Optimizing speech motor learning with neuromodulation: Behavioral outcomes and neural mechanisms

项目摘要/摘要 在美国，中风是导致残疾的主要原因，经常导致言语障碍 在专业、社交和家庭环境中设置参与障碍。虽然可以促进经济复苏 随着言语运动学习治疗的进行，残留残疾仍然是一个突出的问题。这样做的长期目标是 研究旨在通过结合以下方法来提高后天言语障碍患者的干预效果 有针对性的神经调节的理论指导的行为干预。这次会议的主要目标是 建议验证左腹运动前皮质和运动皮质在言语运动学习中的作用，并 证实经颅直流电刺激(Tdcs)可通过以下方式促进言语运动学习 加强大脑皮层语音网络。这项提议的中心假设是语言恢复在 慢性卒中可通过刺激周围左腹前运动皮质和运动皮质来改善，从而 促进他们在言语运动学习治疗中的参与度，并加强皮质言语 通过联想学习建立网络。核心假设将通过追求三个具体目标来检验：1) 建立支持tdcs促进的言语运动学习的神经区域；2)确定 哪种具有个性化电极放置的主动tDDC可以增强言语运动学习干预 在言语失用受损的说话人中，相对于假的tdcs；以及3)确定功能性 与基于言语运动学习的干预相关的连接性变化 有语言失用症的受损说话者。在第一个目标下，拟议的研究将系统地验证 左腹运动前皮质和运动皮质在三叉神经节促进的言语运动学习中的作用 控制：电极极性、电极位置和有源电流的存在。对于第二个目标，单一的- 受试者干预实验将被用来评估tdcs改善失用治疗的程度。 结果，使用个体化的电流建模来靶向左侧腹侧运动前皮质和运动皮质。第三 AIM确定AIM 2中的治疗条件可以改变功能连接性的程度 用静息状态功能神经成像进行测量。拟议的研究是创新的，在申请人的 意见，因为它结合了以实践为基础的言语治疗和靶向tDCs来强化希伯来语 并测量这种方法在多大程度上改变了语音中的功能连通性 网络。这项研究具有重要的意义，因为它将确立言语运动的综合有效性 AOS的学习治疗和tdcs，这是一种未被研究的情况。理解治疗的相互作用 神经调节将建立优化慢性中风康复的能力，直接应用于 增强演讲技巧，提高沟通能力和生活质量。

PROJECT SUMMARY/ABSTRACT Stroke is a leading cause of disability in the United States, frequently leading to speech impairment that creates barriers to participation in professional, social, and family settings. While recovery can be promoted with speech motor learning treatment, residual disability remains a prominent issue. The long-term goal of this research is to enhance intervention outcomes for individuals with acquired speech impairment by combining theoretically-guided behavioral intervention with targeted neuromodulation. The main objectives of this proposal are to verify the role of left ventral premotor and motor cortices in speech motor learning and to establish that transcranial direct current stimulation (tDCS) can enhance speech motor learning treatment by strengthening the cortical speech network. The central hypothesis of this proposal is that speech recovery in chronic stroke can be improved by stimulating perilesional left ventral premotor and motor cortices, thereby promoting their engagement during speech motor learning treatment and strengthening the cortical speech network through associative learning. The central hypothesis will be tested by pursuing three specific aims: 1) Establish the neural regions that underlie tDCS-facilitated speech motor learning; 2) Determine the extent to which active tDCS with individualized electrode placement can enhance speech motor learning intervention relative to sham tDCS in impaired speakers with apraxia of speech; and 3) Determine the functional connectivity changes associated with speech motor learning-based intervention with active vs. sham tDCS in impaired speakers with apraxia of speech. Under the first aim, the proposed research will systematically verify the role of left ventral premotor and motor cortices in tDCS-facilitated speech motor learning using three controls: electrode polarity, electrode position, and presence of active current. For the second aim, single- subject intervention experiments will be used to evaluate the extent to which tDCS enhances apraxia treatment outcomes, using individualized current modeling to target left ventral premotor and motor cortices. The third aim determines the extent to which the treatment conditions in Aim 2 can change functional connectivity measured with resting-state functional neuroimaging. The proposed research is innovative, in the applicant's opinion, because it combines practice-based speech treatment with targeted tDCS to intensify Hebbian plasticity and measures the extent to which this approach changes functional connectivity in the speech network. This research will be significant because it will establish the combined effectiveness of speech motor learning treatment and tDCS in AOS, an understudied condition. Understanding the interaction of treatment and neuromodulation will build capacity to optimize chronic stroke recovery, with direct application to enhancing speech skills to improve communication ability and quality of life.