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Open AccessArticle

The Supplementary Motor Area Responsible for Word Retrieval Decline After Acute Thalamic Stroke Revealed by Coupled SPECT and Near-Infrared Spectroscopy

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Department of Rehabilitation Medicine, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya, Saitama 343-8555, Japan
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Department of Rehabilitation Medicine, Chiba-Hokusoh Hospital Nippon Medical School, 1715 Kamagari, Inzai, Chiba 270-1694, Japan
Brain Sci. 2020, 10(4), 247; https://doi.org/10.3390/brainsci10040247
Received: 28 February 2020 / Revised: 16 April 2020 / Accepted: 21 April 2020 / Published: 22 April 2020
(This article belongs to the Section Neuroimaging)
Damage to the thalamus may affect cognition and language, but the underlying mechanism remains unknown. In particular, it remains a riddle why thalamic aphasia occasionally occurs and then mostly recovers to some degree. To explore the mechanism of the affected cognition and language, we used two neuroimaging techniques—single-photon emission computed tomography (SPECT), suitable for viewing the affected brain distribution after acute thalamic stroke, and functional near-infrared spectroscopy (f-NIRS), focusing on hemodynamic responses of the supplementary motor area (SMA) responsible for speech production in conjunction with the frontal aslant tract (FAT) pathway. SPECT yielded common perfusion abnormalities not only in the fronto–parieto–cerebellar loop, but also in the SMA, IFG and surrounding language-relevant regions. In NIRS sessions during a phonemic verbal fluency task, we found significant word retrieval decline in acute thalamic patients relative to age-matched healthy volunteers. Further, NIRS showed strong correlation between word retrieval and posterior SMA responses. In addition, follow-up NIRS exhibited increased bilateral SMA responses linked to improving word retrieval ability. The findings suggest that cognitive dysfunction may be related to the fronto–parieto–cerebellar loop, while language dysfunction is attributed to the SMA, IFG and language-related brain areas. SMA may contribute to the recovery of word retrieval difficulty and aphasia after thalamic stroke. View Full-Text
Keywords: cerebro-cerebellar diaschisis; FAT: frontal aslant tract; functional near-infrared spectroscopy (f-NIRS); hemodynamic response; perfusion; SPECT; thalamic aphasia; verbal fluency test cerebro-cerebellar diaschisis; FAT: frontal aslant tract; functional near-infrared spectroscopy (f-NIRS); hemodynamic response; perfusion; SPECT; thalamic aphasia; verbal fluency test
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Obayashi, S. The Supplementary Motor Area Responsible for Word Retrieval Decline After Acute Thalamic Stroke Revealed by Coupled SPECT and Near-Infrared Spectroscopy. Brain Sci. 2020, 10, 247.

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