Alterations in CNS activity induced by botulinum toxin treatment in spasmodic dysphonia:: An H215OPET study
Alterations in CNS activity induced by botulinum toxin treatment in spasmodic dysphonia:: An H215OPET study
复制标题
DOI：
10.1044/1092-4388(2006/081
复制
发表时间：
2006-10-01
影响因子：
2.6
通讯作者：
Braun, Allen R.
中科院分区：
文献类型：
--
作者：
Ali, S. Omar;Thomassen, Michael;Braun, Allen R.
应用(H2O)-O-15正电子发射计算机断层扫描技术，对9例成人内收肌痉挛发音障碍(ADSD)患者注射肉毒杆菌毒素(BTX)前后的局部脑血流量(RCBF)进行检测，并与10例年龄、性别相匹配的无神经功能障碍的志愿者进行对照。扫描是在休息时和在连续的叙述性言语和耳语的产生过程中获得的。在扫描采集期间记录语音，以离线量化声音中断、音调中断和不周期性百分比，以评估与治疗相关的rCBF变化与临床改善之间的相关性。结果显示，ADSD患者在注射BTX 3~4周后，与志愿者相比，在这些区域和通常与口腔-喉运动控制有关的左半球运动区，与服用BTX前相比，这些区域的言语反应显著降低。这种反应模式与临床改善的客观指标(声音中断、音调中断和不周期性百分比的减少)密切相关。这些数据提出了ADSD的病理生理学模型，在该模型中，BTX治疗导致感觉信息的更有效的皮质处理，使这些信息可用于运动区域，使用它来更有效地调节喉部运动。
Speech-related changes in regional cerebral blood flow (rCBF) were measured using (H2O)-O-15 positron-emission tomography in 9 adults with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (BTX) injection and 10 age- and gender-matched volunteers without neurological disorders. Scans were acquired at rest and during production of continuous narrative speech and whispered speech. Speech was recorded during scan acquisition for offline quantification of voice breaks, pitch breaks, and percentage aperiodicity to assess correlations between treatment-related changes in rCBF and clinical improvement. Results demonstrated that speech-related responses in heteromodal sensory areas were significantly reduced in persons with ADSD, compared with volunteers, before the administration of BTX Three to 4 weeks after BTX injection, speech-related responses were significantly augmented in these regions and in left hemisphere motor areas commonly associated with oral-laryngeal motor control. This pattern of responses was most strongly correlated with the objective measures of clinical improvement (decreases in the frequency of voice breaks, pitch breaks, and percentage aperiodicity). These data suggest a pathophysiological model for ADSD in which BTX treatment results in more efficient cortical processing of sensory information, making this information available to motor areas that use it to more effectively regulate laryngeal movements.