Cerebellar stimulation for Aphasia Rehabilitation

项目摘要 失语症是中风的一种严重并发症。言语和语言治疗（英语：Speech and language treatment）可以帮助恢复 语言功能，但并非所有人都表现出改善。最近的研究表明，经颅直接 电流刺激（tDCS）是一种很有前途的辅助方法，以提高有效性的治疗。tDCS是一个 无创无痛的大脑电刺激据信tDCS增强神经可塑性， 是复苏的基础大多数失语症的tDCS研究都刺激了左半球 地区然而，中风后失语症患者常见的左半球病变会影响脑内的电场， 不可预测的方式，可能会阻止刺激到达与最佳病变相关的病灶周围组织。 复苏我们的工作通过刺激一个新的区域--右侧小脑来解决这个问题。权 小脑与左半球相连，参与各种认知和语言功能， 包括命名，这在失语症患者中经常受到损害。我们证明了小脑tDCS是安全的， 耐受，并改善了一些中风失语症患者的语言技能。拟建项目 将在这些发现的基础上，进行一项随机、双盲、假对照试验，以确定 右侧小脑阴极tDCS治疗卒中后失语症的有效性我们将比较 15次小脑tDCS加基于证据的命名治疗对15次假手术的影响 加慢性（卒中后至少6个月）失语症患者的基于证据的命名治疗。我们将 评估小脑tDCS对未经训练的图片命名的影响以及对功能的影响。 沟通、内容、效率、图片描述的词检索和生活质量。该项目将 还可以识别成像和语言生物标志物，以确定中风患者的特征， 从小脑tDCS。个体对tDCS治疗的反应是高度可变的，并且对如何进行治疗知之甚少。 与成像和语言特征相关的因素联合收割机组合以诱导治疗反应性。我们将 进行静息态功能磁共振成像（rsfMRI）、弥散张量成像（DTI）、高分辨力磁共振成像（MRI） 分辨率结构成像，并在治疗开始前进行详细的语言测试，以确定是否 这些因素可以预测对小脑tDCS的反应。这项研究的长期目标是为以下方面提供基础： 一项比较小脑tDCS与假手术并同时给予安慰剂治疗慢性 失语症

Project Abstract Aphasia is a devastating complication of stroke. Speech and language treatment (SLT) can be helpful in restoring language function, but not all individuals show improvement. Recent studies indicate that Transcranial Direct Current Stimulation (tDCS) is a promising adjuvant approach to enhance the effectiveness of SLT. tDCS is a noninvasive, non-painful, electrical stimulation of the brain. It is believed that tDCS boosts neural plasticity that underlies recovery with SLT. A majority of the tDCS studies of aphasia have stimulated the left hemisphere regions. However, left hemisphere lesions common in post-stroke aphasia affect the electrical field in unpredictable ways, potentially preventing stimulation from reaching perilesional tissue associated with optimal recovery. Our work addressed this problem by stimulating a novel region, the right cerebellum. The right cerebellum is connected to the left hemisphere and involved in a variety of cognitive and language functions, including naming, which is often impaired in people with aphasia. We show that cerebellar tDCS is safe, easily tolerated, and improved language skills in a number of stroke participants with aphasia. The proposed project will build on these findings by conducting a randomized, double-blind, sham-controlled, trial to determine the effectiveness of cathodal tDCS to the right cerebellum for the treatment of post-stroke aphasia. We will compare the effects of 15 sessions of cerebellar tDCS plus evidenced based naming treatment to 15 sessions of sham plus evidenced based naming treatment in patients with chronic (at least 6 months post stroke) aphasia. We will evaluate the effects of cerebellar tDCS on untrained picture naming as well as the effects on functional communication, content, efficiency, and word-retrieval of picture description, and quality of life. This project will also identify imaging and linguistic biomarkers to determine the characteristics of stroke patients that benefit from cerebellar tDCS. Individual response to tDCS treatment is highly variable, and little is known about how factors related to imaging and linguistic characteristics combine to induce treatment responsiveness. We will carry out resting state functional magnetic resonance imaging (rsfMRI), diffusion tensor imaging (DTI), high resolution structural imaging, and detailed linguistic testing before the start of treatment to determine whether these factors can predict response to cerebellar tDCS. The long-term aim of this study is to provide the basis for a Phase III randomized controlled trial of cerebellar tDCS vs sham with concurrent SLT for treatment of chronic aphasia.