Cortical and subcortical underpinnings of typical and dysarthric speech - Resubmission - 1

典型和构音障碍言语的皮质和皮质下基础 - 重新提交 - 1

• 批准号: 10822457
• 负责人: Heather M Kabakoff
• 金额: $ 6.95万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10822457
• 关键词: Acoustics; Affect; Aphasia; Apraxias; Articulation; Articulators; Basal Ganglia; Behavioral; Bilateral; Brain; Clinical; Communication; Compensation; Complex; Data; Deep Brain Stimulation; Development; Dorsal; Dysarthria; Electrocorticogram; Electrophysiology (science); Epilepsy; Feedback; Frequencies; Future; Goals; Hospital Departments; Image; Impaired cognition; Impairment; Incidence; Individual; Intervention; Investigation; Laryngeal muscle structure; Larynx; Learning; Link; Maps; Measurement; Modeling; Monitor; Motor; Motor Cortex; Neurology; Oral; Outcome; Output; Parkinson Disease; Pathway interactions; Patients; Perioperative; Phonation; Population; Process; Production; Quality of life; Rehabilitation therapy; Reporting; Research; Role; Speech; Speech Development; Speech Disorders; Structure; Structure of subthalamic nucleus; Stuttering; Testing; Time; Vocation; alternative treatment; auditory feedback; behavior measurement; behavioral response; clinical care; design; direct application; improved; motor control; motor disorder; motor impairment; neural; neuroimaging; neuromechanism; neuroregulation; neurosurgery; novel; prevent; programs; recruit; remediation; response; sensorimotor control mechanism; social; theories; therapeutic development

Project Summary/Abstract Individuals with motor speech disorders such as dysarthria are known to show aberrant phonatory and artic- ulatory precision, which can lead to reduced intelligibility when participating in social and vocational activities. Among the most common dysarthrias is that associated with Parkinson’s disease, which involves atypical online modulation of pitch (phonation) and formant frequencies (articulation). Despite high incidence of dysarthria, cog- nitive decline in this population may lead to a reduced capacity to engage actively with speech rehabilitation. The long-term goal of this research is to develop treatment approaches that tap into automatic pro- cesses to improve intelligibility in patients with dysarthria, including approaches that manipulate auditory feedback while applying neuromodulation to cortical regions. Toward this end, we leverage the availability of rare neurosurgical data (Electrocorticography in Epilepsy, Deep Brain Stimulation in Parkinson’s disease) to map out the cortical substrates of phonatory and articulatory control while accounting for the role of subcortical structures. According to prominent models of speech production, deficits in speech motor control are a reflection of ab- normalities in motor circuits spanning cortical and subcortical structures. Experimental perturbation of real-time auditory feedback concurrent with neuroimaging has advanced the current understanding of the cortical under- pinnings for typical incorporation of auditory feedback into speech output (“sensorimotor control”). Meanwhile, investigations of sensorimotor control in patients with Parkinson’s disease have helped elucidate the role of the subthalamic nucleus within the cortical-subcortical motor circuit in atypical sensorimotor control. Some past stud- ies have suggested that pitch and formants are differentially modulated in distinct subregions within premotor cortex, and within the subthalamic nucleus. However, discrepancies across studies have prevented the robust parcellation of cortical and subcortical structures for the specialized control of distinct acoustic features. To pinpoint the neural mechanisms underlying typical feedback-based sensorimotor control, Aim 1 maps out cortical activity associated with compensatory responses to perturbations of pitch and formants using electrocorticography in patients with Epilepsy. To isolate the subthalamic nucleus’s role in sensorimotor con- trol, Aim 2 compares compensatory responses to perturbations of pitch and formants in healthy controls versus patients with Parkinson’s disease in conditions with Deep Brain Stimulation ON versus OFF. The proposed experimental paradigm is significant in that it will clarify conflicting reports about the specializa- tion of cortical and subcortical structures in sensorimotor control of pitch versus formants. Evidence for the effects of neurosurgery on speech outcomes in common motor disorders could directly inform perioperative decisions in clinical care. This research will have direct applications for the future development of neuromodulation to enhance speech treatment for patients with Parkinson’s disease. Results could also inform treatments for a range of motor speech disorders, ultimately maximizing phonatory and articulatory control to improve patient communication.

项目摘要/摘要 众所周知，患有运动性言语障碍(如构音障碍)的人表现出异常的发音和发音- 口齿不清，在参加社交和职业活动时，会导致语言清晰度降低。 最常见的构音障碍是与帕金森氏症有关的构音障碍，这种疾病涉及非典型的在线 音调(发音)和共振峰频率(发音)的调制。尽管构音障碍的发生率很高，但COG- 这一群体的零下降可能会导致积极参与言语康复的能力下降。 这项研究的长期目标是开发利用自动PRO的治疗方法。 改善构音障碍患者清晰度的CESS，包括操纵听觉的方法 将神经调节应用于皮质区域时的反馈。为此，我们利用Rare的可用性 神经外科数据(癫痫的皮质脑电图术，帕金森氏病的脑深部刺激)以绘制地图 发声和发音控制的皮质底物，同时考虑皮质下结构的作用。 根据著名的言语产生模型，在言语运动控制中的defiCits是对语言产生的一种反映。 横跨皮质和皮质下结构的运动神经回路正常。实时的实验摄动 与神经成像同时进行的听觉反馈促进了目前对大脑皮质功能不足的理解。 将听觉反馈典型地结合到语音输出中(“感觉运动控制”)。同时， 帕金森病患者感觉运动控制的研究有助于阐明 在非典型感觉运动控制中，丘脑底核位于皮质-皮质下运动神经回路中。一些过去的种马- IES已经提出，音调和共振峰在运动前的不同亚区中受到不同的调制 大脑皮层和丘脑底核。然而，不同研究之间的差异阻碍了稳健的 皮质和皮质下结构的分离，以专门控制不同的声学特征。 为了明确典型的基于反馈的感觉运动控制背后的神经机制，目标1绘制了 与对基音和共振峰扰动的代偿反应相关的皮质活动 癫痫患者的皮质脑电检查。为了分离丘脑底核在感觉运动控制中的作用- 特罗尔，目标2比较了健康对照组对基音和共振峰扰动的补偿反应 与帕金森氏症患者在脑深部刺激开启和关闭的情况下的对比。 提出的实验范式是重要的，因为它将澄清关于专业化的持续报道--fifl 皮层和皮质下结构在音高和共振峰感觉运动控制中的作用。影响的证据 神经外科手术对常见运动障碍患者语音结果的影响可以直接影响患者的围手术期决策 临床护理。本研究将对今后神经调节的发展具有直接的应用价值 帕金森氏病患者的言语治疗。结果还可以为一系列运动的治疗提供参考 语音障碍，最终最大限度地控制发音和发音，以改善患者沟通。