CORTICAL-SUBCORTICAL INTERACTION IN PD AND NORMAL SPEECH

描述(申请人提供)：拟议的研究将通过正电子发射断层扫描(PET)测量帕金森病(PD)受试者、丘脑底核深部脑刺激(DBS)受试者和正常受试者的局部脑血流量(RCBF)来研究语言产生过程中皮质和皮质下大脑区域之间的相互作用。使用STN的DBS治疗帕金森病提供了一种可逆的方法来改变皮质下区域的活动，包括纹状体、苍白球和丘脑。虽然这种形式的治疗在减少非言语运动症状方面有效，但通常对言语没有影响，甚至是负面影响，这引发了人们对帕金森病患者言语和非言语运动控制之间的关系的质疑，以及更广泛地说，关于言语过程中皮质-皮质下相互作用的性质的问题。我们以前观察到，在正常和共济失调的说话者中，尾状核和额叶下部的rCBF与语速之间存在可靠的负相关关系。这项拟议的研究将通过绘制一系列受控言语产生任务期间的大脑活动图，进一步探索这种关系以及PD和STN的DBS如何改变这种关系。对rCBF和言语产生的同时测量和随后的分析已经对成像数据的功能意义产生了重要的洞察。在理解正常说话者和流利度受到PD和DBS影响的说话者的皮层-皮质下相互作用方面，拟议的研究应该会取得重大进展。本项目还将描述这种交互如何受任务需求的影响，以及PD、DBS和任务需求如何交互。我们的目标是更好地理解正常和不流利言语中的皮质-皮质下相互作用，以及这种相互作用在言语产生的特定方面所起的作用。清晰地说话的能力涉及到一个复杂的大脑系统，而这个系统并没有被完全理解。帕金森氏症干扰了这种能力。这项研究将研究帕金森氏症和一种治疗方式对说话过程中大脑活动的影响，以更好地了解这一系统。这可能会为神经系统疾病中的语言障碍带来新的治疗方法。

DESCRIPTION (provided by applicant): The proposed studies will investigate interactions between cortical and subcortical brain regions during speech production by measuring regional cerebral blood flow (rCBF) with positron emission tomography (PET) in Parkinson's disease (PD) subjects, PD subjects with deep brain stimulation (DBS) of the subthalamic nuclei (STN), and normal subjects. The use of DBS of the STN to treat PD provides a reversible means of modifying the activity of sub-cortical areas including the striatum, globus pallidus, and thalamus. While effective in reducing non-speech motor symptoms, this form of therapy often has no effect or even a negative effect on speech, raising questions about the relationship between speech and non- speech motor control in PD, and more generally, about the nature of cortical-subcortical interactions during speech. We have previously observed a reliable inverse relationship between rCBF in the caudate and inferior frontal area as a function of speech rate in normal and ataxic speakers. The proposed studies will further explore this relationship and the ways in which it is altered by PD and by DBS of the STN by mapping brain activity during a series of controlled speech production tasks. The concurrent measurement and subsequent analysis of rCBF and speech production has already produced significant insight into the functional significance of imaging data. The proposed studies should yield significant progress in understanding cortical-subcortical interactions during speech in normal speakers and in speakers whose fluency has been affected by PD and DBS. This project will also characterize how such interactions are affected by task demands, and how PD, DBS, and task demands interact. The goal is to better understand cortical-subcortical interactions in normal and dysfluent speech, and the role of-such interactions in specific aspects of speech production. The ability to speak clearly involves a complex brain system that is not fully understood. Parkinson's disease interferes with this ability. This research will study the effects of Parkinson's disease and one form of treatment on brain activity during speech to better understand this system. This may lead to new therapies for speech disorders in neurological diseases.