Eine TMS-Studie zur funktionellen Verbindung zwischen kortikalem motorischem Handareal und Sprachareal bei Schlaganfallpatienten mit Restaphasie

摘要

Previous studies showed that in healthy subjects the excitability of the hand area of the motor cortex is enhanced during reading aloud, but only on the language-dominant hemisphere. These results indicate that there is a functional connectivity between cortical areas for hand movement and language on the language-dominant hemisphere. The present study assessed the modulation of this connectivity in patients who have recovered from post-stroke aphasia. In the study the excitability of the right-hand and the left-hand motor cortex during reading aloud was investigated in those patients. The hypothesis was that the excitability of the hand motor cortex of the nondominant hemisphere may be affected in these patients by reading aloud. As control condition, mouth movements without reading were performed. The excitability of the hand motor cortex before, during and after reading was set off by using transcranial magnetic stimulation and measured by motor-evoked potentials. The results showed that the excitability of the hand motor cortex of both hemispheres is enhanced during reading aloud. There was no effect of mouth movements on hand motor cortex excitability. These results suggest a functional connectivity between cortical hand motor and language areas also on the right hemisphere in aphasia patients; this connectivity could be used therapeutically for aphasia rehabilitation. Thus the study may indicate that the right hemisphere is included in the language processing of aphasia patients.