From the Department of Neurosurgery, China-Japan Friendship Hospital
(K.S., H.Z.); the Department of Rehabilitation, China-Japan Friendship
Hospital (Y.X.); Tsinghua University China-Japan Friendship Institute of
Medical Sciences, China-Japan Friendship Hospital (K.S., W.L., H.Z.); Group of
Detection & Analysis of Human Body Movement, Program of BME, Department of
Electrical Engineering, Tsinghua University (W.L.); and the Department of
Neurology, Beijing Union Hospital (S.L.), Beijing, China.
Correspondence and reprint requests to Kaoru Sakatani, MD, DMSc, PhD, Department of Neurosurgery, China-Japan Friendship Hospital, Yinghua East Rd, Hepingli, Beijing 100029, China. E-mail sakatani{at}public.east.cn.net
Background and Purpose—In normal
subjects, regional cerebral blood flow (rCBF) is greatly increased by
neuronal activity, whereas the cerebral metabolic rate for
O2 is increased only slightly. However, it is not clear
what kinds of cerebral blood oxygenation and
hemodynamic changes can be induced by language
activities in language-relevant areas of poststroke aphasics. In the
present study, we investigated the difference in the changes of
cerebral blood oxygenation and
hemodynamics in the left prefrontal cortex induced by
language activities between normal subjects, poststroke nonaphasic
patients, and nonfluent aphasic patients using near-infrared
spectroscopy (NIRS).
Methods—Twenty-nine participants performed speech tasks, such as
confrontational naming, to evaluate changes among poststroke nonfluent
(Broca's) aphasia patients (10 cases; mean±SEM, 56.9±2.2 years),
age-matched normal subjects (13 cases; 50.7±2.2 years) and poststroke
nonaphasic patients (6 cases; 52.5±3.9 years). The optodes of NIRS
were placed over the left prefrontal cortex. We analyzed the
NIRS parameter (oxyhemoglobin [oxy-Hb], deoxyhemoglobin
[deoxy-Hb], and total hemoglobin [total-Hb]) changes by qualitative
pattern analysis of the parameter changes and
quantitative analysis of the parameter values among
the groups.
Results—The most common NIRS parameter change was an
increase in oxy-Hb and total-Hb, with a slight decrease or no change in
deoxy-Hb in the normal subjects (5 of 13 cases, 38.5%) and the
nonaphasic cerebrovascular disease (CVD) patients (3 of 6 cases,
50.0%). In contrast, the most common pattern in the aphasic patients
was an increase of deoxy-Hb, with an increase of oxy-Hb and total-Hb (5
of 10 cases, 50%). However, this pattern was observed in only 3 of 13
cases (23.1%) in the normal subjects and 1 of 6 cases (16.7%) in the
nonaphasic CVD patients. The mean (±SEM) changes of deoxy-Hb of the
aphasic patients, the normal subjects, and the nonaphasic CVD patients
were 0.78±0.29, 0.06±0.16, and –0.18±0.22, respectively. The
statistical analysis demonstrated a significant effect for
deoxy-Hb (P<0.05), with the aphasic patients differing
significantly from the normal subjects and the nonaphasic CVD patients,
while the 2 nonaphasic groups did not differ from each other.
Conclusions—The present results demonstrate a multiplicity of
language-activated cerebral blood oxygenation
and hemodynamic changes in the left prefrontal cortex
in the nonaphasic and aphasic groups. The increase of deoxy-Hb with
increases of oxy-Hb and total-Hb in the aphasics during language tasks
suggests that the left prefrontal cortex of the aphasics utilizes more
oxygen than the nonaphasics during language tasks. Finally, functional
MRI, which images the activation area in the brain by detecting the
reduced concentration of deoxy-Hb during neuronal activation, should be
performed on the patients with cerebral dysfunction, giving special
consideration to the possible multiplicity of the rCBF and cerebral
oxygen metabolism responses to functional tasks.
© 1998 American Heart Association, Inc.
Original Contributions
Language-Activated Cerebral Blood Oxygenation and Hemodynamic Changes of the Left Prefrontal Cortex in Poststroke Aphasic Patients
A Near-Infrared Spectroscopy Study
Key Words: aphasia • cerebral blood flow • cognition • language • spectroscopy, near-infrared
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