- The First Affiliated Hospital of Yunnan University of Chinese Medicine, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Dongyan Wang
- Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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Isakova EV, Kotov SV, Guts ES, Zenina VA. [Possibilities of mirror therapy in cognitive rehabilitation after stroke]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:64-71. [PMID: 39166936 DOI: 10.17116/jnevro202412408264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
The review provides a brief overview of the history of the development of mirror therapy. Current data on the putative mechanisms of mirror therapy as well as the theory of mirror neurons are presented. The authors describe the implementation of the effects of mirror therapy in motor rehabilitation after stroke, including motor imagination or mental simulation of actions, strengthening of spatial attention and self-perception, activation of the ipsilateral corticospinal tract, reorganization of neuronal networks that influence the state of structurally intact but functionally inactive neurons. The authors reflected the prerequisites for the use of mirror therapy in the rehabilitation of cognitive impairment in poststroke patients. The results of current clinical studies and case reports of the use of mirror therapy for the rehabilitation of speech and non-speech cognitive disorders, and neglect syndrome after stroke are presented.
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Affiliation(s)
- E V Isakova
- Vladimirskiy Moscow Regional Research Clinical Institute, Moscow, Russia
| | - S V Kotov
- Vladimirskiy Moscow Regional Research Clinical Institute, Moscow, Russia
| | - E S Guts
- Vladimirskiy Moscow Regional Research Clinical Institute, Moscow, Russia
| | - V A Zenina
- Vladimirskiy Moscow Regional Research Clinical Institute, Moscow, Russia
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Shekari E, Nozari N. A narrative review of the anatomy and function of the white matter tracts in language production and comprehension. Front Hum Neurosci 2023; 17:1139292. [PMID: 37051488 PMCID: PMC10083342 DOI: 10.3389/fnhum.2023.1139292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/24/2023] [Indexed: 03/28/2023] Open
Abstract
Much is known about the role of cortical areas in language processing. The shift towards network approaches in recent years has highlighted the importance of uncovering the role of white matter in connecting these areas. However, despite a large body of research, many of these tracts' functions are not well-understood. We present a comprehensive review of the empirical evidence on the role of eight major tracts that are hypothesized to be involved in language processing (inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, extreme capsule, middle longitudinal fasciculus, superior longitudinal fasciculus, arcuate fasciculus, and frontal aslant tract). For each tract, we hypothesize its role based on the function of the cortical regions it connects. We then evaluate these hypotheses with data from three sources: studies in neurotypical individuals, neuropsychological data, and intraoperative stimulation studies. Finally, we summarize the conclusions supported by the data and highlight the areas needing further investigation.
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Affiliation(s)
- Ehsan Shekari
- Department of Neuroscience, Iran University of Medical Sciences, Tehran, Iran
| | - Nazbanou Nozari
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, United States
- Center for the Neural Basis of Cognition (CNBC), Pittsburgh, PA, United States
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Yu Q, Qian W. Poor Spontaneous Recovery of Aphemia Accompanied by Damage to the Anterior Segment of the Left Arcuate Fasciculus: A Case Report. Brain Sci 2022; 12:brainsci12091253. [PMID: 36138990 PMCID: PMC9496680 DOI: 10.3390/brainsci12091253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/06/2022] [Accepted: 09/15/2022] [Indexed: 11/30/2022] Open
Abstract
Aphemia is a rare and special type of speech disorder, and the mechanisms underlying the occurrence and recovery remain unclear. Here, we present a clinical case of poor spontaneous recovery of aphemia, with the anterior segment of the left arcuate fasciculus server damaged and the posterior segment intact, as detected by diffusion tensor imaging. Aphemia could be caused by the disruption of the cortical and subcortical language circuits. In particular, our data support the view that damage to the anterior segment of the left arcuate fasciculus may result in poor spontaneous recovery from speech production deficits and that an intact posterior segment seems to be crucial for supporting residual language comprehension ability in patients with post-stroke aphasia. Collectively, these data imply the importance of the left arcuate fasciculus during recovery from the language disorder in the subacute stage of stroke.
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de Wit MM, Matheson HE. Context-sensitive computational mechanistic explanation in cognitive neuroscience. Front Psychol 2022; 13:903960. [PMID: 35936251 PMCID: PMC9355036 DOI: 10.3389/fpsyg.2022.903960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Mainstream cognitive neuroscience aims to build mechanistic explanations of behavior by mapping abilities described at the organismal level via the subpersonal level of computation onto specific brain networks. We provide an integrative review of these commitments and their mismatch with empirical research findings. Context-dependent neural tuning, neural reuse, degeneracy, plasticity, functional recovery, and the neural correlates of enculturated skills each show that there is a lack of stable mappings between organismal, computational, and neural levels of analysis. We furthermore highlight recent research suggesting that task context at the organismal level determines the dynamic parcellation of functional components at the neural level. Such instability prevents the establishment of specific computational descriptions of neural function, which remains a central goal of many brain mappers - including those who are sympathetic to the notion of many-to-many mappings between organismal and neural levels. This between-level instability presents a deep epistemological challenge and requires a reorientation of methodological and theoretical commitments within cognitive neuroscience. We demonstrate the need for change to brain mapping efforts in the face of instability if cognitive neuroscience is to maintain its central goal of constructing computational mechanistic explanations of behavior; we show that such explanations must be contextual at all levels.
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Affiliation(s)
- Matthieu M. de Wit
- Department of Neuroscience, Muhlenberg College, Allentown, PA, United States
| | - Heath E. Matheson
- Department of Psychology, University of Northern British Columbia, Prince George, BC, Canada
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Xu S, Yan Z, Pan Y, Yang Q, Liu Z, Gao J, Yang Y, Wu Y, Zhang Y, Wang J, Zhuang R, Li C, Zhang Y, Jia J. Associations between Upper Extremity Motor Function and Aphasia after Stroke: A Multicenter Cross-Sectional Study. Behav Neurol 2021; 2021:9417173. [PMID: 34795804 PMCID: PMC8595012 DOI: 10.1155/2021/9417173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/08/2021] [Accepted: 10/18/2021] [Indexed: 12/21/2022] Open
Abstract
METHODS Patients with stroke were compared and correlated from overall and three periods (1-3 months, 4-6 months, and >6 months). Fugl-Meyer assessment for the upper extremity (FMA-UE) and action research and arm test (ARAT) were used to compare the UE motor status between patients with PSA and without PSA through a cross-sectional study among 435 patients. Then, the correlations between the evaluation scale scores of UE motor status and language function of patients with PSA were analyzed in various dimensions, and the language subfunction most closely related to UE motor function was analyzed by multiple linear regression analysis. RESULTS We found that the scores of FMA-UE and ARAT in patients with PSA were 14 points ((CI) 10 to 18, p < 0.001) and 11 points lower ((CI) 8 to 13, p < 0.001), respectively, than those without PSA. Their FMA-UE (r = 0.70, p < 0.001) and ARAT (r = 0.62, p < 0.001) scores were positively correlated with language function. Regression analysis demonstrated that spontaneous speech ability may account for UE motor function (R 2 = 0.51, p < 0.001; R 2 = 0.42, p < 0.001). Consistent results were also obtained from the analyses within the three time subgroups. CONCLUSION Stroke patients with PSA have worse UE motor performance. UE motor status and language function showed positive correlations, in which spontaneous speech ability significantly accounts for the associations.
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Affiliation(s)
- Shuo Xu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhijie Yan
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Xinxiang Medical University, Xinxiang, China
| | - Yongquan Pan
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qing Yang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhilan Liu
- Department of Rehabilitation Medicine, Shanghai Fourth Rehabilitation Hospital, Shanghai, China
| | - Jiajia Gao
- Department of Neurorehabilitation, The Shanghai Third Rehabilitation Hospital, Shanghai, China
| | - Yanhui Yang
- Department of Rehabilitation Medicine, Shaanxi Provincial Rehabilitation Hospital, Shaanxi, China
| | - Yufen Wu
- Department of Rehabilitation Medicine, Liuzhou Traditional Chinese Medicine Hospital, Guangxi, China
| | - Yanan Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine, Jilin, China
| | - Jianhui Wang
- Department of Rehabilitation Medicine, Nanshi Hospital Affiliated to Henan University, Henan, China
| | - Ren Zhuang
- Department of Rehabilitation Medicine, Changzhou Dean Hospital, Jiangsu, China
| | - Chong Li
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Shanghai University of Sport, Shanghai, China
| | - Yongli Zhang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Jie Jia
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, China
- National Center for Neurological Disorders, Shanghai, China
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Lv Q, Xu G, Pan Y, Liu T, Liu X, Miao L, Chen X, Jiang L, Chen J, He Y, Zhang R, Zou Y. Effect of Acupuncture on Neuroplasticity of Stroke Patients with Motor Dysfunction: A Meta-Analysis of fMRI Studies. Neural Plast 2021; 2021:8841720. [PMID: 34188677 PMCID: PMC8192216 DOI: 10.1155/2021/8841720] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 03/17/2021] [Accepted: 05/21/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To analyze the pattern of intrinsic brain activity variability that is altered by acupuncture compared with conventional treatment in stroke patients with motor dysfunction, thus providing the mechanism of stroke treatment by acupuncture. Methods Chinese and English articles published up to May 2020 were searched in the PubMed, Web of Science, EMBASE, and Cochrane Library databases, China National Knowledge Infrastructure, Chongqing VIP, and Wanfang Database. We only included randomized controlled trials (RCTs) using resting-state fMRI to observe the effect of acupuncture on stroke patients with motor dysfunction. R software was used to analyze the continuous variables, and Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) was used to perform an analysis of fMRI data. Findings. A total of 7 studies comprising 143 patients in the treatment group and 138 in the control group were included in the meta-analysis. The results suggest that acupuncture treatment helps the healing process of motor dysfunction in stroke patients and exhibits hyperactivation in the bilateral basal ganglia and insula and hypoactivation in motor-related areas (especially bilateral BA6 and left BA4). Conclusion Acupuncture plays a role in promoting neuroplasticity in subcortical regions that are commonly affected by stroke and cortical motor areas that may compensate for motor deficits, which may provide a possible mechanism underlying the therapeutic effect of acupuncture.
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Affiliation(s)
- Qiuyi Lv
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Guixing Xu
- The Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuxin Pan
- Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Tongtong Liu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaodong Liu
- Beijing University of Chinese Medicine, Beijing, China
| | | | - Xing Chen
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Lan Jiang
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Jie Chen
- School of Life Science, Peking University, Beijing, China
| | - Yingjia He
- Beijing University of Chinese Medicine, Beijing, China
| | - Rong Zhang
- Beijing University of Chinese Medicine, Beijing, China
| | - Yihuai Zou
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
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Hybbinette H, Schalling E, Plantin J, Nygren-Deboussard C, Schütz M, Östberg P, Lindberg PG. Recovery of Apraxia of Speech and Aphasia in Patients With Hand Motor Impairment After Stroke. Front Neurol 2021; 12:634065. [PMID: 33868144 PMCID: PMC8044583 DOI: 10.3389/fneur.2021.634065] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/03/2021] [Indexed: 12/19/2022] Open
Abstract
Objective: Aphasia and apraxia of speech (AOS) after stroke frequently co-occur with a hand motor impairment but few studies have investigated stroke recovery across motor and speech-language domains. In this study, we set out to test the shared recovery hypothesis. We aimed to (1) describe the prevalence of AOS and aphasia in subacute stroke patients with a hand motor impairment and (2) to compare recovery across speech-language and hand motor domains. In addition, we also explored factors predicting recovery from AOS. Methods: Seventy participants with mild to severe paresis in the upper extremity were assessed; 50% of these (n = 35) had left hemisphere (LH) lesions. Aphasia, AOS and hand motor assessments and magnetic resonance imaging were conducted at 4 weeks (A1) and at 6 months (A2) after stroke onset. Recovery was characterized in 15 participants showing initial aphasia that also had complete follow-up data at 6 months. Results: All participants with AOS and/or aphasia had LH lesions. In LH lesioned, the prevalence of aphasia was 71% and of AOS 57%. All participants with AOS had aphasia; 80% of the participants with aphasia also had AOS. Recovery in aphasia (n = 15) and AOS (n = 12) followed a parallel pattern to that observed in hand motor impairment and recovery correlated positively across speech-language and motor domains. The majority of participants with severe initial aphasia and AOS showed a limited but similar amount of recovery across domains. Lesion volume did not correlate with results from behavioral assessments, nor with recovery. The initial aphasia score was the strongest predictor of AOS recovery. Conclusion: Our findings confirm the common occurrence of AOS and aphasia in left hemisphere stroke patients with a hand motor impairment. Recovery was similar across speech-language and motor domains, even in patients with severe impairment, supporting the shared recovery hypothesis and that similar brain recovery mechanisms are involved in speech-language and motor recovery post stroke. These observations contribute to the knowledge of AOS and its relation to motor and language functions and add information that may serve as a basis for future studies of post stroke recovery. Studies including neuroimaging and/or biological assays are required to gain further knowledge on shared brain recovery mechanisms.
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Affiliation(s)
- Helena Hybbinette
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine, Stockholm, Sweden
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Ellika Schalling
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Jeanette Plantin
- Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine, Stockholm, Sweden
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Catharina Nygren-Deboussard
- Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine, Stockholm, Sweden
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Marika Schütz
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Per Östberg
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Påvel G. Lindberg
- Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine, Stockholm, Sweden
- Institut de Psychiatrie et Neurosciences Paris, Inserm U1266, Université de Paris, Paris, France
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Ginex V, Gilardone G, Viganò M, Monti A, Judica E, Passaro I, Gilardone M, Vanacore N, Corbo M. Interaction Between Recovery of Motor and Language Abilities After Stroke. Arch Phys Med Rehabil 2020; 101:1367-1376. [PMID: 32417441 DOI: 10.1016/j.apmr.2020.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/27/2020] [Accepted: 04/17/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To analyze the nature of the interaction between motor and language recovery in patients with motor impairment and aphasia following left hemispheric stroke and to investigate prognostic factors of best recovery, that is, the significant recovery of both functions simultaneously. DESIGN Retrospective cohort study. SETTING Specialized inpatient rehabilitation facility. PARTICIPANTS Patients (N=435) with left hemispheric stroke in the postacute phase with motor impairment and aphasia. INTERVENTION Not applicable. MAIN OUTCOME MEASURE Patients who reached the minimal clinically important difference in the motor-FIM (M-FIM) were classified as motor responders, patients who reached a significant change in Aachen Aphasia Test were classified as language responders, and patients who reached a simultaneous and significant improvement in both functions were classified as motor and language responders. RESULTS Of the sample 45% were motor responders, 58% were language responders, and 35% were motor and language responders. Responder groups showed lower motor impairment and less severe aphasia at admission and greater improvement in both functions at discharge compared with nonresponder groups. Premorbid autonomy, dysphagia, apraxia, and number of rehabilitative sessions were also significantly different between groups. A logistic regression model identified M-FIM, repetition abilities, and number of sessions of speech and language therapy as independent predictors of best response (ie, motor and language responders). CONCLUSIONS This study provides evidence about a possible interaction between motor and language recovery after stroke. The improvement in one function was never associated with deterioration in the other. The results actually suggest a synergic effect between the amelioration of the 2 functions, with an overall increased efficiency when the 2 recovery pathways are combined.
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Affiliation(s)
- Valeria Ginex
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy.
| | - Giulia Gilardone
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
| | - Mauro Viganò
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
| | - Alessia Monti
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
| | - Elda Judica
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
| | - Ilaria Passaro
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
| | - Marco Gilardone
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
| | - Nicola Vanacore
- National Institute of Health, National Centre for Epidemiology, Surveillance, and Health Promotion Italian, Rome, Italy
| | - Massimo Corbo
- Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy
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Yu Q, Wang H, Li S, Dai Y. Predictive role of subcomponents of the left arcuate fasciculus in prognosis of aphasia after stroke: A retrospective observational study. Medicine (Baltimore) 2019; 98:e15775. [PMID: 31169676 PMCID: PMC6571406 DOI: 10.1097/md.0000000000015775] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/31/2019] [Accepted: 05/01/2019] [Indexed: 12/14/2022] Open
Abstract
The relationship between the left arcuate fasciculus (AF) and stroke-related aphasia is unclear. In this retrospective study, we aimed to investigate the role of subcomponents of the left AF in predicting prognosis of aphasia after stroke. Twenty stroke patients with aphasia were recruited and received language assessment as well as diffusion tensor tractography scanning at admission. According to injury of the left AF, the participants were classified into four groups: group A (4 cases), the AF preserved intactly; group B (6 cases), the anterior segment injured; group C (4 cases), the posterior segment injured; and group D (6 cases), completely injured. After a consecutive speech therapy, language assessment was performed again. Changes of language functions among the groups were compared and the relation between these changes with segments injury of the AF was analyzed. After therapy, relatively high increase score percentage changes in terms of all the subcategories of language assessment were observed both in group A and C; by contrast, only naming in group B, and spontaneous speech in group D. Although no statistical difference was demonstrated among the four groups. In addition, there was no significant correlation between improvement of language function with segments injury of the AF. The predictive role of subcomponents of the left AF in prognosis of aphasia is obscure in our study. Nevertheless, it indicates the importance of integrity of the left AF for recovery of aphasia, namely that preservation of the left AF on diffusion tensor tractography could mean recovery potential of aphasia after stroke.
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Affiliation(s)
- Qiwei Yu
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University
| | - Hong Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University
- Integrated Traditional Chinese And Western Medicine Hospital Affiliated of Jinan University, Guangzhou, Guangdong, China
| | - Shuqing Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University
| | - Yanhong Dai
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University
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Anderlini D, Wallis G, Marinovic W. Language as a Predictor of Motor Recovery: The Case for a More Global Approach to Stroke Rehabilitation. Neurorehabil Neural Repair 2019; 33:167-178. [PMID: 30757952 DOI: 10.1177/1545968319829454] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Stroke is the third leading cause of death in the developed world and the primary cause of adult disability. The most common site of stroke is the middle cerebral artery (MCA), an artery that supplies a range of areas involved in both language and motor function. As a consequence, many stroke patients experience a combination of language and motor deficits. Indeed, those suffering from Broca's aphasia have an 80% chance of also suffering hemiplegia. Despite the prevalence of multifaceted disability in patients, the current trend in both clinical trials and clinical practice is toward compartmentalization of dysfunction. In this article, we review evidence that aphasia and hemiplegia do not just coexist, but that they interact. We review a number of clinical reports describing how therapies for one type of deficit can improve recovery in the other and vice versa. We go on to describe how language deficits should be seen as a warning to clinicians that the patient is likely to experience motor impairment and slower motor recovery, aiding clinicians to optimize their choice of therapy. We explore these findings and offer a tentative link between language and arm function through their shared need for sequential action, which we term fluency. We propose that area BA44 (part of Broca's area) acts as a hub for fluency in both movement and language, both in terms of production and comprehension.
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Affiliation(s)
- Deanna Anderlini
- 1 The University of Queensland, St Lucia, Queensland, Australia.,2 Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Guy Wallis
- 1 The University of Queensland, St Lucia, Queensland, Australia
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12
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Wortman-Jutt S, Edwards DJ. Transcranial Direct Current Stimulation in Poststroke Aphasia Recovery. Stroke 2017; 48:820-826. [PMID: 28174328 DOI: 10.1161/strokeaha.116.015626] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/17/2016] [Accepted: 12/15/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Susan Wortman-Jutt
- From the Burke Rehabilitation Hospital, White Plains, NY (S.W.-J.); Neuromodulation and Human Motor Control Laboratory, Burke Medical Research Institute, White Plains, NY (D.J.E.); Department of Neurology, Weill-Cornell Medical College, New York, NY (D.J.E.); School of Medical and Health Sciences, Edith Cowan University, Western Australia (D.J.E.); and Beth-Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.J.E.).
| | - Dylan J Edwards
- From the Burke Rehabilitation Hospital, White Plains, NY (S.W.-J.); Neuromodulation and Human Motor Control Laboratory, Burke Medical Research Institute, White Plains, NY (D.J.E.); Department of Neurology, Weill-Cornell Medical College, New York, NY (D.J.E.); School of Medical and Health Sciences, Edith Cowan University, Western Australia (D.J.E.); and Beth-Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.J.E.)
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