Cortical and subcortical underpinnings of typical and dysarthric speech - Resubmission - 1

典型和构音障碍言语的皮质和皮质下基础 - 重新提交 - 1

• 批准号: 10822457
• 负责人: Heather M Kabakoff
• 金额: $ 6.95万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10822457
• 关键词: Acoustics; Affect; Aphasia; Apraxias; Articulation; Articulators; Basal Ganglia; Behavioral; Bilateral; Brain; Clinical; Communication; Compensation; Complex; Data; Deep Brain Stimulation; Development; Dorsal; Dysarthria; Electrocorticogram; Electrophysiology (science); Epilepsy; Feedback; Frequencies; Future; Goals; Hospital Departments; Image; Impaired cognition; Impairment; Incidence; Individual; Intervention; Investigation; Laryngeal muscle structure; Larynx; Learning; Link; Maps; Measurement; Modeling; Monitor; Motor; Motor Cortex; Neurology; Oral; Outcome; Output; Parkinson Disease; Pathway interactions; Patients; Perioperative; Phonation; Population; Process; Production; Quality of life; Rehabilitation therapy; Reporting; Research; Role; Speech; Speech Development; Speech Disorders; Structure; Structure of subthalamic nucleus; Stuttering; Testing; Time; Vocation; alternative treatment; auditory feedback; behavior measurement; behavioral response; clinical care; design; direct application; improved; motor control; motor disorder; motor impairment; neural; neuroimaging; neuromechanism; neuroregulation; neurosurgery; novel; prevent; programs; recruit; remediation; response; sensorimotor control mechanism; social; theories; therapeutic development

Project Summary/Abstract Individuals with motor speech disorders such as dysarthria are known to show aberrant phonatory and artic- ulatory precision, which can lead to reduced intelligibility when participating in social and vocational activities. Among the most common dysarthrias is that associated with Parkinson’s disease, which involves atypical online modulation of pitch (phonation) and formant frequencies (articulation). Despite high incidence of dysarthria, cog- nitive decline in this population may lead to a reduced capacity to engage actively with speech rehabilitation. The long-term goal of this research is to develop treatment approaches that tap into automatic pro- cesses to improve intelligibility in patients with dysarthria, including approaches that manipulate auditory feedback while applying neuromodulation to cortical regions. Toward this end, we leverage the availability of rare neurosurgical data (Electrocorticography in Epilepsy, Deep Brain Stimulation in Parkinson’s disease) to map out the cortical substrates of phonatory and articulatory control while accounting for the role of subcortical structures. According to prominent models of speech production, deficits in speech motor control are a reflection of ab- normalities in motor circuits spanning cortical and subcortical structures. Experimental perturbation of real-time auditory feedback concurrent with neuroimaging has advanced the current understanding of the cortical under- pinnings for typical incorporation of auditory feedback into speech output (“sensorimotor control”). Meanwhile, investigations of sensorimotor control in patients with Parkinson’s disease have helped elucidate the role of the subthalamic nucleus within the cortical-subcortical motor circuit in atypical sensorimotor control. Some past stud- ies have suggested that pitch and formants are differentially modulated in distinct subregions within premotor cortex, and within the subthalamic nucleus. However, discrepancies across studies have prevented the robust parcellation of cortical and subcortical structures for the specialized control of distinct acoustic features. To pinpoint the neural mechanisms underlying typical feedback-based sensorimotor control, Aim 1 maps out cortical activity associated with compensatory responses to perturbations of pitch and formants using electrocorticography in patients with Epilepsy. To isolate the subthalamic nucleus’s role in sensorimotor con- trol, Aim 2 compares compensatory responses to perturbations of pitch and formants in healthy controls versus patients with Parkinson’s disease in conditions with Deep Brain Stimulation ON versus OFF. The proposed experimental paradigm is significant in that it will clarify conflicting reports about the specializa- tion of cortical and subcortical structures in sensorimotor control of pitch versus formants. Evidence for the effects of neurosurgery on speech outcomes in common motor disorders could directly inform perioperative decisions in clinical care. This research will have direct applications for the future development of neuromodulation to enhance speech treatment for patients with Parkinson’s disease. Results could also inform treatments for a range of motor speech disorders, ultimately maximizing phonatory and articulatory control to improve patient communication.

项目概要/摘要 众所周知，患有构音障碍等运动性言语障碍的人会表现出异常的发音和发音。 调节精度，这可能会导致参与社交和职业活动时的清晰度降低。 最常见的构音障碍是与帕金森病相关的构音障碍，该病涉及非典型在线 音高（发声）和共振峰频率（发音）的调制尽管构音障碍的发生率很高，但认知障碍的发生率很高。 该人群的语言能力下降可能会导致积极参与言语康复的能力下降。 这项研究的长期目标是开发利用自动亲和力的治疗方法 提高构音障碍患者的清晰度的方法，包括操纵听觉的方法 为此，我们利用了稀有的可用性。 神经外科数据（癫痫中的皮层电图、帕金森病中的深部脑刺激）来绘制 发声和发音控制的皮质基底，同时考虑皮质下结构的作用。 根据语音产生的著名模型，语音运动控制的定义反映了 ab- 跨越皮层和皮层下结构的运动回路的常态。实时的实验扰动。 听觉反馈与神经影像学的结合促进了目前对皮质下神经系统的理解。 同时，将听觉反馈典型地纳入语音输出（“感觉运动控制”）。 对帕金森病患者感觉运动控制的研究有助于阐明感觉运动控制的作用 皮层-皮层下运动回路内的底丘脑核在非典型感觉运动控制中的一些过去的研究。 ies 表明，音高和共振峰在前运动内的不同子区域中受到不同的调制 然而，研究之间的差异阻碍了稳健的研究。 皮质和皮质下结构的分区，用于专门控制不同的声学特征。 为了查明典型的基于反馈的感觉运动控制背后的神经机制，目标 1 绘制了 与对音高和共振峰扰动的补偿反应相关的皮层活动 癫痫患者的皮质电图分离丘脑底核在感觉运动控制中的作用。 trol，目标 2 比较健康对照组对音高和共振峰扰动的补偿反应 与帕金森病患者在深部脑刺激开启与关闭的情况下进行比较。 所提出的实验范式具有重要意义，因为它将澄清有关专业化的相互矛盾的报告。 皮层和皮层下结构在音高与共振峰的感觉运动控制中的作用证据。 神经外科对常见运动障碍言语结果的研究可以直接影响围手术期决策 这项研究将对神经调节的未来发展有直接的应用，以增强临床护理。 帕金森病患者的言语治疗结果也可以为一系列运动治疗提供参考。 言语障碍，最终最大限度地提高发声和发音控制，以改善患者的沟通。