Uncinate fasciculus and its cortical terminals in aphasia after subcortical stroke: A multi-modal MRI study
Aphasia, one of the most common cognitive impairments after stroke, is commonly considered to be a cortical deficit. However, many studies have reported cases of post subcortical stroke aphasia (PSSA). The pathology and recovery mechanism of PSSA remain unclear. This study aimed to investigate PSSA...
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Elsevier
2021-01-01
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| Series: | NeuroImage: Clinical |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213158221000413 |
| _version_ | 1818661779752878080 |
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| author | Binlong Zhang Jingling Chang Joel Park Zhongjian Tan Lu Tang Tianli Lyu Yi Han Ruiwen Fan Ying Gao Jian Kong |
| author_facet | Binlong Zhang Jingling Chang Joel Park Zhongjian Tan Lu Tang Tianli Lyu Yi Han Ruiwen Fan Ying Gao Jian Kong |
| author_sort | Binlong Zhang |
| collection | DOAJ |
| description | Aphasia, one of the most common cognitive impairments after stroke, is commonly considered to be a cortical deficit. However, many studies have reported cases of post subcortical stroke aphasia (PSSA). The pathology and recovery mechanism of PSSA remain unclear. This study aimed to investigate PSSA mechanism through a multimodal magnetic resonance imaging (MRI) approach and a two-session study design (baseline and one month after treatment). Thirty-six PSSA patients and twenty-four matched healthy controls (HC) were included. All patients had subcortical infarctions involving left subcortical white matter for 1 to 6 months. The patients underwent MRI scan and Western Aphasia Battery (WAB) examination before and after one month’s comprehensive treatment. Region-wise lesion-symptom mapping (RLSM), tractography, fractional anisotropy (FA), and amplitude of low-frequency fluctuations (ALFF) analysis were conducted. After MRI preprocessing and exclusion, FA analysis included 35 patients pre-treatment and 16 patients post-treatment. ALFF analysis included 30 patients pre-treatment and 14 patients post-treatment. We found: 1) the amount of damage in the left uncinate fasciculus (UF) was associated with WAB aphasia quotient (AQ); 2) the left UF FA and left temporal pole (TP) ALFF were decreased and positively correlated with WAB-AQ, spontaneous speech, and naming in PSSA patients; and 3) PSSA patients showed increased left TP ALFF when their language ability recovered after treatment. The left TP ALFF change was positively correlated with AQ change. Our results demonstrate the importance of left UF and left TP (one of the cortical terminals of the left UF) in PSSA pathology and recovery. These results may further provide support for the disconnection theory in the mechanism of PSSA. |
| first_indexed | 2024-12-17T04:50:29Z |
| format | Article |
| id | doaj.art-f046c43ee9d646188061d4a05b2fa9f9 |
| institution | Directory Open Access Journal |
| issn | 2213-1582 |
| language | English |
| last_indexed | 2024-12-17T04:50:29Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage: Clinical |
| spelling | doaj.art-f046c43ee9d646188061d4a05b2fa9f92022-12-21T22:02:55ZengElsevierNeuroImage: Clinical2213-15822021-01-0130102597Uncinate fasciculus and its cortical terminals in aphasia after subcortical stroke: A multi-modal MRI studyBinlong Zhang0Jingling Chang1Joel Park2Zhongjian Tan3Lu Tang4Tianli Lyu5Yi Han6Ruiwen Fan7Ying Gao8Jian Kong9Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; Department of Acupuncture and Moxibustion, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaDepartment of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; Key Laboratory of Encephalopathy Treatment of Chinese Medicine, State Administration of Traditional Chinese Medicine of the Peoples Republic of China, Beijing, ChinaDepartment of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USADepartment of Radiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; Department of Acupuncture and Moxibustion, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaDepartment of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; Key Laboratory of Encephalopathy Treatment of Chinese Medicine, State Administration of Traditional Chinese Medicine of the Peoples Republic of China, Beijing, China; Corresponding authors at: Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, 5 Haiyuncang Hutong, Dongcheng District, Beijing 100700, China (Y. Gao). Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 120, 2nd Ave, Charlestown, MA 02129, USA (J. Kong)..Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Corresponding authors at: Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, 5 Haiyuncang Hutong, Dongcheng District, Beijing 100700, China (Y. Gao). Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 120, 2nd Ave, Charlestown, MA 02129, USA (J. Kong)..Aphasia, one of the most common cognitive impairments after stroke, is commonly considered to be a cortical deficit. However, many studies have reported cases of post subcortical stroke aphasia (PSSA). The pathology and recovery mechanism of PSSA remain unclear. This study aimed to investigate PSSA mechanism through a multimodal magnetic resonance imaging (MRI) approach and a two-session study design (baseline and one month after treatment). Thirty-six PSSA patients and twenty-four matched healthy controls (HC) were included. All patients had subcortical infarctions involving left subcortical white matter for 1 to 6 months. The patients underwent MRI scan and Western Aphasia Battery (WAB) examination before and after one month’s comprehensive treatment. Region-wise lesion-symptom mapping (RLSM), tractography, fractional anisotropy (FA), and amplitude of low-frequency fluctuations (ALFF) analysis were conducted. After MRI preprocessing and exclusion, FA analysis included 35 patients pre-treatment and 16 patients post-treatment. ALFF analysis included 30 patients pre-treatment and 14 patients post-treatment. We found: 1) the amount of damage in the left uncinate fasciculus (UF) was associated with WAB aphasia quotient (AQ); 2) the left UF FA and left temporal pole (TP) ALFF were decreased and positively correlated with WAB-AQ, spontaneous speech, and naming in PSSA patients; and 3) PSSA patients showed increased left TP ALFF when their language ability recovered after treatment. The left TP ALFF change was positively correlated with AQ change. Our results demonstrate the importance of left UF and left TP (one of the cortical terminals of the left UF) in PSSA pathology and recovery. These results may further provide support for the disconnection theory in the mechanism of PSSA.http://www.sciencedirect.com/science/article/pii/S2213158221000413AphasiaSubcortical strokeMultimodal MRIUncinate fasciculusTemporal poleDisconnection theory |
| spellingShingle | Binlong Zhang Jingling Chang Joel Park Zhongjian Tan Lu Tang Tianli Lyu Yi Han Ruiwen Fan Ying Gao Jian Kong Uncinate fasciculus and its cortical terminals in aphasia after subcortical stroke: A multi-modal MRI study NeuroImage: Clinical Aphasia Subcortical stroke Multimodal MRI Uncinate fasciculus Temporal pole Disconnection theory |
| title | Uncinate fasciculus and its cortical terminals in aphasia after subcortical stroke: A multi-modal MRI study |
| title_full | Uncinate fasciculus and its cortical terminals in aphasia after subcortical stroke: A multi-modal MRI study |
| title_fullStr | Uncinate fasciculus and its cortical terminals in aphasia after subcortical stroke: A multi-modal MRI study |
| title_full_unstemmed | Uncinate fasciculus and its cortical terminals in aphasia after subcortical stroke: A multi-modal MRI study |
| title_short | Uncinate fasciculus and its cortical terminals in aphasia after subcortical stroke: A multi-modal MRI study |
| title_sort | uncinate fasciculus and its cortical terminals in aphasia after subcortical stroke a multi modal mri study |
| topic | Aphasia Subcortical stroke Multimodal MRI Uncinate fasciculus Temporal pole Disconnection theory |
| url | http://www.sciencedirect.com/science/article/pii/S2213158221000413 |
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