Turkeltaub Peter E, Swears Mary K, D'Mello Anila M, Stoodley Catherine J
Department of Neurology, Georgetown University, Washington, D.C., USA.
Research Division, MedStar National Rehabilitation Hospital, Washington, D.C., USA.
Restor Neurol Neurosci. 2016 May 24;34(4):491-505. doi: 10.3233/RNN-150633.
Aphasia is an acquired deficit in the ability to communicate through language. Noninvasive neuromodulation offers the potential to boost neural function and recovery, yet the optimal site of neuromodulation for aphasia has yet to be established. The right posterolateral cerebellum is involved in multiple language functions, interconnects with left-hemisphere language cortices, and is crucial for optimization of function and skill acquisition, suggesting that cerebellar neuromodulation could enhance aphasia rehabilitation.
To provide preliminary behavioral and functional connectivity evidence from healthy participants that cerebellar neuromodulation may be useful for rehabilitation of aphasia.
In Experiment 1, 76 healthy adults performed articulation and verbal fluency tasks before and after anodal, cathodal or sham transcranial direct current stimulation (tDCS) was applied over two cerebellar locations (anterior, right posterolateral). In Experiment 2, we examined whether anodal tDCS over the right posterolateral cerebellum modulated resting-state functional connectivity in language networks in 27 healthy adults.
TDCS over the right posterolateral cerebellum significantly improved phonemic fluency. Cerebellar neuromodulation increased functional connectivity between the cerebellum and areas involved in the motor control of speech, and enhanced the correlations between left-hemisphere language and speech-motor regions.
We provide proof-of-principle evidence that cerebellar neuromodulation improves verbal fluency and impacts resting-state connectivity in language circuits. These findings suggest that the cerebellum is a viable candidate for neuromodulation in people with aphasia.
失语症是一种通过语言进行交流的能力的后天性缺陷。非侵入性神经调节有增强神经功能和促进恢复的潜力,但针对失语症的最佳神经调节部位尚未确定。右侧后外侧小脑参与多种语言功能,与左半球语言皮层相互连接,并且对于功能优化和技能习得至关重要,这表明小脑神经调节可能会增强失语症的康复效果。
从健康参与者中提供初步的行为和功能连接证据,证明小脑神经调节可能对失语症康复有用。
在实验1中,76名健康成年人在对两个小脑部位(前侧、右侧后外侧)施加阳极、阴极或假经颅直流电刺激(tDCS)之前和之后进行了发音和言语流畅性任务。在实验2中,我们检查了对27名健康成年人右侧后外侧小脑施加阳极tDCS是否调节了语言网络中的静息态功能连接。
对右侧后外侧小脑进行tDCS显著提高了音素流畅性。小脑神经调节增加了小脑与参与言语运动控制区域之间的功能连接,并增强了左半球语言区域与言语运动区域之间的相关性。
我们提供了原理性证据,证明小脑神经调节可改善言语流畅性并影响语言回路中的静息态连接。这些发现表明,小脑是失语症患者进行神经调节的一个可行候选部位。