| Objective To explore the brain mechanism of post-stroke aphasia on the level of the white matter fiber structure by investigating the correlation between the arcuate fasciculus(AF) and the occurrence, types, and recovery of post-stroke aphasia. Methods This study contains two parts. Part 1,the research on the correlation between the dominant AF and the occurrence and type of post-stroke aphasia.22 patients with aphasia after stroke in Department of rehabilitation medicine and Department of Neurology of our hospital were collected during January 2015 to 2016 January and all patients received language function evaluation, conventional MRI, DWI and DTI examination. Classifying aphasia types according to language function evaluation results and Benson ’s classification criteria of aphasia for all patients, and determining the injury site of dominant lateral arcuate fasciculus according to the DTI results. Measuring and comparing the FA values and ADC values of the injury site of dominant lateral arcuate fasciculus and contralateral symmetrical parts. Observing and analyzing the correlation between the injury of the dominant AF and the occurrence and type of post-stroke aphasia. Part 2,the research on the correlation between the bilateral AF and the recovery of post-stroke aphasia.9 of 22 cases were selected to receive language function assessment and DTI follow-up,the time interval range from 1 to 5 months. Observing and analyzing the change of language function and the bilateral AF structure shape of all cases. Statistical software package(SPSS13.0) was used to analyze the data collected. Results Part 1,22 patients with aphasia after stroke were all included in the study. Among them, there were 5 cases of Broca aphasia, 5 cases of Wernicke aphasia, 2 cases of conduction aphasia,3 cases of transcortical motor aphasia, 2 cases of transcortical sensory aphasia, 4 cases of global aphasia and 1 cases of anomic aphasia. Left AF complete injury in 8 cases, anterior injury in 8 cases, middle injury in 0 cases, posterior injury in 4 cases and no injury in 2 cases. 22 cases of patients with left atrial fibrillation(AF) at the site of injury and symmetrical parts of the side FA values and ADC values were measured results show that, the injured part of the left AF FA values decreased than that of the contralateral symmetrical parts and ADC value, ratio of side symmetrical parts increases, the differences were statistically significant. No clear correlation Between aphasia types and injury site of the left AF was found.Part 2,The language function of all of the 9 patients completed the review have different degrees of improvement. The hyperplasia phenomenon of the left AF structure was observed in 8 of 9 patients,and 1case with performance degradation phenomenon; the density of the right AF structure increased in 2 cases, and the other 7 cases with no obvious structural change. The mean FA value of the injury site of dominant lateral arcuate fasciculus in 9 cases was higher than that of the first examination, and the result was statistically significant(P<0.05),while the mean FA value on the right contralateral side was some increased, and the mean ADC value of both site of the arcuate fasciculus were lower than that of the first examination, the results were not statistically significant(P > 0.05). Conclusion There may be some correlation between the damage to the dominant arcuate fasciculus and the onset of aphasia. But no clear correlation between the injury site of the dominant arcuate fasciculus and aphasia types was found. During the aphasia recovery process, the damaged arcuate fasciculus will commonly occurring structural changes, mainly for repaired phenomenon. This kind of change may be one of the recovery mechanisms of post-stroke aphasia. |
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