中国康复理论与实践2025，Vol.31Issue(10)：1143-1155,13.DOI:10.3969/j.issn.1006-9771.2025.10.005
卒中后失语和卒中后抑郁自发脑活动改变的静息态功能磁共振成像Meta分析
Spontaneous brain activity changes in post-stroke aphasia and post-stroke depression:a meta-analysis of resting state functional magnetic resonance imaging
摘要
Abstract
Objective To analyze the respective abnormal brain regions and commonly altered brain regions of spontaneous brain ac-tivity in post-stroke aphasia(PSA)and post-stroke depression(PSD),and to explore the potential pathological mechanisms underlying single disease and comorbidity. Methods Literatures were retrieved from PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang data,VIP and SinoMed,from establishment to April 19th,2025.Resting-state functional magnetic resonance imaging(fMRI)studies were included if they focused on patients with PSA or PSD,with healthy controls(HC)serving as control group,and amplitude of low-frequency fluctuation(ALFF),fractional amplitude of low-frequency fluctu-ation(fALFF)and regional homogeneity(ReHo)were adopted as outcome indicator.Data regarding differential brain regions were extracted from the original studies,and a neuroimaging meta-analysis was conducted using SDM-PSI V6.23 beta. Results A total of 17 articles on PSA(339 patients and 351 HC)and five articles on PSD(102 patients and 149 HC)were included.The spontaneous brain activity in the left cerebellar area 9,right middle temporal gyrus and right insula was significantly higher in PSA patients than in HC(P<0.05),while activity in the right cerebellar area 6,left medial superior frontal gyrus(SFGmed),left middle frontal gyrus and right anterior cingulate/paracingulate gyrus was lower(P<0.05).For PSD,spontaneous brain activity was elevated in the right cuneus gyrus and right superior occipital gyrus compared to HC(P<0.05),while it was reduced in the left SFGmed and left inferior pa-rietal lobe(P<0.05).Additionally,spontaneous brain activity in the left medial superior frontal gyrus was lower in both diseases compared to HC(P<0.05). Conclusion The pathological mechanism of PSA may involve a pattern of right-sided compensatory hyperfunction and left-sided inhibitory damage within the language-related network,accompanied by cross-hemispheric synergistic activity of the cerebellum.The occurrence of PSD may be attributed to hyperactivity of the right occipital net-work,and functional inhibition involving the left inferior parietal lobe.The inhibition observed in the left SFG-med(MNI coordinates x=0,y=26,z=44)likely represents the language-emotion integration hub,mediating the co-occurrence of PSA and PSD.关键词
卒中后失语/卒中后抑郁/静息态功能磁共振成像/自发脑活动/Meta分析Key words
post-stroke aphasia/post-stroke depression/resting-state functional magnetic resonance imaging/spontaneous brain activity/meta-analysis分类
临床医学引用本文复制引用
陈宇航,杨瑜爱,卢轩禹,王昱航,张蒙园,张梓寒,王荟荧,常静玲..卒中后失语和卒中后抑郁自发脑活动改变的静息态功能磁共振成像Meta分析[J].中国康复理论与实践,2025,31(10):1143-1155,13.基金项目
1.国家自然科学基金面上项目(No.81973790) （No.81973790）
2.中央高水平中医医院临床科研业务费资助项目(No.DZMG-LJRC0016) （No.DZMG-LJRC0016）
3.北京中医药大学东直门医院科技创新专项(No.DZMKJCX-2024-027) Supported by National Natural Science Foundation of China(General)(No.81973790),Clinical Research Funding Project of Central High-level Traditional Chinese Medicine Hospital(No.DZMG-LJRC0016),and Special Project of Science and Technology Innovation of Dongzhimen Hospital,Beijing University of Chinese Medicine(No.DZMKJCX-2024-027) （No.DZMKJCX-2024-027）
