Speech and Brain Function in Subjects with Cleft Lip and Palate-

唇腭裂(CLP)患者通常有问题的发音，如僵硬的上唇和悬雍垂，先天性缺失和脱位的上颌牙齿。这些因素可能会使CLP患者成功地替代1101关节的不同位置和方式。通过利用受限的口周结构的新策略来适应受损的关节环境意味着中枢神经网络的可塑性。要了解CLP患者的言语功能，必须从脑功能和外周运动两个方面进行综合分析。首先，用LISING功能磁共振成像(FMRI)研究了CLP受试者双唇、牙槽和舌叶辅音的皮质表达。在/pa/、/ta/和/ka/发音过程中，所有CLP受试者的双侧初级感觉运动皮质(SI/MI)都发现了激活灶。在单侧慢性阻塞性肺病患者中，与CLP同侧的Si/MI显示更大的激活，其中…更重要的是，在双侧CLP的受试者中，早期进行唇裂成形术的一侧的SI/MI显示出更大的激活。结果提示，在辅音发音过程中，皮层辅音可能存在不同的激活模式，这种差异与CLP的侧向有关。其次，用MRI电影研究了CLP受试者和正常成年男性志愿者发音/pa/、/ta/和/ka/时口咽结构的动态变化。与正常志愿者相比，CLP患者在发音过程中观察到不同的模式。CLP患者舌体后上移和咽后壁前移清晰可见。因此，MRI电影因其非侵入性和无辐射的性质，似乎是评估CLP受试者语言功能的一种有前途的工具。我们目前正在研究与代偿性发音运动相关的代偿性大脑功能。较少

Subjects with cleft lip and palate (CLP) often have problematic articulators such as a stiff upper lip and uvula, congenital loss and dislocation of maxillary teeth. These factors may make the patient with CLP manage to substitute different place and manner of articulation 1101. Adaptation to impaired articulatory environment through novel strategies utilizing restricted perioral structures implicates a plasticity of central neural network. A comprehensive approach from brain function and peripheral movement is necessary to understand speech function in subjects with CLP. First, cortical representation of articulation of, bilabial, alveolar and velar consonants in subjects with CLP was studied by Lising functional magnetic resonance imaging (fMRI). Activation foci were found in the bilateral primary sensorimotor cortex (SI/MI) in all CLP subjects during articulation of /pa/, /ta/ and /ka/. The Si/MI ipsilateral to the CLP showed greater activation in patients with unilateral CLP, where … More as the SI/MI contralateral to the side, on which earlier cheiloplasty was performed, showed greater activation in the subject with bilateral CLP. The results suggest that there be a difference in the cortical consonant may activation pattern during consonant articulation, which is related to the side of CLP. Second, dynamic changes in oropharyngeal structures during the articulation of /pa/, /ta/ and /ka/ by a subject with CLP and a normal adult male volunteer were assessed by MRI movie. Different patterns were observed during articulation in the subject with CLP compared to the normal volunteer. Posterosuperior movement of the tongue and the anterior movement of the posterior pharyngeal wall were clearly visualized in the subject with CLP. Thus, MRI movie appears to be a promising tool for evaluating speech function in subjects with CLP because of its non-invasive and non-radiative nature. We are currently working on compensatory brain function that is associated with compensatory articulatory movement. Less