Vagus Nerve Stimulation as a Potential Adjuvant to Rehabilitation for Post-stroke Motor Speech Disorders.
Vagus Nerve Stimulation as a Potential Adjuvant to Rehabilitation for Post-stroke Motor Speech Disorders.
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DOI：
10.3389/fnins.2021.715928
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发表时间：
2021
影响因子：
4.3
通讯作者：
Kilgard MP
中科院分区：
文献类型：
--
作者：
Morrison RA;Hays SA;Kilgard MP
中风经常留下影响口面功能的永久性损伤。虽然语言治疗能够增强中风后的功能，但许多患者在治疗后只能看到适度的改善。康复后功能的部分恢复表明需要进一步干预。增强传统言语治疗效果的复述策略有望产生更大的疗效，并减少与运动性言语障碍相关的残疾。最近的研究表明，短暂的迷走神经刺激（VNS）可以促进康复干预的好处。迷走神经刺激配合上肢康复训练促进慢性脑卒中患者上肢功能恢复动物研究表明，这些改善是由运动网络中VNS依赖的突触可塑性驱动的。此外，临床前证据表明，一个类似的配对VNS的策略可以促进口面网络的突触重组。基于这些发现，我们假设VNS导向的口面可塑性可以针对中风后运动性语言障碍。在这里，我们概述了配对VNS与传统的语言治疗，以提高语言运动功能中风的背景下恢复的基本原理。我们还探讨了类似的治疗，旨在提高突触可塑性在言语治疗，以及如何VNS不同于这些现有的治疗策略。基于这一证据，我们认为VNS配对语言治疗作为一种促进中风后运动性语言障碍恢复的手段是有希望的。持续的发展是必要的，以全面建立和优化这种方法，这有可能提高生活质量的许多人患有这些常见的障碍。
Stroke often leaves lasting impairments affecting orofacial function. While speech therapy is able to enhance function after stroke, many patients see only modest improvements after treatment. This partial restoration of function after rehabilitation suggests that there is a need for further intervention. Rehabilitative strategies that augment the effects of traditional speech therapy hold promise to yield greater efficacy and reduce disability associated with motor speech disorders. Recent studies demonstrate that brief bursts of vagus nerve stimulation (VNS) can facilitate the benefits of rehabilitative interventions. VNS paired with upper limb rehabilitation enhances recovery of upper limb function in patients with chronic stroke. Animal studies reveal that these improvements are driven by VNS-dependent synaptic plasticity in motor networks. Moreover, preclinical evidence demonstrates that a similar strategy of pairing VNS can promote synaptic reorganization in orofacial networks. Building on these findings, we postulate that VNS-directed orofacial plasticity could target post-stroke motor speech disorders. Here, we outline the rationale for pairing VNS with traditional speech therapy to enhance recovery in the context of stroke of speech motor function. We also explore similar treatments that aim to enhance synaptic plasticity during speech therapy, and how VNS differs from these existing therapeutic strategies. Based on this evidence, we posit that VNS-paired speech therapy shows promise as a means of enhancing recovery after post-stroke motor speech disorders. Continued development is necessary to comprehensively establish and optimize this approach, which has the potential to increase quality of life for the many individuals suffering with these common impairments.
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影响因子：
5.1
作者：
Ben-Menachem E;Revesz D;Simon BJ;Silberstein S
通讯作者：
Silberstein S
影响因子：
5.7
作者：
Fridriksson, Julius;Richardson, Jessica D.;Fillmore, Paul;Cai, Bo
通讯作者：
Cai, Bo
影响因子：
48
作者：
Carnaby, G;Hankey, G;Pizzi, J
通讯作者：
Pizzi, J
影响因子：
8.3
作者：
Dawson J;Pierce D;Dixit A;Kimberley TJ;Robertson M;Tarver B;Hilmi O;McLean J;Forbes K;Kilgard MP;Rennaker RL;Cramer SC;Walters M;Engineer N
通讯作者：
Engineer N
DOI：
10.1124/jpet.106.104166
发表时间：
2006-08-01
影响因子：
3.5
作者：
Dorr, Adrienne E.;Debonnel, Guy
通讯作者：
Debonnel, Guy