Deep Brain Stimulation in Laryngeal Dystonia and Voice Tremor

脑深部刺激治疗喉肌张力障碍和声音震颤

• 批准号: 10488256
• 负责人: Kristina Simonyan
• 金额: $ 64.84万
• 依托单位: MASSACHUSETTS EYE AND EAR INFIRMARY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10488256
• 关键词: Architecture; Area; Basal Ganglia; Brain; Bypass; Caring; Clinical; Clinical Trials; Communication; Data; Deep Brain Stimulation; Development; Diagnosis; Disease; Dorsal; Dystonia; Electric Stimulation; Electrocorticogram; Electroencephalography; Equipment; Essential Tremor; Evaluation; Functional Magnetic Resonance Imaging; Functional disorder; Goals; Human; Image; Impairment; Incidence; Individual; Inferior; Knowledge; Larynx; Limb Dystonia; Limb Tremors; Limb structure; Lobule; Location; Maps; Measures; Mission; Motor; Movement Disorders; Neurologic; Neurologic Voice Disorder; Neurosciences; Neurosurgeon; Operative Surgical Procedures; Outcome; Parietal; Participant; Pathway Analysis; Patients; Phenotype; Physiology; Postoperative Period; Prevalence; Production; Protocols documentation; Quality of life; Reporting; Research; Research Personnel; Scalp structure; Sensory; Site; Spastic Dysphonias; Speech; Standardization; Structure of supramarginal gyrus; Symptoms; Techniques; Testing; Thalamic structure; Tremor; United States National Institutes of Health; Voice; Voice Disorders; Work; awake; base; clinical phenotype; clinical practice; comorbidity; design; disability; implantation; improved; motor behavior; motor symptom; multidisciplinary; multimodality; neural correlate; neural network; neuroimaging; neurophysiology; next generation; non-invasive imaging; phenotypic data; relating to nervous system; response; sensory cortex

PROJECT SUMMARY / ABSTRACT Loss of voice control, which is critical for conveying effective spoken communication, is often a significant feature in patients with movement disorders, such as dystonia and essential tremor. Voice dysfunction, however, has been overshadowed clinically by a focus on limb motor symptoms. For example, deep brain stimulation (DBS) effectively reduces limb dystonia and tremor in these patients, but the modulation of voice symptoms by DBS has been vastly understudied. It is assumed that the production and modulation of voice are regulated by the basal ganglia-thalamo-cortical network in a loop architecture that is common to all motor behaviors. There is, however, little empirical data to inform our specific understanding of how voice function is encoded in basal ganglia-thalamo-cortical interactions. The overall goal of this Project is to use a combination of invasive and non-invasive human neuroscience to improve our understanding of the incidence and neural correlates of neurological voice disorders (laryngeal dystonia and voice tremor) in patients with isolated dystonia and essential tremor undergoing DBS surgery. We will use simultaneous electrocorticography (ECoG) and subcortical activity recording in dystonia and tremor patients who are awake and speaking during DBS implantation surgery. We will supplement these data with non- invasive, multimodal scalp magneto/electroencephalography (M/EEG) and functional MRI (fMRI) recordings before DBS surgery and longitudinal M/EEG recordings within one year after surgery to enhance our understanding of DBS-induced neural network modulation relevant to voice motor symptoms in dystonia and tremor patients. This work will be facilitated by the fact that all participating Center sites already use the same equipment and techniques for DBS implantation and will follow standardized experimental protocols. The disorder-specific intracranial neurophysiological signatures will be correlated with non-invasive imaging findings, stimulation location defined connectivity maps, and voice outcomes. The results of this Project will inform the development of strategies for closed-loop brain stimulation specifically to treat neurological voice dysfunction that can be tested in a subsequent clinical trial.

项目摘要 /摘要 语音控制的损失对于传达有效的口语沟通至关重要，通常是重要的 运动障碍患者（例如肌张力障碍和基本震颤）的特征。语音功能障碍， 但是，由于关注肢体运动症状，临床上已经掩盖了临床。例如，大脑 刺激（DB）有效地减少了这些患者的肢体肌张力障碍和震颤，但声音的调节 DBS的症状已被大量研究。假定声音的产生和调制是 在循环体系结构中由基底神经节 - thalamo-cortical网络调节，这是所有电动机的共同点 行为。但是，几乎没有经验数据可以告知我们对语音功能的特定理解 在基底神经节 - 丘脑 - 皮质相互作用中编码。该项目的总体目标是使用 侵入性和非侵入性人类神经科学的结合，以提高我们对 神经系统语音障碍的发病率和神经相关性（喉肌张力障碍和配音震颤） 在患有DBS手术的孤立肌张力障碍和必需震颤的患者中。我们将使用 肌张力障碍和震颤患者的同时皮质摄影（ECOG）和皮质下活性记录 在DBS植入手术期间醒着和讲话的人。我们将用非 - 侵入性，多模式的头皮磁力/脑电图（M/EEG）和功能性MRI（fMRI）记录 在手术后一年内DBS手术和纵向M/EEG记录之前 了解DBS诱导的与肌张力障碍语音运动症状有关的神经网络调节 震颤患者。所有参与中心网站都已经使用相同的事实，将促进这项工作 DBS植入的设备和技术，并将遵循标准化的实验协议。这 障碍特异性颅内神经生理学特征将与非侵入性成像相关 发现，刺激位置定义了连接图和语音结果。这个项目的结果将 告知专门治疗神经声音的闭环大脑刺激策略的制定 可以在随后的临床试验中测试的功能障碍。