脑卒中后丘脑失语症患者丘脑皮质网络的参与[j] - Neurology - JO - Neurology SP - e485 LP - e496 DO - 10.1212/WNL.000000000020148半岛投注体育官网8VL - 100 IS - 5 AU - Anika Stockert AU - Sophia Hormig-Rauber AU - Max Wawrzyniak AU - Julian Klingbeil AU - Hans Ralf Schneider AU - Mandy Pirlich AU - Stefan Schob AU - Karl-Titus Hoffmann AU - Dorothee Saur Y1 - 2023/01/31 UR - http://n.半岛投注体育官网neurology.org/content/100/5/e485.abstract N2 -背景和客观理论认为丘脑中风可能由于连接的皮质网络功能障碍而导致失语。这考虑到大脑功能是在分布式网络中组织的，反过来，局部损伤可能导致网络紊乱，如丘脑失语症。在这项研究中，我们调查了丘脑与特定丘脑皮质网络的整合是否在丘脑中风后的症状基础上。我们假设语言障碍患者的丘脑病变在功能上与语言和认知的皮质网络有关。方法对急性或亚急性首次丘脑卒中患者进行回顾性队列研究，采用非参数病变定位方法。使用基于非参数体素的病变症状映射来评估病变位置与语言障碍之间的关系。这种方法显示的区域更频繁受损的患者与那些没有感兴趣的症状。为了测试这些症状是否与共同的丘脑皮质网络有关，我们还进行了病变-网络-症状映射。该方法使用来自健康参与者(n = 65)静息状态fMRI的规范连接组数据进行功能连接分析，病变部位作为种子。将语言障碍患者与运动和感觉障碍患者的损伤依赖网络连通性作为基线进行比较。结果共纳入101例患者，平均[SD]年龄64.1[14.6]岁，左侧57例，右侧42例，双侧病变2例。 Voxel-based lesion-symptom mapping showed an association of language impairments with damage to left mediodorsal thalamic nucleus lesions. Lesion-network-symptom mapping revealed that language compared with sensory deficits were associated with higher normative lesion-dependent network connectivity to left frontotemporal language networks and bilateral prefrontal, insulo-opercular, midline cingular, and parietal domain-general networks. Lesions related to motor and sensory deficits showed higher lesion-dependent network connectivity within the sensorimotor network spanning prefrontal, precentral, and postcentral cortices.Discussion Thalamic aphasia relates to lesions in the left mediodorsal thalamic nucleus and to functionally connected left cortical language and bilateral cortical networks for cognitive control. This suggests that dysfunction in thalamocortical networks contributes to thalamic aphasia. We propose that inefficient integration between otherwise undamaged domain-general and language networks may cause thalamic aphasia.BA=Brodmann area; BOLD=blood-oxygenation-level dependent; DWI=diffusion-weighted imaging; FC=functional connectivity; FLAIR=fluid-attenuated inversion recovery; FWE=family-wise error; LNC=lesion-dependent network connectivity; LNSM=lesion-network-symptom mapping; MNI=Montreal Neurological Institute; ROI=region of interest; SPM12=Statistical Parametric Mapping, version 12; VLSM=voxel-based lesion-symptom mapping ER -