Investigating the neural mechanisms underlying language recovery through rhythm therapy in Aphasia

每年大约有10万人被诊断为失语症--一种语言障碍 导致他们的日常沟通出现了很大的困难。根据观察，许多 患有失语症的人可以唱出他们不能说的话，旋律语调疗法 (MIT)是在20世纪70年代发展起来的。虽然公认为标准的失语症治疗， MIT的神经机制在很大程度上尚未被探索。 我们的第一个目标是确定这种基于音乐的干预的有效成分， 语言恢复虽然节奏一直被认为是次要的旋律，最近 有证据挑战了这一观念，证明节奏本身就足以 促进失语症患者语言流畅性的改善。为了证实 节奏的作用，我们将训练失语症患者利用“节奏”来表达句子/短语 通过一个有趣和引人入胜的视频游戏平台提供。这种干预来自于 语言过程严重依赖的神经成像数据建立的理论框架 感觉运动和额-纹状体回路内的神经资源有助于节律/定时 流程. 我们的第二个目标是描述与语言恢复相关的神经可塑性 由新型节律疗法推动。我们假设神经可塑性 本身作为增加的白色物质束，可能是由于髓鞘形成的变化， 同侧或对侧（同源）语言区。为了有效测量髓磷脂白色 为了在候选区域中获得更高的脑白质分数（MWF），我们将主要使用专利的髓磷脂成像技术。 此外，我们将使用BOLD（血氧- 水平依赖）fMRI。最后，我们将尝试使用fNIRS（功能性）记录皮质活动。 近红外光谱）。 总之，拟议的跨学科研究具有理论，方法， 临床创新和意义。这一探索性工作将作为一个关键步骤， 石头走向解开音乐在神经系统疾病和意志的治疗成分 为临床医生和治疗师提供循证指南。

Every year, approximately 100,000 people are diagnosed with aphasia—a language disorder leading to substantial difficulties in their daily communication. Based on the observation that many people with aphasia can sing words that they otherwise cannot speak, melodic intonation therapy (MIT) was developed in the 1970s. Although recognized as a standard aphasia treatment, the neural mechanisms of MIT have been largely unexplored. Our first goal is to identify the active ingredient of this music-based intervention that leads to language recovery. Although rhythm has long been considered secondary to melody, recent evidence has challenged this notion by demonstrating that rhythm alone is sufficient enough to facilitate improvements in speech fluency for people with aphasia. To corroborate the faciliatory role of rhythm, we will train aphasic patients to leverage “rhythm” for sets of sentences/phrases delivered through a fun and engaging video gaming platform. This intervention emerges from the theoretical framework, built from neuroimaging data, that language processes heavily rely on neural resources within the sensorimotor and fronto-striatal circuits that subserve rhythm/timing processes. Our second goal is to characterize the neural plasticity associated with language recovery promoted by the novel rhythm-based therapy. We hypothesize that neuroplasticity will manifest itself as increased white matter tracts, presumably due to changes in myelination in either ipsilateral or contralateral (homologues) language areas. To effectively measure myelin white matter fraction (MWF) in candidate tracts, we will mainly use a patented Myelin-imaging technique. Additionally, we will measure resting-state functional connectivity using BOLD (Blood Oxygen- Level Dependent) fMRI. Lastly, we will attempt to record cortical activity using fNIRS (functional Near-Infrared Spectroscopy) during the pre-post behavioral assessments. Taken together, the proposed interdisciplinary research has theoretical, methodological, and clinical innovations and significance. This exploratory work will serve as a critical stepping stone toward unraveling the therapeutic component of music in neurological disorders and will provide evidence-based guidance to the clinicians and therapists.