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（由申请人提供）：原发性进行性失语症（PPA）是一种相对常见的临床神经退行性综合征，首先影响语言能力。PPA通常发病较早（50-60岁），对工作和家庭生活造成不良影响。口语和书面文字表达缺陷是最早受到影响的语言技能，对其病程具有重要的预后和诊断价值。目前尚无针对受影响个体的治疗方法。行为语言治疗和命名和拼写干预特别显示出适度但令人鼓舞的收益，然而，这并不普遍适用于未经训练的项目，并且不会随着时间的推移而持续。经颅直流电刺激（tDCS）是一种相对较新的，安全的，非侵入性的，无痛的大脑电刺激;它已被证明可以改善语言和认知能力，在语言治疗期间，健康对照组和中风和痴呆患者。重复和连续的tDCS被认为会诱导大脑中一种影响突触连接的长时程增强。只有一项已发表的研究（由我们的小组）支持tDCS与拼写疗法相结合对PPA患者有有益的影响。在这个项目中，我们建议调查tDCS的行为和神经调节作用，在PPA参与者的口语和书面文字生产治疗的组合随着时间的推移。在具体目标1中，我们将检验以下假设：当阳极tDCS与口语和书面文字产生疗法联合使用时，将比单独的行为口语和书面文字产生疗法更能改善PPA患者的表现。我们还假设，随着时间的推移，这种改善将持续下去，并推广到受刺激的大脑区域所服务的其他语言和认知功能，并将对参与者的生活质量产生积极影响。在Speciic Aim 2中，我们检验了这样一个假设，即通过静息态fMRI测量的功能连接的变化在tDCS与口语和书面文字产生干预相结合后比单独进行行为口语和书面文字产生干预后更大，同时控制了通过体积和弥散张量成像（DTI）测量的灰质体积和白色物质束损失。研究结果可能有助于优化未来对PPA或其他神经退行性疾病患者的干预措施，为神经退行性综合征提供新的治疗选择，而这些综合征没有经过证实的有效治疗方法。更好地了解由于tDCS引起的行为和功能连接变化将提供对阻碍神经退行性变的方法的见解，这些方法可能会改善PPA和其他痴呆患者的生活质量。