From singing to speaking: Why singing may lead to recovery of expressive language function in patients with Broca's aphasia
From singing to speaking: Why singing may lead to recovery of expressive language function in patients with Broca's aphasia
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DOI：
10.1525/mp.2008.25.4.315
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发表时间：
2008-04-01
期刊：
影响因子：
2.3
通讯作者：
Norton, Andrea
中科院分区：
文献类型：
--
作者：
Schlaug, Gottfried;Marchina, Sarah;Norton, Andrea
有报道称，严重不流利的失语症患者唱歌词比说同样的话更好。这一观察启发了旋律语调疗法(MIT)的发展，这种疗法的效果已经显示出来，但其有效性尚未得到证实，神经相关性仍未确定。由于麻省理工学院有可能接触/揭开未受影响的右半球的语言能力区域，因此特别适合有较大左半球病变的患者。使用两名具有相似损害和卒中大小/位置的患者，我们展示了MIT和对照干预的效果。两种干预措施的治疗后结果都显示，命题言语(概括为未经练习的单词和短语)的显著改善；然而，麻省理工学院治疗的患者的收益超过了对照治疗的患者。与治疗相关的成像变化表明，麻省理工学院通过歌唱和左手敲击右脑来启动感觉运动和运动前皮质以进行发音，这是其效果优于非语调语言治疗的原因。
IT HAS BEEN REPORTED THAT PATIENTS WITH SEVERELY nonfluent aphasia are better at singing lyrics than speaking the same words. This observation inspired the development of Melodic Intonation Therapy (MIT), a treatment whose effects have been shown, but whose efficacy is unproven and neural correlates remain unidentified. Because of its potential to engage/unmask language-capable regions in the unaffected right hemisphere, MIT is particularly well suited for patients with large left-hemisphere lesions. Using two patients with similar impairments and stroke size/location, we show the effects of MIT and a control intervention. Both interventions' post-treatment outcomes revealed significant improvement in propositional speech that generalized to unpracticed words and phrases; however, the MIT-treated patient's gains surpassed those of the control-treated patient. Treatment-associated imaging changes indicate that MIT's unique engagement of the right hemisphere, both through singing and tapping with the left hand to prime the sensorimotor and premotor cortices for articulation, accounts for its effect over nonintoned speech therapy.