| Aphasia is an acquired linguistic dysfunction caused by injury of Brain,as one of the common complications and sequelae after stroke,and affect the patients quality of life seriously.Therefore,more attention paid to the treatment and rehabilitation of aphasia.Traditional Chinese medicine treatment of aphasia after stroke has favorbale effect,acupuncture treatment is one of the methods.A large number of studies show that on the basis of conventional medical treatment,acupuncture combined with language rehabilitation training in the treatment of cerebral apoplexy aphasia has show the distinct effect,but the mechanism is not clear.Functional Magnetic Resonance Imaging and neurolinguistic scale are effective means to diagnosis and evaluate the aphasia after stroke,which provide an objective basis for exploring the injury mechanism,recovery mechanism and therapeutic evaluation of aphasia after stroke.Therefore,this study the comprehensive rehabilitation scheme of TCM as a means of intervention,combined with neurolinguistic scale and nuclear magnetic resonance imaging in evaluating means.To observe the resting state of brain functional network changes of cortical lesions of motor aphasia after stroke who received comprehensive rehabilitation scheme of traditional Chinese medicine treatment.And to evaluate the effect mechanism of comprehensive rehabilitation scheme of traditional Chinese medicine.And then explore evaluation study model based on fMRI.Objective:Use the research methods of the brain functional network,analysis after brain stroke in the cortex damage motor aphasia(PSA)group and healthy control(HC)group resting state functional brain network,combined with BDAE and WAB score of motor aphasia brain injury mechanism and language function improvement after stroke,explore cortical injury based brain network recovery mechanism and evaluation study model based on fMRI.Methods:This study is a prospective matching parallel control study.We studied motor aphasia patients after ischemic cerebral stroke who have cortical lesions mainly,All PSA accepted thirty-days integrated intervention with acupuncture,language rehabilitation training,and basic treatment.Patients were exposed to cranial Resting-state functional magnetic resonance imaging(RS-fMRI)and neurolinguistics scale assessment at the beginning and after the intervention respectively.HC group received cranial RS-fMRI,who matching each aphasia patients in gender,age and education background.In the first point,compared the fMRI data of PSA group with the fMRI data of HC group and analysis the change of brain functional networks,and carried on the correlation analysis with score of scale,to explore the injury mechanism of brain functional network in PSA.In the second point,observed brain functional network changes of PSA group before and after treatment,carried on the Pearson correlation analysis with score of scale,to explore the cerebral mechanism of PSA after comprehensive rehabilitation treatment of traditional Chinese medicine.Results:(1)After 30 days treatment with the comprehensive rehabilitation scheme of traditional Chinese medicine,the scale of BDAE and WAB,including information,fluency,listening comprehension,naming sub-item scores and AQ value.which the difference is statistically significant(p<0.05),especially the BDAE,AQ value and naming sub-item scores(p<0.01).Repeating ability score did not show obvious improvement(p>0.05),but the repeating ability improved than before.(2)Compared with the HC group,the functional connection strength in PSA groups were reduced.The left inferior frontal gyrus and the left inferior parietal lobule in LFPN.Right inferior parietal lobule in RFPN.Right frontal gyrus and right anterior cingulate in SN.The left angular gyrus in aDMN.Right superior frontal gyrus,the left superior parietal lobule,right precuneus and right inferior frontal gyrus in pDMN.Compared with HC group,in LFPN,the average value of the functional connected strength of the left inferior frontal gyrus and the left inferior parietal lobule in PSA group were positive associated with the retelling ability score(r=0.627,p=0.052).In aDMN,the average value of the functional connected strength of the left angular gyrus were positive associated with the comprehensive ability score r=0.590,p=0.072).(3)Compared with the previous treatment,we found that after treatment the functional connection strength of the left frontal gyrus and right central posterior gyrus in RFPN were enhanced.The functional connection strength of right edge of the upper back were reduced.In aDMN,the functional connection strength of the left medial frontal gyrus and the left middle frontal gyrus brain region were reduced,but the original brain areas which functional connectivity was reduced did not show significant changes.In LFPN,pDMN and SN,functional connection was not show significant changes.Compared PSA after treatment with PSA before treatment,in aDMN,the reduction of the functional connected strength of the left medial frontal gyrus and the left middle frontal gyrus brain region were negative associated with the changes of fluency score(r?-0.615,p=0.058).In RFPN,the average value of the functional connected strength which were enhanced than before treatment were not associated with the changes in score of neurolinguistics scale.The reduction of the functional connected strength of the right edge of the upper back were positive associated with the changes of AQ value,repeating score and naming score(r=0.678,p=0.031;r=0.631,p=0.050;r=0.558,p=0.094).Conclusions:(1)The comprehensive rehabilitation scheme of traditional Chinese medicine which include acupuncture,language rehabilitation training,and basic treatment can improve the language features of motor aphasia after stroke.(2)The damage of language functions of motor aphasia after stroke is a common injury caused by multiple brain functional network.(3)The improvement of the motor aphasia s language function is related to the changes of Right Fronto Paietal Network,anterior Default Mode Network and Left Fronto Paietal Network.(4)Combineing with functional brain imaging evaluation and Linguistic evaluation scale,can reflect the efficacy mechanism of the motor aphasia after stroke objectively. |
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