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Language is an advanced and important human functions, language barriers may occur in the case of many brain diseases, including stroke, cancer, trauma and so on
.
However, language dysfunction is variable.
On the contrary, congenital diseases involving language regions can provide a research model of language reorganization from another perspective
.
Cerebral arteriovenous malformation (AVM) is considered an ideal example
It happened before the period of language learning and the establishment of language networks
.
However, patients with unruptured AVM who involve traditional language areas usually do not have language barriers during their lifetime
However, the research on the plasticity of the language function of brain AVMs is limited.
The specific cortical and subcortical damage and remodeling mechanisms are still unclear, especially the language-related white matter (WM) changes in different locations of AVMs, which may reflect different subcortical changes.
Language reorganization mechanism
.
In addition, the language network is very complex, with many fiber bundles participating
.
According to the dual-stream model of language processing, the language network consists of two different pathways: dorsal and ventral pathways
At the same time, diffusion tensor imaging (DTI) is a non-invasive magnetic resonance imaging technique that can measure the anisotropy of water diffusion in brain tissue
.
Quantitative indicators that can be extracted from DTI data sets, such as anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD), are usually used to detect axons in the central nervous system And the microscopic abnormalities of the myelin sheath are very sensitive
In this way, Xiaofeng Deng and others of Tiantan Hospital recruited AVM patients involved in different language regions and conducted this study, using the AFQ method to prove the mechanism of language reorganization from the perspective of structural connection
.
They prospectively recruited 33 patients with AVMs involving language areas
.
According to the location of the lesion, the patients were divided into 3 groups: frontal lobe group (14 patients), temporal lobe group (15 patients) and parietal lobe group (4 patients)
According to the Western Aphasia Battery test, the language function of all subjects was normal
.
In the frontal lobe group, the anisotropy (FA) value decreased in the left arcuate fascicle, and increased in the left superior longitudinal fasciculus and uncinate fascicle;
In the parietal group, the FA value of left arcuate fascicle and inferior longitudinal fascicle decreased, and the FA value of bilateral bilateral anterior thalamic radiations and uncinate
fascicles and right inferior fronto-occipital fascicle increased
.
In fiber bundles with decreased FA value, the increase in radial diffusivity is common, and fiber bundles with increased FA value are usually accompanied by an increase in axial diffusivity
.
The important significance of this research lies in the discovery: when the traditional language area is accumulated by AVM nodules, the language-related white matter will be reshaped , and the reorganization mode varies with the location of the AVM nodules
.
Cascade damage is mainly caused by loss of myelin sheath, and its plasticity may be dominated by the process of axon remodeling
.
When the traditional language area is exhausted by AVM nodules, the language-related white matter will be reshaped
Original source:
Deng X, Yin H, Zhang Y, et al.
Impairment and Plasticity of Language-Related White Matter in Patients With Brain Arteriovenous Malformations.
Stroke.
Published online December 2021:STROKEAHA.
121.
035506.
doi:10.
1161/STROKEAHA.
121.
035506
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