双靶点TMS干预传导性失语患者言语运动障碍的神经机制研究

传导性失语是一种以严重口语复述障碍为特点的脑卒中后失语症，发病机制除了传统的联系中断学说之外，还存在听觉感知-发声运动系统的整合异常。经颅磁刺激（TMS）作为一种安全有效的非侵入性神经调控手段，已经被证实能用于调控听觉感知-言语运动网络和治疗脑卒中后失语症。双重通路假说提出听觉感知-言语运动网络存在“自上而下”和“自下而上”通路的并行调控，为双靶点TMS干预传导性失语言语运动障碍的叠加效应提供了理论支持，预实验结果也提示双靶点TMS干预言语运动功能比单靶点和假刺激效果更佳。因此，本项目利用基于听觉反馈扰动的声学技术和事件相关电位技术，研究双靶点TMS改善言语运动功能的叠加效应、最佳组合模式以及对传导性失语患者言语运动功能的干预效果，并利用溯源分析和动态因果模型探寻其内在康复机制。本项目有助于深入理解传导性失语言语障碍机制，为研发改善口语复述障碍的言语康复新技术奠定理论基础。

Conductive aphasia is a speech motor disorder after stroke characterized by severe reputation disorder. In addition to the traditional connection interruption theory, the pathogenesis of conductive aphasia also comes to the abnormal integration of the auditory perception-speech motor system. Transcranial Magnetic Stimulation (TMS), as a safe and effective non-invasive neuromodulation method, has been proven to be used to regulate the auditory perception-speech motor network and treat aphasia after stroke. The dual pathway hypothesis proposes that auditory perception-speech motor exists "from top to bottom" and "from bottom to top" theory of parallel controlling, which provides a theoretical support for the superimposed effect of dual-site TMS intervention in conductive aphasia patients. Preliminary experiments on dual-site TMS intervention in speech motor function also suggest that its results are better than single and sham stimulation. Therefore, this project uses acoustic technology based on auditory feedback perturbation and event-related potential technology to study the superimposed effect of dual-site TMS improving speech motor function and the intervention effect on speech motor function of patients with conductive aphasia. Using sLORETA analysis and dynamic causal model to explore its intrinsic recovery mechanism. This project helps to understand the mechanism of conductive aphasia and lays a theoretical foundation for the research and development of new speech rehabilitation techniques to improve oral paraphrase disorders.