流利型失语症患者名词词组的使用特征与命名能力的关系

目的 研究汉语失语症患者的看图叙事语言,探讨名词词组的使用特征及其与失语症患者命名能力之间的关系. 方法 观察组为4名流利型失语症患者,对照组为4名正常人.对患者做西部失语检查法汉语版的测试和影像学检查,要求所有被试者在阅读连环画后逐页讲述故事,录制并转写语料.从系统功能语言学的视角,计算并分析名词词组的直白程度、复杂程度,以及和命名成绩之间的关系. 结果 患者使用的名词词组存在过度简化、错语等现象,复杂程度完全低于正常人,直白程度部分低于正常人.患者命名成绩和使用名词词组的复杂程度呈负向关系. 结论 患者使用名词词组的过度简化及错语现象在语言诊断与康复过程中值得关注,以更好判断和改善患者的命名能力.患者使用名词词组的复杂程度低,名词词组的复杂程度与患者的命名能力有负向趋势,而直白程度与命名能力的关系不明确.     

失语症患者口语命名障碍中语义错误的原因初探

目的从认知神经心理学的角度分析失语症患者口语命名障碍中语义错误的不同机制。方法对2例口语中语义错误的汉语失语症患者，分别通过口语图形命名、图形写名、词／图匹配及图／词核证等测验，检查他们各项任务的正确率及错误模式，分析各自的损伤环节。结果2例患者在口语图形命名任务中正确率相当，并都犯有大量的语义错误，但在几项理解任务中，例1基本正常，而例2的成绩显著偏低。2例所犯的错误性质有所不同。结论口语图形命名障碍中的语义错误源于不同的损伤环节：例1主要为语义后的输出系统受损，而例2则为中心语义系统受损。     

前部失语症患者句法理解障碍的研究

后部语言区病变的失语症患对句子的理解障碍众所周知，而前部失语症患对语句的理解表面上没有困难，但对句法的理解存在一定程度的障碍，笔拟对其可能机制进行分析和讨论。     

非流利型失语患者汉语反身代词指称理解障碍浅析

目的通过对比人称代词和反身代词在句子中指称理解受损表现的差异,分析汉语非流利型失语症患者反身代词指称理解障碍的特点,用以指导康复治疗。方法采用北京医科大学汉语失语症标准化检查法,将诊断为非流利型失语症的患者作为测试对象。设计相应（ABCDE型）句子,A型句和C型句含人称代词,B型句和D型句将人称代词替换汉语反身代词。通过听句子-配正确图和听句子-配错误图进行上述句子测试,把被试者测试的分数进行统计分析。结果10例失语症患者听句子-配图理解得分数明显低于对照组;失语症患者在听句子-配正确图理解所得分数中B型句组低于A型句组（P〈0.05）;D型句组低于C型句组（P〈0.05）。结论汉语失语症患者的反身代词的指称受损伤程度相对于人称代词的指称受损伤程度较重,含反身代词的句子理解和加工过程具有独特性。     

不同型失语症患者的复述障碍

目的 探讨不同型失语症患者的复述障碍特点。方法 设计8组近音单字词及词的图画,对不同型失语症患者做复述检查。结果 3例传导性失语症患者复述障碍最重,复述错误主要为音位性错语,但大多配画正确;3例经皮质感觉性失语症患者的复述错误中,9个音位性错语及2个词义性错语,大多错语配画正确,但16个复述正确的词配错画;7例经皮质运动性失语症患者中,5例复述和配画全对,另1例口语表达表现为语音障碍,1例在复述中有持续现象。结论 本文三型失语症患者复述障碍的特点不同,揭示其复述障碍各有不同的病理生理机制。     

失语症恢复机制的神经影像学研究进展

失语症是脑病变后获得性语言符号系统的理解和表达障碍。大多数失语症患者无论是否接受过治疗,包括语言治疗,都会有不同程度的恢复。近年来,应用功能影像学方法,使我们能够初步了解神经恢复的脑机制。脑的语言功能可以用神经生理学技术进行研究,如脑电图、脑磁图(MEG)、正电子发射计算机体层摄影术(PET)和功能性磁共振(fMRI),这些方法可以用来揭示失语症患者的语言恢复是否与语言系统的功能重组有关。     

脑卒中失语症的早期个体化语言康复训练

目的 探讨早期个体化语言康复训练的效果.方法 将60例脑卒中失语症患者随机分为早期康复组、延迟康复组和对照组,针对患者失语症类型合理组合语言训练手段进行1个月的治疗,用西方失语症成套测查量表(WAB)在治疗前后进行失语商(AQ)测查,并在3组之间进行比较.结果 治疗前3组间AQ评分差异无显著性(P＞0.05),治疗后早期康复组、延迟康复组与对照组比较均有显著性差异(P＜0.05),早期康复组与延迟康复组之间亦有显著性差异(P＜0.05).结论 早期语言康复训练较延迟语言康复训练有更好的疗效.针对患者失语症类型合理组合语言训练手段的语言康复有更好的疗效.     

汉语失语症患者主语问句和宾语问句理解和表达障碍的特点

目的观察汉语失语症患者疑问句理解和表达障碍的特点，探讨其理解及表达障碍的机制，为失语症患者的诊断及康复训练方法提供依据。方法根据《汉语语法量表》选择10例失语法性失语症患者作为失语法性失语组（简称失语法组），选择14例非失语法性失语症患者作为非失语法性失语组（简称非失语法组），另外选取24例正常人作为正常对照组。用经过设计的主语问句和宾语问句（各20句）对患者进行理解能力和表达能力的测试。结果失语法组患者两种疑问句的理解正确率间差异无统计学意义（P〉0．05），失语法组患者两种疑问句的表达正确率间差异有统计学意义（P〈0．05）；失语法组患者对两种疑问句的理解能力和表达能力明显低于非失语法组患者和对照组（P〈0．05）。结论汉语失语法性失语症患者对疑问句的理解和表达障碍有其自身特点，可能为以后失语患者康复计划的制定及预后判断提供有用资料。     

护理细节管理在脑血管病失语症患者语言训练中的应用

目的 探讨护理细节管理在脑血管失语症患者语言康复训练中的应用效果.方法 对56例患者在语言训练时实施护理细节管理,包括环境的要求、训练师的要求、训练时间的要求、训练方式、调动患者的支持网络、注重心理护理、注重协调关系.结果 失语症患者可尽快恢复语言表达能力,回归家庭和社会,提高了生存质量,减少病残率.结论 在脑血管疾病失语症患者语言训练中做好护理细节管理能使患者心情舒畅,尽快掌握训练的技巧和方法 ,对语言表达能力的恢复起到事半功倍的作用.     

Conceptualizing and Measuring Working Memory and its Relationship to Aphasia

BACKGROUND: General agreement exists in the literature that individuals with aphasia can exhibit a working memory deficit that contributes to their language processing impairments. Though conceptualized within different working memory frameworks, researchers have suggested that individuals with aphasia have limited working memory capacity, impaired attention-control processes as well as impaired inhibitory mechanisms. However, across studies investigating working memory ability in individuals with aphasia, different measures have been used to quantify their working memory ability and identify the relationship between working memory and language performance. AIMS: The primary objectives of this article are to (1) review current working memory theoretical frameworks, (2) review tasks used to measure working memory, and (3) discuss findings from studies that have investigated working memory as they relate to language processing in aphasia. MAIN CONTRIBUTION: Though findings have been consistent across studies investigating working memory ability in individuals with aphasia, discussion of how working memory is conceptualized and defined is often missing, as is discussion of results within a theoretical framework. This is critical, as working memory is conceptualized differently across the different theoretical frameworks. They differ in explaining what limits capacity and the source of individual differences as well as how information is encoded, maintained, and retrieved. When test methods are considered within a theoretical framework, specific hypotheses can be tested and stronger conclusions that are less susceptible to different interpretations can be made. CONCLUSIONS: Working memory ability has been investigated in numerous studies with individuals with aphasia. To better understand the underlying cognitive constructs that contribute to the language deficits exhibited by individuals with aphasia, future investigations should operationally define the cognitive constructs of interest and discuss findings within theoretical frameworks.     

卒中后失语语言和非语言认知功能相关的静息态功能磁共振成像研究

目的 本研究拟借助静息态功能磁共振成像（resting-state functional magnetic resonance imaging,rsfMRI ）,探讨卒中后失语（post-stroke aphasia,PSA）患者语言及非语言认知功能特征及其相关的脑功 能变化情况。 方法 选择2019年3月-2020年1月连续就诊于首都医科大学附属北京天坛医院的PSA患者作为病例 组,筛选年龄、性别、受教育程度相匹配的健康志愿者作为健康对照（healthy controls,HCs）组。应 用西方失语成套测验（western aphasia battery,WAB）及洛文斯顿作业疗法认知评定（Loewenstein occupational therapy cognitive assessment,LOTCA）评估语言及非语言认知功能。应用rs-fMRI采集低 频振幅（amplitude of low frequency fluctuation,ALFF）及功能连接密度（functional connectivity density, FCD）等参数。比较两组影像学参数,并将其与WAB及LOTCA评分进行Pearson相关分析。 结果 本研究纳入16例PSA患者及17例HCs。与HCs组比较,PSA组双侧海马、海马旁回、颞下回等区 域ALFF值升高,左侧额下回岛盖部、岛叶等部位ALFF值降低;右侧海马、海马旁回的FCD值升高,左 侧顶下回、枕上回、枕中回、楔前叶等脑区FCD值降低。ALFF值与WAB及LOTCA评分的相关性分析显 示,左侧额下回岛盖部的ALFF值与WAB-失语商及流畅度得分呈正比（r =0.693,P =0.026;r =0.662, P =0.037）;左侧额下回岛盖部的ALFF值与LOTCA定向得分呈正比（r =0.642,P =0.045）,左侧海马的 ALFF值与LOTCA注意力及专注力评分呈正比（r =0.706,P =0.022）。 结论 PSA患者合并部分脑区局部自发活动的强度变化及脑区间的连通性改变,这些改变与PSA患 者语言障碍和非语言认知功能障碍密切相关,这些影像学改变可以作为PSA重要影像学标记。     

100例脑卒中患者利手与语言优势半球关系的研究

选择１９８８年５月～１９９６年８月经头颅ＣＴ证实为单侧脑卒中且病灶波及语言相关区的病人１００例，在发病２周内进行失语检查，要求患者接受检查时神志清楚，定向力及记忆力好，无智能障碍，既往无脑病疾病史，其检测结果，左脑病变８０例中，有６６例失语；右脑病变２０例中，仅４例失语。经统计学处理差别有高度显著性，说明中国人左脑和右脑均可能控制语言，语言优势侧多在左侧，同时发现，右利手中，６８例左脑病变者有５８     

Task-modulated neural activation patterns in chronic stroke patients with aphasia

Background: Neuroimaging research on language recovery in patients with aphasia due to left hemisphere damage has generated some intriguing results. However, it is still not clear what role the right hemisphere plays in supporting recovered language functions in the chronic phase for patients with different site and size of lesion when different tasks are used.

Aims: The present study aimed at exploring the role of perilesional, ipsilesional, and contralesional activation in participants with aphasia with different site and size of lesion using two different language tasks. All participants were in the chronic stage with well- recovered or significant improvements in language functions.

Methods & Procedures: Functional magnetic resonance imaging (fMRI) was used to characterise brain activations in eight stroke patients and eight age/gender-matched controls during semantic judgement and oral picture naming. An event-related design using jittered interstimulus intervals (ISIs) was employed to present the stimuli.

Outcomes & Results: The fMRI scans of both language tasks in patients revealed differences in activation pattern relative to the normal control participants. The nature of this difference was task specific. During the semantic judgement task patients without lesions involving the left frontal region activated the left inferior frontal gyrus similar to observations in the normal control participants. Participants with left frontal lesions activated contralesional regions in addition to perilesional left frontal regions. During the picture-naming task all participants activated bilateral brain regions irrespective of the site or size of lesion, consistent with other published studies utilising this task. Subsequent regions of interest analysis and laterality index analysis revealed that patients with large lesions produced greater right hemisphere activation than patients with small lesions.

Conclusions: The results of this study demonstrate that recovery is task, lesion site, and size specific. Further, the results also indicate a role for both activation of homologous contralesional cortex and activity of left hemisphere regions (perilesional and ipsilesional) as efficient mechanisms for supporting language functions in chronic stroke patients.     

卒中后失语患者非语言认知功能损害特点的临床研究

目的 探讨卒中后失语患者非语言认知功能损害的特点，并分析卒中后失语患者语言障碍与非语言 性认知功能损害之间的关系。 方法 选择2017年5月-2018年6月就诊的卒中患者共32例，经西方失语症成套测验（western aphasia battery，WAB）评估语言功能，分为失语组和无失语组，其中失语组15例，无失语组17例。洛文斯顿成 套测验中文版（Loewenstein occupational therapy cognitive assessment，LOTCA）第2版评估患者非语言认 知功能。对失语组与非失语组的LOTCA各分项分值及总分分别进行非参数检验；对WAB中各分项得 分及失语商与LOTCA各认知分项得分及总分进行偏相关分析，并行多元逐步回归分析。 结果 失语组的LOTCA总分低于无失语组，差异有统计学意义[85.0（69.0～92.0）分 vs 99.0 （86.0～102.5）分，P <0.05]；失语患者LOTCA总分与WAB各分项及失语商呈正相关（r =0.587～0.883， 均P <0.05），WAB分项中的各分项与LOTCA中各分项之间呈正相关（r =0.521～0.843，均P <0.05）；多 元逐步回归分析显示，影响患者失语商的主要因素为LOTCA总分（β=0.707，P =0.003）。 结论 卒中后失语患者存在非语言认知功能障碍，失语程度越重其非语言认知功能受损程度越重。     

Global Aphasia with Seizure Onset in the Dominant Basal Temporal Region

Summary: A 33-year-old right-handed woman had intractable simple and complex partial seizures (SPS, CPS) that began with global aphasia. EEG closed-circuit TV (EEG-CCTV) monitoring with sphenoidal electrodes showed left inferomesial temporal ictal onset of CPS. Subdural electrodes were implanted over the left frontotemporal convexity, sub temporally and subfrontally. Stimulation of the basotemporal cortex produced global aphasia. A posterolaterotemporal language area was also identified. Spontaneous SPS had focal onset in the basal temporal language area (BTLA). Ictal discharges did not involve the posterotemporal region. This case shows that aphasic speech arrest at seizure onset may be due to seizure discharge in the basotemporal region and that the BTLA is clinically relevant in seizure semiology.     

不同严重程度缺血性卒中患者静脉溶栓后失语改善情况分析

目的 比较不同严重程度急性缺血性卒中（acute ischemic stroke,AIS）患者rt-PA静脉溶栓后失语改 善的比例及程度。 方法 回顾性分析2015年4月-2017年3月在郑州人民医院神经内科卒中中心连续入院接受rt-PA静 脉溶栓治疗的AIS患者360例,根据NIHSS评分分为NIHSS评分≤8分组和NIHSS评分＞8分组。收集两组 患者的年龄、性别、高血压病史、糖尿病病史、心脏病病史、吸烟饮酒史、LDL-C、发病至溶栓时间等 基线资料。比较两组患者溶栓24 h后神经功能显著好转、失语改善的比例差异,并比较两组失语改 善程度的差异。 结果 共计纳入伴有失语的AIS患者158例,其中NIHSS评分≤8分患者49例,NIHSS评分＞8分患者109 例,两组基线资料及溶栓24 h后神经功能显著好转等指标差异无统计学意义;NIHSS评分≤8分组溶 栓24 h后失语改善比例高于NIHSS评分＞8分组（67.3% vs 45.9%,P =0.021）,NIHSS评分≤8分组失语 完全改善比例高于NIHSS评分＞8分组（69.7% vs 44.0%,P =0.021）。 结论 伴有失语的AIS患者rt-PA静脉溶栓24 h后,NIHSS评分≤8分患者失语改善比例高于NIHSS评分 ＞8分患者。     

导学法在脑梗死失语患者言语治疗查房中的个案化应用

导学法通过针对性、个案化的查房思路设计,可以辅助进修医师在言语治疗教学中更好地理解患者的临床表现与解剖、脑网络加工机制的关系.本文通过一例脑梗死失语患者言语治疗的教学查房,介绍导学法在具体教学中的示范、实践指导、辅助支持、拓展思考等过程,及其查房思路对进修医师学习言语治疗的帮助.     

Short form of the Bilingual Aphasia Test in Russian: Psychometric data of persons with aphasia

Background: There is currently a lack of standardised aphasia batteries available in the Russian language. The psychometric properties of a short form of the Russian version of the Bilingual Aphasia Test (BAT) (Paradis, 1987 Paradis, M. 1987. The assessment of bilingual aphasia, Hillsdale, NJ: Lawrence Erlbaum Associates Inc.  [Google Scholar]) were examined. The BAT (Paradis & Zeiber, 1987 Paradis, M. and Zeiber, T. 1987. Bilingual Aphasia Test (Russian version), Hillsdale, NJ: Lawrence Erlbaum Associates Inc.  [Google Scholar]) is one of the few published tests in Russian.

Aims: The primary aims were: (1) to describe the psychometric properties of a modified short form of the BAT in Russian by analysing the data collected on a large sample of Russian‐speaking adults with aphasia; (2) to identify needs for further modification, validation, and standardisation; and (3) to provide a preliminary evidence base for clinicians and investigators using the test.

Methods & Procedures: The modified short form of the Russian BAT was administered to 83 patients with mild to severe aphasia. All were native speakers of Russian.

Outcomes & Results: The test was effective in discriminating patients according to level of severity of language impairment. Most of the tasks constituting the short form of the test had strong internal consistency. These results support the utility of each assessed component of the BAT in quantifying language deficits in speakers of Russian with aphasia. However, problems with the internal consistency and the validity of some items were identified.

Conclusions: The study provides preliminary data on the psychometric properties of an aphasia test in Russian. Needs for modification of the test, suggestions for further development of the test, and recommendations for further study of its psychometric properties are discussed.