Neural Markers of Persistence and Recovery from Childhood Stuttering: An fMRI Study of Continuous Speech Production

儿童口吃持续和恢复的神经标志物：连续言语产生的功能磁共振成像研究

• 批准号: 9549161
• 负责人: Ho Ming Chow
• 金额: $ 13.64万
• 依托单位: ALFRED I. DU PONT HOSP FOR CHILDREN
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-20 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9549161
• 关键词: Address; Area; Basal Ganglia; Behavior; Brain; Child; Childhood; Childhood Stuttering; Clinical assessments; Data; Data Analyses; Development; Developmental Stuttering; Disease; Emotional; Exhibits; Experimental Designs; Foundations; Functional Magnetic Resonance Imaging; Future; Goals; Imaging Techniques; Imaging technology; Incidence; Individual; Inferior frontal gyrus; Intervention; Investigation; Knowledge; Left; Methodological Studies; Methodology; Methods; Mission; Monitor; Motor; Movement; National Institute on Deafness and Other Communication Disorders; Neurologic Deficit; Neuronal Plasticity; Noise; Outcome; Partner in relationship; Pattern; Play; Prevalence; Procedures; Process; Production; Recovery; Research; Resolution; Rest; Role; Speech; Speech Disorders; Structural defect; Stuttering; Symptoms; Techniques; Testing; Therapeutic Intervention; Treatment Efficacy; Wakefulness; Work; base; effective therapy; imaging study; innovation; insight; motor control; neural circuit; neuroimaging; neurophysiology; novel; prevent; relating to nervous system; social; sound; therapeutic development; therapy development; translational impact; treatment strategy

Although symptoms of childhood stuttering fully manifest during overt, continuous speech production, little is known about the neural processes associated with speech production in children, and how these processes are disrupted, resulting in the overt manifestation of stuttering instances. Moreover, the majority of children who stutter recover naturally, but we do not know how children’s brains functionally adapt to cope with the disorder and achieve fluent speech. Absent such knowledge, the neurological deficits underlying stuttering and how the disorder resolves itself cannot be fully understood, a difficulty that limits our ability to develop advances in clinical assessment and intervention. Our long-term goal is to develop effective therapeutic interventions to treat and prevent persistent stuttering during childhood. The objective of the present application, which is the next step in pursuing that goal, is to determine brain activity patterns associated with continuous speech production in children with persistent (pCWS) and children who recovered from stuttering (rCWS). The central hypothesis of the application is that persistent stuttering is associated with anomalous brain activity in the neural circuits for speech-motor control, while recovery from stuttering is associated with greater involvement of right frontal areas. The rationale of this proposed research is that an empirically-based understanding of brain activity patterns associated with continuous speech production of pCWS and rCWS is foundational for the development of future therapeutic interventions attempting to modify anomalous activity. Using a novel fMRI technique, we will test our central hypothesis by pursuing the following specific aims: 1) Identify brain activity associated with continuous speech production that characterizes persistent stuttering, and 2) Identify brain activity associated with continuous speech production that characterizes recovery from stuttering. To achieve Aim #1, brain activity associated fluent speech production between pCWS and controls will be compared. Furthermore, brain activity associated with fluent and stuttered speech production in pCWS will be separated and compared. To achieve Aim #2, brain activity associated with fluent speech production between rCWS and controls will be compared. This application is innovative because it will be the first study to examine both cortical and subcortical activity associated with continuous speech production in children with high spatial resolution using a novel fMRI de-noising technique. Findings of this project will be significant because they are expected to fundamentally advance our understanding of the neural processes associated with fluent and disfluent continuous speech production in children who stutter and provide insights into neuroplasticity associated with recovery from childhood stuttering. Ultimately, this new knowledge may guide the future development of better treatment strategies for childhood stuttering.

尽管儿童口吃的症状在公开、持续的言语表达过程中充分显现出来，但很少有 了解与儿童言语产生相关的神经过程，以及这些过程是如何进行的 中断，导致明显的口吃实例。而且，大多数孩子 口吃会自然恢复，但我们不知道儿童的大脑如何在功能上适应应对这种疾病 并达到流利的言语。如果缺乏这些知识，口吃背后的神经缺陷以及口吃如何发生？ 无序的自行解决无法被完全理解，这一困难限制了我们在这方面取得进展的能力 临床评估和干预。我们的长期目标是开发有效的治疗干预措施 治疗和预防儿童时期的持续性口吃。本申请的目的是 追求这一目标的下一步是确定与连续语音相关的大脑活动模式 持续性口吃儿童 (pCWS) 和口吃康复儿童 (rCWS) 的生产。这 该申请的中心假设是，持续性口吃与大脑异常活动有关 言语运动控制的神经回路，而从口吃中恢复与更大的 右额叶区域的参与。这项研究的基本原理是基于经验的 对与 pCWS 和 rCWS 的连续语音产生相关的大脑活动模式的理解是 为未来试图改变异常活动的治疗干预措施的发展奠定了基础。 使用新颖的功能磁共振成像技术，我们将通过追求以下具体目标来检验我们的中心假设：1) 识别与持续言语产生相关的大脑活动，其特征是持续口吃， 2）识别与连续言语产生相关的大脑活动，其特征是从 口吃。为了实现目标#1，大脑活动与 pCWS 和对照组之间流畅的语音产生相关 将会被比较。此外，pCWS 中与流利和口吃的言语产生相关的大脑活动 会被分开比较。为了实现目标#2，大脑活动与流利的言语产生相关 将比较 rCWS 和对照之间的差异。该应用程序具有创新性，因为它将是第一项研究 检查与持续言语产生相关的皮层和皮层下活动 使用新型功能磁共振成像去噪技术实现高空间分辨率。该项目的研究结果将具有重大意义 因为它们有望从根本上增进我们对与相关神经过程的理解 口吃儿童的流利和不流利的连续言语表达并提供见解 神经可塑性与儿童口吃的恢复有关。最终，这些新知识可能会指导 未来制定更好的儿童口吃治疗策略。