帕金森病言语运动障碍康复的反馈机制研究

帕金森病（Parkinson’s disease，PD）是一种神经退行性疾病，目前中国PD患者人数超过270万。高达89%的PD患者出现运动性言语障碍，但无法通过药物和手术治疗。申请人前期研究提出并证实了PD言语运动障碍与反馈功能异常有关的假说，但是其内在的神经基础尚不明确，且是否可以通过改善反馈功能治疗PD言语运动障碍不得而知。本项目将基于听觉反馈扰动的心理声学和脑电技术与多模态神经影像技术相结合，研究PD皮层和皮层下区域的结构和功能损伤与言语运动实时性和适应性调控障碍之间的内在关联，并利用LSVT LOUD言语康复技术研究改善听觉反馈功能治疗PD言语运动障碍的神经机制，在个体和组间水平上阐释PD言语运动障碍的神经基础和康复机制；进而从大脑反馈功能异常和改善的角度揭示PD言语运动障碍及康复的脑结构和功能基础，为利用脑网络标记实现PD言语障碍的早期诊断和精准康复奠定基础。

Parkinson's disease (PD) is a neurodegenerative disorder and affects over 2.7 million people in China. Approximately 89% of individuals with PD develop motor speech disorders that cannot be treated with anti-PD drugs and neurosurgery. Previous work accomplished by the applicant have proposed and demonstrated a hypothesis that disorders of speech motor control are associated with impaired feedback control function. However, the neural mechanisms underlying these disorders in PD remain poorly understood. Moreover, whether the treatment of motor speech disorders can be accomplished through the improvement of feedback control function is largely unknown. By using a combination of the psychoacoustical and event-related potential techniques based on the altered auditory feedback paradigm and the multimodal neuroimaging technique, the proposed project will investigate the associations between impairments in the structure and function of cortical and sub-cortical regions and neurobehavioral disorders in real-time and adaptive control of speech production caused by PD. On the other hand, the project will investigate whether and how improvement of feedback control function can benefit the treatment of motor speech disorders in individuals with PD who receive LSVT LOUD training. Overall, the proposed project will explore the neural mechanisms of disorders of speech motor control in PD and their rehabilitation at the individual and group levels. Finally, this project will unravel the structural and functional bases of motor speech disorders and their treatment from the perspective of feedback control dysfunction and improvement, laying the foundation of establishing the neuroimaging biomarkers for early diagnosis and precise treatment of motor speech disorders caused by PD.