University of Haifa, Haifa, Israel.
University of Toronto, Toronto, ON, Canada.
Neural Plast. 2018 Mar 29;2018:6214095. doi: 10.1155/2018/6214095. eCollection 2018.
Melody-based treatments for patients with aphasia rely on the notion of preserved musical abilities in the RH, following left hemisphere damage. However, despite evidence for their effectiveness, the role of the RH is still an open question. We measured changes in resting-state functional connectivity following melody-based intervention, to identify lateralization of treatment-related changes. A patient with aphasia due to left frontal and temporal hemorrhages following traumatic brain injuries (TBI) more than three years earlier received 48 sessions of melody-based intervention. Behavioral measures improved and were maintained at the 8-week posttreatment follow-up. Resting-state fMRI data collected before and after treatment showed an increase in connectivity between motor speech control areas (bilateral supplementary motor areas and insulae) and RH language areas (inferior frontal gyrus pars triangularis and pars opercularis). This change, which was specific for the RH, was greater than changes in a baseline interval measured before treatment. No changes in RH connectivity were found in a matched control TBI patient scanned at the same intervals. These results are compatible with a compensatory role for RH language areas following melody-based intervention. They further suggest that this therapy intervenes at the level of the interface between language areas and speech motor control areas necessary for language production.
基于旋律的治疗方法依赖于 RH 在左半球损伤后保留音乐能力的概念。然而，尽管有证据表明它们的有效性，但 RH 的作用仍然是一个悬而未决的问题。我们测量了基于旋律的干预后静息状态功能连接的变化，以确定治疗相关变化的偏侧化。一名患者因左额颞部出血性脑损伤（TBI）导致失语症，TBI 发生在三年多前，接受了 48 次基于旋律的干预。行为测量得到改善，并在治疗后 8 周的随访中得到维持。治疗前后采集的静息态 fMRI 数据显示，运动言语控制区（双侧辅助运动区和岛叶）与 RH 语言区（额下回三角部和额下回眶部）之间的连接增加。这种变化是 RH 特有的，比治疗前基线间隔测量的变化更大。在相同时间间隔扫描的匹配对照 TBI 患者中，未发现 RH 连接的变化。这些结果与基于旋律的干预后 RH 语言区的代偿作用一致。它们进一步表明，这种治疗方法干预了语言区和言语运动控制区之间的界面水平，这是语言产生所必需的。
