Abstract Subcortical aphasia results from damage to subcortical regions, but the exact underlying mechanism is unclear. We investigated the influence of arcuate fasciculus (AF) damage on the severity of subcortical aphasia after stroke using brain diffusion tensor imaging (DTI). We enrolled subjects from the “Stroke Outcome Prediction (STOP)” database: 41 patients with first-ever, left hemispheric subcortical stroke (33 with hemorrhagic, eight with ischemic stroke) who underwent the Western Aphasia Battery (WAB) evaluation and DTI. We performed a correlation analysis between lesion volume (LV) and the DTI parameters of the AF, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD), and AF type, and the WAB scores, and a classification and regression tree (CART) analysis to identify significant neuroimaging predictors for subcortical aphasia. FA significantly correlated with the aphasia quotient (AQ) and the naming score, and LV with the AQ and several WAB subtests (fluency, repetition, naming). At the subgroup level, FA and AF type showed significant correlations with the AQ, comprehension, and naming in the ischemic stroke group, while LV was associated with naming in the hemorrhagic stroke group. LV and FA were significant predictors of the AQ in all subjects, while FA was the only predictor of the language score in the hemorrhagic stroke group. Damage to the AF may be an important underlying mechanism of subcortical aphasia, and the FA value representing the integrity of the AF is an important predictor of the severity of subcortical aphasia.

中文翻译：

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弓状束的完整性是皮质下卒中后语言障碍的良好预测指标

摘要 皮层下失语症由皮层下区域损伤引起，但确切的机制尚不清楚。我们使用脑弥散张量成像 (DTI) 研究了弓状束 (AF) 损伤对中风后皮层下失语症严重程度的影响。我们从“卒中结果预测 (STOP)”数据库中招募了受试者：41 名首次接受了西方失语症电池 (WAB) 评估和 DTI 的左半球皮质下卒中患者（33 名出血性卒中，8 名缺血性卒中）。我们对病灶体积 (LV) 和 AF 的 DTI 参数进行了相关性分析，包括分数各向异性 (FA)、平均扩散率 (MD)、径向扩散率 (RD)、轴向扩散率 (AD) 和 AF 类型，以及WAB分数，以及分类和回归树 (CART) 分析，以确定皮层下失语症的重要神经影像学预测因素。FA 与失语商数 (AQ) 和命名评分显着相关，LV 与 AQ 和几个 WAB 子测试（流畅性、重复性、命名）显着相关。在亚组水平，FA和AF类型与缺血性卒中组的AQ、理解和命名显着相关，而LV与出血性卒中组的命名相关。LV 和 FA 是所有受试者 AQ 的重要预测因子，而 FA 是出血性卒中组语言评分的唯一预测因子​​。AF 的损伤可能是皮层下失语症的重要潜在机制，代表 AF 完整性的 FA 值是皮质下失语症严重程度的重要预测因子。