CAJ | 학술논문

目的：采用静息态功能MRI技术，分析正常人静息态下左侧额下回后部的功能连接，并初步探讨该技术在脑梗死运动性失语患者中的应用。方法采用1.5 T MR扫描仪对11例男性脑梗死运动性失语患者和11名男性正常志愿者行静息态fMRI数据采集。应用统计参数图（SPM）2、功能神经成像分析（ AFNI）、矩阵实验室（ MATLAB）等软件进行预处理和统计分析，基于词语联想任务脑激活结果选择左侧额下回后部作为种子点，与全脑其他所有体素的时间序列做相关分析。采用单样本t检验和两样本t检验进行组内和组间分析。结果对照组在静息状态下与左侧额下回后部语言中枢正相关的脑区包括左侧额下回、左侧额中回、左侧运动前区、左侧楔前叶、左岛叶、左侧壳核、右侧额下回、右侧小脑半球、双侧顶下小叶（体素范围33～809，t值为5.80～23.55，P值均＜0.005）。患者组与左侧额下回后部存在功能连接的脑区包括左侧额下回、左侧额中回、左侧运动前区、左侧楔前叶、左侧顶下小叶和右侧额下回（体素范围34～833，t值为5.08～20.34，P值均＜0.005），组间分析显示患者组左侧梭状回与左侧额下回后部的功能连接低于对照组（体素84，t＝6.25，P＜0.005）。结论正常人在静息状态下存在由多个脑区构成的与语言输出功能相关的神经网络，静息态下的脑功能连接方法可用于研究脑梗死患者运动性失语发生和语言功能恢复的神经机制。
목적：채용정식태공능MRI기술，분석정상인정식태하좌측액하회후부적공능련접，병초보탐토해기술재뇌경사운동성실어환자중적응용。방법채용1.5 T MR소묘의대11례남성뇌경사운동성실어환자화11명남성정상지원자행정식태fMRI수거채집。응용통계삼수도（SPM）2、공능신경성상분석（ AFNI）、구진실험실（ MATLAB）등연건진행예처리화통계분석，기우사어련상임무뇌격활결과선택좌측액하회후부작위충자점，여전뇌기타소유체소적시간서렬주상관분석。채용단양본t검험화량양본t검험진행조내화조간분석。결과대조조재정식상태하여좌측액하회후부어언중추정상관적뇌구포괄좌측액하회、좌측액중회、좌측운동전구、좌측설전협、좌도협、좌측각핵、우측액하회、우측소뇌반구、쌍측정하소협（체소범위33～809，t치위5.80～23.55，P치균＜0.005）。환자조여좌측액하회후부존재공능련접적뇌구포괄좌측액하회、좌측액중회、좌측운동전구、좌측설전협、좌측정하소협화우측액하회（체소범위34～833，t치위5.08～20.34，P치균＜0.005），조간분석현시환자조좌측사상회여좌측액하회후부적공능련접저우대조조（체소84，t＝6.25，P＜0.005）。결론정상인재정식상태하존재유다개뇌구구성적여어언수출공능상관적신경망락，정식태하적뇌공능련접방법가용우연구뇌경사환자운동성실어발생화어언공능회복적신경궤제。
Objective To analyze the resting-state functional connectivity of the left posterior inferior frontal gyrus in normal subjects with functional MRI and to investigate its preliminary application in post-stroke aphasia.Methods Eleven male patients with post-stroke aphasia and 11 male normal subjects were recruited in this study.Resting-state fMRI data were obtained with GE 1.5 T Twin speed MR Scanner.The fMRI data were processed with SPM2, AFNI and Matlab programs.Based on the results of previous fMRI study with category member generation task , the region of interest ( ROI ) was created in the left posterior inferior frontal gyrus The time course correlations between the ROI and other voxels within whole brain were analyzed.Intra-and inter-group analysis was performed with single sample t-test and two sample t-test.Results Brain regions showed positive resting-state functional connectivity with the ROI in normal subjects including left inferior/middle frontal gyrus , left premotor cortex , left precuneus , left insula , left putamen, right inferior frontal gyrus, right cerebellum and bilateral inferior parietal lobules (voxels 33-809, t=5.80-23.55,P<0.005,uncorrected).Brain regions functionally connected with the ROI in patients with post-stroke aphasia included left inferior/middle frontal gyrus , left premotor cortex , left precuneus , left inferior parietal lobules and right inferior frontal gyrus ( voxels 34-833, t =5.08-20.34, P<0.005, uncorrected ).The left fusiform gyrus was the only region showed significantly decreased functional connectivity with the ROI in the patients group (voxels 84,t=6.25,P<0.005, uncorrected).Conclusions The neural network related to language output exists in normal subjects at the resting-state.Resting-state functional connectivity can be used to investigate the neural mechanism of development and restoration of post-stroke aphasia.