皮层下失语的BEAM及CT图像标准化研究

目的：研究皮层下失语的临床特征及发病机理。方法：选择经颅脑CT扫描证实为单侧皮层下病变患者105例，在发病2周，1个月及2个月分别进行失语症检查。同时进行脑电地形图（BEAM）及CT图像标准化处理。结果：皮层下失语患者病灶多在基底节区偏外侧、偏前部及偏上部。病变偏外侧及丘脑性失语患者BEAM异常率高，且此类患者多有较重的听理解障碍，而尾状核受损患者失语中有明显的构音障碍及音韵障碍。结论：皮层下失语有其临床特点，导致失语的机制多与皮层下病变直接或间接影响皮层语言区（血流量减少、代谢低下）有关，但尾状核似可作为言语的皮层下整合中枢，丘脑可作为皮层下语言中枢，在部分患者的失语中起作用。

A Study on Subcortical Aphasia by CT Image Standardization and Brain Electrical Activity Mapping

Objective: To study the clinical characteristics and pathogenetic mechanism of subcortical aphasia. Methods: One hundred and five patients with unilateral subcortical lesions confirmed by CT scans were studied. Aphasia examinations, brain electrical activity mapping (BEAM) and CT image standardization were performed in 2 weeks, one month and 2 months after onset. Results: Most aphasia patients had lesions in the lateral, front and upper part of basal ganglion. BEAM was largely abnormal in the aphasia patients of lateral type and thalamic aphasia who had serious auditory comprehension disturbance. Prominent dysarthria and dysprosody occurred in aphasia patients with lesions in candate nucleus. Conclusion: Subcortical aphasia has its clinical manifestations. It is mostly due to the damage of language related zone of hemisphere caused directly or indirectly by subcortical lesions (blood supply insufficiency and low metabolism). Caudate nucleus and thalamus serves as a subcortical center in controlling language and its disturbance causes aphasia in some patients.