Online cathodal transcranial direct current stimulation to the right homologue of Broca's area improves speech fluency in people who stutter
Online cathodal transcranial direct current stimulation to the right homologue of Broca's area improves speech fluency in people who stutter
复制标题
对布罗卡区右侧同源体进行在线阴极经颅直流电刺激可改善口吃者的言语流畅性
DOI：
10.1111/pcn.12796
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发表时间：
2018
影响因子：
11.9
通讯作者：
Hashimoto Ryu‐ichiro
中科院分区：
文献类型：
--
作者：
Yada Yasuto;Tomisato Shuta;Hashimoto Ryu‐ichiro
先前的功能成像研究表明，口吃（PWS）的人在说话时表现出Broca和Wernicke区域及其右半球同源物的过度和不足激活。然而，目前还不清楚这种改变激活是否代表言语不流利的神经原因或二次代偿激活PWS。为了阐明经典语言区域及其右侧同源区域激活模式改变的功能意义，我们研究了当这些区域的激活受到脑刺激调制时，口吃的严重程度是否受到影响。我们应用经颅直流电刺激（tDCS）使用电极蒙太奇，包括放置在语言区之一及其右半球同源物上的阳极或阴极电极，第二电极放置在对侧眶上区上。每个参与者都经历了阳极和阴极tDCS会话，每个会话都包括假刺激。刺激极性和电极位置对口吃频率的影响进行了分析。随访分析显示，tDCS蒙太奇包括阴极电极右布罗卡区（RB）显着降低口吃的频率。ConclusionThe结果表明，口吃的严重程度得到改善时，过度激活RB减少tDCS。这一观察结果进一步表明，PWS的言语不流利可能是由RB的功能改变或与RB相关的言语运动控制区的异常激活引起的。
AimPrevious functional imaging studies demonstrate that people who stutter (PWS) exhibit over‐ and under‐activation of Broca's and Wernicke's areas and their right hemisphere homologues when speaking. However, it is unclear whether this altered activation represents the neural cause of speech dysfluency or a secondary compensatory activation in PWS. To clarify the functional significance of the altered activation pattern in classic language areas and their right homologues, we examined whether the severity of stuttering was affected when the activation of these areas was modulated by brain stimulation.MethodsWhile PWS read passages aloud, we applied transcranial direct current stimulation (tDCS) using electrode montages that included an anodal or cathodal electrode placed over one of the language areas and its right hemisphere homologue, with the second electrode placed over the contralateral supraorbital region. Each participant underwent both anodal and cathodal tDCS sessions, each of which included a sham stimulation. Effects of stimulation polarity and electrode location on the frequency of stuttering were analyzed.ResultsWe observed a significant interaction between polarity and location on the frequency of stuttering. Follow‐up analyses revealed that a tDCS montage including the cathodal electrode over right Broca's area (RB) significantly reduced the frequency of stuttering.ConclusionThe results indicated that stuttering severity was ameliorated when overactivation in RB was reduced by tDCS. This observation further suggests that speech dysfluency in PWS may be caused either by functional alteration in RB or by abnormal activation in speech motor control areas that are connected with RB.