Cortical-Subcortical Interaction in PD and Normal Speech

描述（由申请人提供）：拟议的项目将继续和扩展我们目前的研究皮层-皮层下的相互作用，在语音使用PD和DBS的影响，以探测运动语言控制的神经基础，PD和DBS对语音的影响。继续我们的PET功能成像，我们将增加结构成像，扩散张量成像和纤维束成像使用MRI。我们将通过一系列的任务继续探索言语，这些任务包括阅读、背诵、重复和自发言语。我们将评估可懂度和感知等级，使用这些结果来通知声学分析。我们正在增加统计建模和MRI应用于声音病理学研究的专业知识。我们的目标是回答基本的临床和言语科学问题。在这一领域需要解决几个基本问题。在临床上，我们需要更好地估计DBS导致更大言语障碍的频率，以及何时发生，如何表征。我们需要了解DBS相关的言语障碍在多大程度上是由言语脑网络的变化、整体脑效应和/或丘脑底核附近运动束的刺激引起的。从言语科学的角度来看，我们需要描述一系列言语任务的皮质-皮质下相互作用，以更好地理解基底神经节、皮质和小脑区域在言语中的作用。我们正在接近这个项目的目标，结合良好的对照实验研究，特殊情况下，可能是特别翔实的研究，并创新的方法进行临床调查研究。我们的发现，DBS增强了一些组件的讲话，而延迟其他提供了一个重要的一步，在理解不一致的文献。此外，我们的PET数据的分析表明，DBS改变了语音和皮质-皮质下相互作用之间的基本关系。我们的主要工作假设是：皮质侧不对称与流畅性;皮质下区域与发声，特别是前两个共振峰，强烈相关，这些都转移在DBS;当DBS加强发声，额外的负担是放在发音控制;大脑和语音效果都是任务依赖性的，在会话过程中观察到的最大困难。我们的工作还表明，全球血流与言语停顿有关，DBS打开和关闭，以及没有DBS的PD受试者。这可能反映了PD患者中枢神经系统的完整性，并将通过弥散张量成像进行进一步检查。除了详细的影像学研究外，我们还将对DBS手术前后的对话和重复言语进行更广泛的临床研究。综上所述，这些研究应该提供了一个更好的理解的范围和严重程度的言语变化后DBS，以及大脑的变化与这些变化。

DESCRIPTION (provided by applicant): The proposed project will continue and extend our present studies on cortical-subcortical interactions during speech using the effects of PD and DBS to probe the neurological basis of motor speech control, and the effects of PD and DBS on speech. Continuing our functional imaging with PET, we will add structural imaging, diffusion tensor imaging, and tractography using MRI. We will continue probing speech with a range of tasks incorporating reading, recitation, repetition, and spontaneous speech. We will evaluate intelligibility and perceptual ratings, using these results to inform acoustic analyses. We are adding expertise in statistical modeling and the application of MRI to the study of voice pathology. Our goal is to answer basic clinical and speech science questions. Several fundamental questions need to be addressed in this field. Clinically, we need a better estimate of how often DBS results in greater speech impairment, and when it occurs, how it can be characterized. We need to understand the extent to which DBS-related speech impairments result from changes in brain networks for speech, global brain effects, and/or stimulation of motor tracts adjacent to the subthalamic nucleus. From the speech science perspective, we need to characterize cortical-subcortical interactions for a range of speech tasks to better understand the role of the basal ganglia, cortical, and cerebellar regions in speech. We are approaching the goals of this project with a combination of well-controlled experimental studies, studies of special cases that may be especially informative, and an innovative approach to clinical survey studies. Our finding that DBS enhances some components of speech while retarding others provides an important step in understanding an inconsistent literature. Further, analysis of our PET data suggests that DBS changes the basic relationship between speech and cortical-subcortical interactions. Our major working hypotheses are that: cortical lateral asymmetry is associated with fluency; subcortical regions are strongly associated with phonation, particularly the first two formants, and these are shifted during DBS; when DBS strengthens phonation, an additional burden is placed on articulatory control; both brain and speech effects are task dependent, with the greatest difficulty observed during conversation. Our work also suggests that global blood flow is related to pausing during speech, with DBS on and off, and in PD subjects without DBS. This may reflect the integrity of the central nervous system in PD, and will be further examined with diffusion tensor imaging. In addition to the detailed imaging studies, we will conduct a broader, clinic-based study of conversational and repeated speech before and after DBS surgery. Taken together, these studies should provide a better understanding of the range and severity of speech changes following DBS, and the brain changes associated with these changes.