Simple Assessment And Neural Mechanism Study Of Aphasia After Stroke

BackgroundPost-stroke aphasia is one of the most severe symptoms of stroke because acquired brain injury(cerebrovascular disease)affects the extensive damage of cortical and subcortical structural networks in the dominant hemisphere of language,resulting in the loss of the complex process of interpretation and formation of language signs.Most of after-stroke aphasia are older and sicker,so it is difficult to complete the long-term assessment test.Therefore,concise,standard and targeted test tool are more suitable for early assessment of patients and later follow-up of patients.In addition to behavioral assessing,the use of simple and effective neuroimaging methods to explore the functional changes of non-structural damage areas is of great significance for understanding the neuropsychological mechanism of aphasia and exploring the follow-up targeted rehabilitation therapy.The analysis of resting state functional Magnetic Resonance Imaging(rs-f MRI)reflect the spontaneous brain activity,providing an effective tool for analyzing the neuromechanism of brain network in aphasia after stroke.ObjectiveAt present,the aphasia battery of Chinese is a common scale for assessment language function.Although the scale is comprehensive,its operation is complex.The vital signs of patients are not stable in the acute stage of post-stroke aphasia.It is urgent to produce a brief,rapid and effective assessment scale.The neural mechanism of post-stroke aphasia is not clear,so we consider using resting state functional magnetic resonance imaging(rs-f MRI)to analyze the neural mechanism of aphasia in order to explore target of physical therapy.(1)The reliability and validity of the simplified language assessment scale were evaluated based on the population with aphasia after stroke.(2)To investigate the changes of spontaneous neural activity in the brain of acute-subacute aphasia and its relationship with language dysfunction.Methods(1)The aphasia battery of Chinese(ABC)and the simplified language assessment scale were used to evaluate the langue function among 91 patients with post-stroke aphasia.The language performance was evaluated to calculate the reliability and validity.(2)Resting state functional magnetic resonance imaging was used to assess the differences in spontaneous neural activity between 31 patients with acute-subacute aphasia and 32 healthy controls and its correlation with language function in aphasia.The amplitude of low-frequency fluctuation(ALFF)was used to reflect spontaneous neural activity,using the aphasia battery of Chinese(ABC)to evaluate the language function of aphasia.Results(1)The alternate-form reliability of the simplified language assessment scale and split parts were reliable(r > 0.700 for all).The split-half reliability and internal reliability coefficient of the simplified language assessment scale was 0.825 and 0.910.The factor analysis results suggested that the construction validity of the battery was good.(2)Compared with healthy controls,acute-subacute aphasia showed decreased ALFF values in the regions of left temporo-parietal junction(TPJ)and supplementary motor area(SMA).The ALFF value in the SMA showed positive correlation with the speaking,reading and comprehension scores.Conclusion(1)The simplified language assessment scale was applicable to post-stroke aphasia with good reliability and validity.(2)The left TPJ and SMA might play an important role in language dysfunction of acute-subacute aphasia,providing a basis for the targeted treatment of aphasia.