Laryngeal adaptation in speech and swallowing

项目摘要 这个建议的总体目标是检查前馈喉适应的讲话和吞咽。 几十年来，关于喉在言语和吞咽中的功能的研究文献主要有 假设感觉反馈驱动喉部调节以维持足够的喉部功能。在 反馈控制，感官输入可以用来调整正在进行的运动。然而，在前馈控制中， 来自先前完成的动作的输入用于预测、计划和执行未来动作， 尚未发生。我们认为，前馈范式值得更多的关注，可能更有效 因为语言和吞咽的许多方面本质上是前馈的， 控制这是因为反馈修改在（a）吞咽喉部运动中可能是不可能的 其是弹道式的或在（B）非常短的语音或早期发声周期中。我们假设喉部 健康成年人的功能在言语和吞咽方面非常准确，因为可以避免错误 在它们发生之前由于前馈控制。然而，在患有神经源性构音障碍的个体中， 吞咽困难，我们假设持续的功能障碍可能是由于受损的喉前馈 适应我们将用两个目标来检验这个假设。目的1是区分前馈喉适应 在脑卒中、脊髓小脑共济失调6型（SCA 6）和健康对照组中，当（1A）言语 受呼吸负荷干扰以限制声音响度，以及（1B）吞咽受颈部干扰 电刺激以限制喉部抬高。目的2是检查是否喉适应结果 在脑卒中和共济失调患者中，与吞咽困难和/或构音障碍严重程度相关， 一年我们的初步数据表明，前馈喉适应微调健康成人。 其特征在于仅适应对于克服呼吸困难至关重要的喉功能。 干扰，而其他非必要的喉功能保持稳定。相反，脑卒中患者 中风和SCA 6不具有微调喉适应。相反， 扰动可能会干扰正在进行的错误减少过程。这两个病人群体提供了一个 这是一个独特的机会，可以检查大脑与小脑对喉功能的不同影响。 在自然发生的人类疾病模型中的适应和控制。这笔赠款是我们漫长的- 如果前馈控制，建立语言和吞咽康复长期目标可能更有效 原则是结合起来的。这项研究的科学严谨性和团队的力量确保了结果 将影响身体其他几个系统的感觉运动适应的未来方向。

Project Summary The overall goal of this proposal is to examine feed-forward laryngeal adaptation in speech and swallowing. Over several decades, the research literature on laryngeal function in speech and swallowing has primarily assumed that sensory feedback drives laryngeal modulation to maintain adequate laryngeal function. In feedback control, sensory input can be used to adjust ongoing movements. In feed-forward control, however, input from previously completed movements are used to predict, plan and execute future movements that have not yet occurred. We posit that a feed-forward paradigm deserves more attention and might be more effective in rehabilitation programs because many aspects of speech and swallowing are inherently under feed-forward control. This is because feedback modifications may not be possible in (a) swallowing laryngeal movements that are ballistic or in (b) very short speech sounds or early voicing periods. We hypothesize that laryngeal function in healthy adults is remarkably accurate in speech and swallowing because errors can be avoided before they occur due to feed-forward control. However, in individuals with neurogenic dysarthria and dysphagia, we hypothesize that continued dysfunction could be due to impaired laryngeal feed-forward adaptation. We will test this hypothesis with 2 Aims. Aim 1 is to differentiate feed-forward laryngeal adaptation among cerebral stroke, spinocerebellar ataxia type 6 (SCA6), and healthy controls when (1A) speech is perturbed with respiratory loading to restrict vocal loudness and (1B) swallowing is perturbed with neck electrical stimulation to restrict laryngeal elevation. Aim 2 is to examine whether laryngeal adaptation outcomes in patients with cerebral stroke and ataxia correlate with dysphagia and/or dysarthria severity over a period of one year. Our preliminary data suggest that feed-forward laryngeal adaptation is fine-tuned in healthy adults. This is characterized by adaptation of only laryngeal functions that are essential to overcoming the perturbation, while other non-essential laryngeal functions remain stable. Conversely, patients with cerebral stroke and SCA6 do not have fine-tuned laryngeal adaptation. Instead, extraneous movements during the perturbation might be interfering with ongoing error-reduction processes. These two patient groups offer a unique opportunity to examine the differential effects of cerebral versus cerebellar contributions to laryngeal adaptation and control in naturally occurring human models of disease. This grant is the first step in our long- term goal to establish that speech and swallowing rehabilitation might be more effective if feed-forward control principles are incorporated. The scientific rigor of this study and the strength of the team assure that outcomes will impact future directions of sensory-motor adaptation across several other systems of the body.