Effects of tDCS on spoken and written production in Primary Progressive Aphasia

经颅直流电刺激 (tDCS) 对原发性进行性失语症口语和书面表达的影响

• 批准号: 8861556
• 负责人: Kyrana Tsapkini
• 金额: $ 76.87万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-02 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8861556
• 关键词: Affect; Aftercare; Age-Years; Alzheimer' s Disease; Aphasia; Area; Behavior Therapy; Behavioral; Biological Neural Networks; Brain; Characteristics; Clinical; Clinical Research; Clinical Trials; Combined Modality Therapy; Communication; Coupled; Crossover Design; Data; Dementia; Development; Diagnostic; Diffusion Magnetic Resonance Imaging; Disease; Effectiveness; Electrical Stimulation of the Brain; Family; Foundations; Functional Magnetic Resonance Imaging; Future; Hour; Image; Individual; Inferior frontal gyrus; Intervention; Language; Language Disorders; Language Therapy; Left; Life; Light; Link; Long-Term Potentiation; Measures; Monitor; Motor; Motor Skills; Names; Nerve Degeneration; Neurodegenerative Disorders; Orthography; Painless; Participant; Performance; Primary Progressive Aphasia; Production; Protocols documentation; Publishing; Quality of life; Reporting; Research; Resources; Rest; Stroke; Support Groups; Symptoms; Synapses; Syndrome; Techniques; Testing; Therapeutic; Time; Training; Work; Writing; alternative treatment; clinically relevant; cognitive ability; cognitive function; early onset; effective therapy; gray matter; improved; indexing; insight; intervention effect; lexical; neuroregulation; novel; phonology; post intervention; post stroke; prognostic; public health relevance; relating to nervous system; skill acquisition; skills; spelling; white matter

 DESCRIPTION (provided by applicant): Primary progressive aphasia (PPA) is a relatively common clinical neurodegenerative syndrome that first and foremost affects language abilities. PPA usually has an early onset (50-60 years of age), detrimentally affecting work and family life. Spoken and written word production deficits are the earliest affected language skills with significant prognostic and diagnostic value for its course. There is no available treatment for affected individuals. Behavioral language therapy and naming and spelling interventions in particular have shown modest but encouraging gains, which, however, do not generalize to untrained items and do not sustain over time. Transcranial Direct Current Stimulation (tDCS) is a relatively new, safe, non-invasive, non-painful electrical stimulation of the brain; it has been shown to improve language and cognitive abilities in healthy controls and individuals with stroke and dementia when administered during language therapy. Repetitive and consecutive sessions of tDCS are thought to induce a type of long-term potentiation in the brain that affects synaptic connectivity. There is only one published study (by our group) supporting that tDCS coupled with spelling therapy has beneficial effects in people with PPA. In this project we propose to investigate the behavioral and neuromodulatory effects of tDCS during a combination of spoken and written word production therapy in PPA participants over time. In Specific Aim 1, we will test the hypothesis that anodal tDCS, when administered in combination with spoken and written word production therapy, will improve performance of individuals with PPA more than behavioral spoken and written word production therapy alone. We also hypothesize that improvements will be sustained over time and generalize to other language and cognitive functions subserved by the stimulated brain areas and will positively affect the quality of life of participants. In Speciic Aim 2, we test the hypothesis that changes in functional connectivity as measured by resting-state fMRI are greater after tDCS coupled with spoken and written word production intervention than after behavioral spoken and written word production intervention alone while controlling for gray matter volume and white matter tract loss as measured by volumetric and diffusion tensor imaging (DTI). Study results may help optimize future interventions in individuals with PPA or other neurodegenerative disease by providing novel treatment alternatives in a neurodegenerative syndrome with no proven effective treatment. A better understanding of the behavioral as well as functional connectivity changes due to tDCS will offer insights into ways of impeding neurodegeneration that may improve quality of life for individuals with PPA and other dementias.

 描述（由适用提供）：主要的进行性失语症（PPA）是一种相对常见的临床神经退行性综合症，首先会影响语言能力。 PPA通常早期发作（50-60岁），对工作和家庭生活产生不利影响。口语和书面单词生产定义是最早的语言技能，其课程具有明显的预后和诊断价值。没有针对受影响的个体的可用治疗方法。行为语言疗法，命名和拼写干预措施尤其表现出适度但令人鼓舞的收益，但是，这并不能推广到未经训练的项目，并且随着时间的推移不会维持。经颅直流刺激（TDCS）是对大脑的相对新，安全，无创，无毒性的电刺激。在语言疗法期间进行治疗时，已显示它可以提高健康对照的语言和认知能力，并具有中风和痴呆症的个人。 TDC的重复性和连续会议被认为会引起大脑中影响突触连通性的长期潜力。只有一项已发表的研究（由我们的小组）支持TDC和拼写疗法对PPA患者具有有益的影响。在这个项目中，我们建议研究TDC在PPA参与者中的口语和书面单词生产疗法中TDC的行为和神经调节作用。在特定的目标1中，我们将检验以下假设：阳极TDC与口语和书面单词生产疗法结合使用，将使PPA患者的性能更重要，而不是行为口语和书面单词生产疗法。我们还假设，随着时间的流逝，改进将得到维持，并推广到刺激的大脑区域提交的其他语言和认知功能，并将积极影响参与者的生活质量。在特定的目标2中，我们检验了以下假设：通过静止状态fMRI衡量的功能连接性变化在TDC和口语和书面单词生产干预后，与单独进行行为和书面文字生产干预后相比，通过控制灰质物质和白质损失，通过大量和散射量和差异损失（dte）（dti）（dti）（dti）。研究结果可能有助于优化PPA或其他神经退行性疾病个体的未来干预措施，通过在神经退行性综合征中提供新的治疗替代方法，而无需证明有效治疗。对TDCS引起的行为以及功能连接的变化有了更好的理解，将为您提供阻碍神经变性的方式的见解，这可能会改善PPA和其他痴呆症患者的生活质量。