皮层性失语的神经语言学特点及发病机制研究

目的：研究汉语皮层性失语的神经语言学特点及发病机制，方法：采用ABC法及补充语法检查对67例脑血管病致皮层单灶性损害患者进行神经语言学检查，并行头颅CT图像标准化及脑电地形图检查。结果：运动性失语（BA）病损范围大于Broca区，经皮层运动性失语（TCMA）少数也有Broca区部分受损，感觉性失语病灶范围差异较大，经皮层混合性失语（TMA）病灶介于TCMA及经皮层感觉性失语（TCSA）之间，BA及TCMA均有音位及声调障碍，功能词完成差，实质词正常，主动句正常，被动句理解障碍；感觉性失语（WA）及TCSA音位声调正常，功能词正常,实质词完成极差，尤以同义词较多的名词提取障碍，主动句及被动句理解均障碍，结论：各型失语病灶有其结构及功能定位，可指导临床医生进行定位诊断，各型失语神经语言学特点不同，应作为针对性制安康复计划的客观依据。

A study of the neurolinguistic characteristics and pathogenesis of cortical aphasia

Objective To study the neurolinguistic manifestations and pathogenesis of cortical aphasia. Methods Sixty seven cases of cortical aphasia caused by cerebrovascular diseases were studied. Neurolinguistic examinations were performed with ABC method and supplementary grammar test in two weeks after the onset of aphasia. CT image standardization and brain electrical activity mapping (BEAM) were performed in all patients. Results The lesions in the motor aphasics (BA) were beyond the Broca aera. Similar Broca area lesions could be found in the transcortical motor aphasics (TCMA), but were usually mild. The extent of lesions of the sensory aphasics (WA) varied greatly. The lesion in the transcortical mixed aphasics (TMA) was between that in TCMA and transcortical sensory aphasics (TCSA). Patients with BA and TCMA manifested tonic and phonemic disturbances, disturbances in understanding of functional words and passive sentences. The patients with WA and TCSA manifested key words disturbances, especially the abilities for retrieval of nouns with many aynonyms, and disturbances in understanding of active and passive sentences. Conclusion Different types of lesions of the aphasics are related to different locations of the brain. Various types of aphasia have their own unique neurolinguistic characteristics which can provide objective evidences for making rehibilitation plans.