在前叶切除后,语言网络中的长期神经可塑性
Maria Sablik1,2,3, Marine N Fleury1,2, Lawrence P Binding1,2,4
1Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.
Epilepsia
|November 6, 2024
概括
手术中的神经可塑性持续长达9年,语言恢复与双边大脑激活相关. 早期干预和康复可以改善前叶切除 (ATLR) 后的认知结果.
科学领域:
- 神经科学是一个神经科学.
- 神经外科 神经外科
- 发病学 (Epileptology) 是一个专业的学科.
背景情况:
- 前叶切除 (ATLR) 有效地治疗耐药性叶 (TLE).
- 语言缺陷可以发生在ATLR后,但长期的神经可塑性仍然不太了解.
- 之前的研究表明,在ATLR后的12个月内,语言网络的重组.
研究的目的:
- 在ATLR后10年内研究语言功能可塑性.
- 为了将长期的神经可塑性与认知特征相关联.
- 为了检查手术后重组语言网络的效率.
主要方法:
- 在24名TLE患者 (12名左侧[LTLE],12名右侧[RTLE]) 和10名对照患者的长度研究中.
- 在四个时间点进行神经心理评估和功能性MRI (fMRI):手术前,4个月,12个月和ATLR后9年.
- 对fMRI激活和与认知变化相关性的分析,包括对海马硬化症 (HS) 患者的单独分析.
主要成果:
- 长时间LE患者显示左侧额外和逆侧激活增加,与双边激活相关的语言更好.
- 患有HS的患者表现出更广泛的双边激活.
- 患有RTLE的患者在左侧外区域表现出可塑性,这与更好的语言结果有关.
- 在9年内实现了认知稳定,超过50%的LTLE患者有所改善.
- 年龄较大,持续时间较长和手术前认知储备较低对长期语言表现产生了负面影响.
结论:
- 神经可塑性在LTLE和RTLE中延长至ATLR后9年.
- 有效的语言恢复与时间和时间外区域的双边参与有关.
- 适应性重组与改善的认知结果相关,具有挑战性的局部化手术效果观点.
- 研究结果支持早期干预,量身定制的咨询和延长ATLR后康复,以持续认知收益.
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