中国神经再生研究(英文版) ›› 2013, Vol. 8 ›› Issue (13): 1236-1246.doi: 10.3969/j.issn.1673-5374.2013.13.009

• 原著:脑损伤修复保护与再生 • 上一篇    

非优势大脑半球在失语后的作用:神经康复的意义

  

  • 收稿日期:2012-11-19 修回日期:2013-03-13 出版日期:2013-05-05 发布日期:2013-05-05

Communicating with the non-dominant hemisphere Implications for neurological rehabilitation

Fabricio Ferreira de Oliveira, Sheilla de Medeiros Correia Marin, Paulo Henrique Ferreira Bertolucci   

  1. Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
  • Received:2012-11-19 Revised:2013-03-13 Online:2013-05-05 Published:2013-05-05
  • About author:Fabricio Ferreira deOliveira☆, M.D., M.Sc.,Universidade Federal de S?o Paulo (UNIFESP),Escola Paulista de Medicina,Departamento de Neurologiae Neurocirurgia,Rua Botucatu 740, Vila Clementino,CEP 04023-900,S?o Paulo, SP,Brazil, fabricioferreiradeoliveira@ hotmail.com.

摘要:

失语症通常是由于大脑优势半球损伤所致。虽然大脑语言功能区存在细微个体差异,但大脑优势半球损伤后,语言功能的恢复机制似乎相对固定,包括损伤急性期时损伤周围脑区的激活和亚急性期时非优势大脑半球语言功能区的激活,慢性期时转为优势大脑半球的激活。非优势大脑半球在失语症康复过程中发挥了重要作用,但目前的康复手段在改善患者语言功能方面作用仍有限。需要大规模随机对照试验的开展,以研究神经康复手段提高非优势大脑半球在语言功能恢复中神经可塑性的机制。目前的研究可为失语症患者的康复措施的制定提供有用数据。

关键词: 神经再生, 综述, 语言, 失语症, 康复, 非优势大脑半球, 失用评估, 预后, 大脑, 功能, 基金资助文章

Abstract:

Aphasic syndromes usually result from injuries to the dominant hemisphere of the brain. Despite the fact that localization of language functions shows little interindividual variability, several brain areas are simultaneously activated when language tasks are undertaken. Mechanisms of language recovery after brain injury to the dominant hemisphere seem to be relatively stereotyped, including activations of perilesional areas in the acute phase and of homologues of language areas in the non-dominant hemisphere in the subacute phase, later returning to dominant hemisphere activation in the chronic phase. Plasticity mechanisms reopen the critical period of language development, more specifically in what leads to disinhibition of the non-dominant hemisphere when brain lesions affect the dominant hemisphere. The non-dominant hemisphere plays an important role during recovery from aphasia, but currently available rehabilitation therapies have shown limited results for efficient language improvement. Large-scale randomized controlled trials that evaluate well-defined interventions in patients with aphasia are needed for stimulation of neuroplasticity mechanisms that enhance the role of the non-dominant hemisphere for language recovery. Ineffective treatment approaches should be replaced by more promising ones and the latter should be evaluated for proper application. The data generated by such studies could substantiate evidence-based rehabilitation strategies for patients with aphasia.

Key words: neural regeneration, reviews, linguistics, aphasia, language, speech, non-dominant hemisphere, disability evaluation, prognosis, cerebrum, function, grants-supported paper, neuroregeneration