A Case of Dysgraphia after Cerebellar Infarction Where Functional NIRS Guided the Task Aimed at Activating the Hypoperfused Region

Author:

Fujii Mutsumi1ORCID,Tanigo Kazumi2,Yamamoto Hirokazu2,Kikugawa Keijyu2,Shirakawa Masayuki2,Ohgushi Miki1,Chin Takaaki3

Affiliation:

1. Department of Physical Medicine and Rehabilitation, Hyogo Rehabilitation Center, Kobe, Japan

2. Department of Rehabilitation, Hyogo Rehabilitation Center, Kobe, Japan

3. Hyogo Rehabilitation Center, Kobe, Japan

Abstract

Background. Linguistic impairment following cerebellar lesions is characterized by a marked cerebellocerebral diaschisis with decreased perfusion in the left cerebral hemisphere. Case. We report on a 60-year-old right-handed French chef who presented with linguistic deficits following a right cerebellar infarction. Neurolinguistic examinations in the acute phase showed impaired graphomotor planning, especially for kanji (Japanese morphograms). Despite the absence of any structural damage to the supratentorial brain regions, a quantitative 123I-IMP SPECT study revealed a relative hypoperfusion, mainly around the left posterior middle temporal gyrus, considered to be a crossed cerebellar-cerebral diaschisis. We performed functional near-infrared spectroscopy (fNIRS) and observed that a picture card task could increase blood perfusion in the affected area. This task was as follows: once he saw a picture card depicting a dish, the patient had to list the ingredients that make up the dish. For example, he had to name vegetables, meat, and spices upon seeing a “curry” picture card. We added this task to his daily speech-hearing therapy regimen. In the chronic phase, we confirmed symptom amelioration in linguistic performance-paralleled reduction in the level of hypoperfusion on SPECT study. Discussion. This case is the first report of an fNIRS approach used to evaluate evidence-based prospective speech-hearing tasks by observing blood flow to the hypoperfused area of the cerebral cortex surface.

Publisher

Hindawi Limited

Subject

General Medicine

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