皮层下脑梗死后全脑语言功能网络重塑的调控机制研究

项目名称： 皮层下脑梗死后全脑语言功能网络重塑的调控机制研究

项目编号： No.81471172

项目类型： 面上项目

立项/批准年度： 2015

项目学科： 医药、卫生

项目作者： 刘雁

作者单位： 中国人民解放军南部战区总医院

项目金额： 85万元

中文摘要： 急性脑卒中后，由于脑的内在环路被破坏，语言冲动的传导受阻，患者出现语言功能障碍，同时脑内启动调节机制，通过环路中剩余脑区及神经元自我调节及修复，以及调动远隔区域功能相关神经核团，尽可能完成语言代偿，并最终建立新的语言模式，某些已知因素可促进此过程，如拟肾上腺素类药物、适度康复训练及经颅磁刺激等。本课题拟在前研究基础上，选取急性卒中患者60名，分别采用语言功能评定、认知功能检测、独立生活指数及社会适应指数等临床观察手段，结合功能核磁共振及功能联系分析等，对急性皮层下脑卒中患者的语言功能改变进行动态观察，分析语言恢复相伴随的的皮层兴奋性及功能联系的动态演变，分别观察文拉法辛组、单独使用经颅磁刺激组、同时使用经颅磁刺激组对患者双侧皮层兴奋性、脑功能联系的影响并评价其对预后、独立生活能力及社会适应性改善的作用。本研究有望加深对脑卒中后皮层语言功能修复的病理生理机制及大脑语言环路代偿重建的认识。

中文关键词： 脑梗死；语言皮层；功能磁共振；功能连接；文拉法辛

英文摘要： Ischemic cerebral stroke usually damage internal functional network and block the transmission of language relative activities and stop the produce and receiving of any language. It would also initiated a series of mechanisms of self-compensation and internal modulation to respond to these changes and finaly reconstruct a new language system. This process is also regulated by some of the well-known factors such as adrenalin mimic medicine/moderate rehabilitation training as well as trans- cranial magnetics stimulation. Here a group of new studies would be conducted on the basis of our previously investigation to observe dynamically the language behavior, cognitive abilities, independent index and society adaptation index, as well as the cortical activities and functional connectivity associated with the language functional recovery on 106 patients following the acute subcortical cerebral infarction. The reaction of language cortex on SNRI medicine venlafaxine alone or with trans-cranial hyperfrequency magnetic stimulation. The language associated cortical activities and functional connectivities was used as the measure of effects of physical as well as medical treatment in post stroke aphasia. The study would help us to have a better understanding on the dynamic changes of language impairment, its self-compensation and regeneration and reconstruction of the damaged language functional network.

英文关键词： cerebral infarction;language cortext;fMRI;functional connectivity;venlafaxine