BACKGROUND:In this study, resting-state functional magnetic resonance imaging (rs-fMRI) was used to investigate the characteristics of functional connectivity of brain networks in patients with post-stroke global aphasia (PGA).METHODS:PGA patients hospitalized in Wuxi Tongren Rehabilitation Hospital during their subacute stage were selected as a case group, and healthy volunteers with matching age, sex, and education level were selected as healthy controls (HCs). rs-fMRI scans were performed to compare the differences of functional connectivity in resting-state networks (RSNs) and in the whole brain between the two groups.RESULTS:A total of 11 patients with PGA and 11 HCs were included in this study. PGA patients showed decreased inter-hemispheric connectivity of homologs within the sensorimotor network (SMN), salience network, and language network. In the analysis of the whole brain functional connections, PGA patients exhibited both inter-hemispheric and intra-hemispheric hypoconnectivity when compared with HCs. However, they exhibited some stronger connections than HCs between the language network and cerebellar network, which may indicate compensatory mechanisms.CONCLUSIONS:Using rs-fMRI to research differences in the functional connectivity of brain networks in post-stroke global aphasia will help us further understand it's neurological mechanism and provide an important basis for the accurate selection of therapeutic targets in the future to promote better recovery of language function.

OBJECTIVE:To evaluate and compare the effects of repetitive transcranial magnetic stimulation (rTMS) over the right pars triangularis of the posterior inferior frontal gyrus (pIFG) and the right posterior superior temporal gyrus (pSMG) in global aphasia following subacute stroke.METHODS:Fifty-four patients with subacute poststroke global aphasia were randomized to 15-day protocols of 20-minute inhibitory 1 Hz rTMS over either the right triangular part of the pIFG (the rTMS-b group) or the right pSTG (the rTMS-w group) or to sham stimulation, followed by 30 minutes of speech and language therapy. Language outcomes were assessed by aphasia quotient (AQ) scores obtained from the Chinese version of the Western Aphasia Battery (WAB) at baseline and immediately after 3 weeks (15 days) of experimental treatment.RESULTS:Forty-five patients completed the entire study. The primary outcome measures include the changes in WAB-AQ score, spontaneous speech, auditory comprehension, and repetition. These measures indicated significant main effect between the baseline of the rTMS-w, rTMS-b, and sham groups and immediately after stimulation (P<0.05). Compared with the sham group, the increases were significant for auditory comprehension, repetition, and AQ in the rTMS-w group (P<0.05), whereas the changes in repetition, spontaneous speech, and AQ tended to be higher in the rTMS-b group (P<0.05).CONCLUSIONS:Inhibitory rTMS targeting the right pIFG and pSTG can be an effective treatment for subacute stroke patients with global aphasia. The effect of rTMS may depend on the stimulation site. Low-frequency rTMS inhibited the right pSTG and significantly improved language recovery in terms of auditory comprehension and repetition, whereas LF-rTMS inhibited the right pIFG, leading to apparent changes in spontaneous speech and repetition.

Background. Glenohumeral subluxation (GHS) is common in patients with acute hemiplegia caused by stroke. GHS and upper limb function are closely related. Objective. Using musculoskeletal ultrasonography (MSUS) to objectively evaluate the efficacy of functional magnetic stimulation (FMS) in the treatment of GHS in acute hemiplegic patients after stroke. Methods. The study used prospective case control study. Stroke patients with GHS were recruited and assigned to control group and FMS group. Control group received electrode stimulation at the supraspinatus and deltoid muscles of the hemiplegic side, while FMS group was stimulated at the same locations. Before and after treatment, the distances of the acromion-greater tuberosity (AGT), acromion-lesser tuberosity (ALT), acromiohumeral distance (AHD), supraspinatus thickness (SST), and deltoid muscle thickness (DMT) in patients’ bilateral shoulder joint were measured by MSUS, respectively. Meanwhile, Fugl-Meyer Assessment (FMA) was used to evaluate the improvement of upper limb function. Results. 30 patients were recruited. After FMS treatment, there was a significant decrease in the difference value between ipsilateral side and contralateral side of AGT [t=8.595, P<0.01], ALT [t=11.435, P<0.01], AHD [t=8.375, P<0.01], SST [t=15.394, P<0.01], and DMT [t=24.935, P<0.01], and FMA score increased [t=-13.315, P<0.01]. Compared with control group, FMS group decreased more significantly in the difference value between ipsilateral side and contralateral side of AGT [t=2.161, P<0.05], ALT [t=3.332, P<0.01], AHD [t=8.768, P<0.01], SST [t=6.244, P<0.01], and the DMT [t=3.238, P<0.01], and FMA score increased more significantly in FMS group [t=7.194, P<0.01]. Conclusion. The study preliminarily shows that the MSUS can objectively and dynamically evaluate the treatment effect of GHS in hemiplegic patients. Meanwhile, compared with control group, the FMS is more effective and has fewer side effects, and the long-term effect of FMS is worth further study. This trial is registered with ChiCTR1800015352.