Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
Department of Telecommunications, Brno University of Technology, Technicka 12, 616 00, Brno, Czech Republic.
Parkinsonism Relat Disord. 2019 Apr;61:187-192. doi: 10.1016/j.parkreldis.2018.10.011. Epub 2018 Oct 10.
Hypokinetic dysarthria (HD) is a common symptom of Parkinson's disease (PD) which does not respond well to PD treatments. We investigated acute effects of repetitive transcranial magnetic stimulation (rTMS) of the motor and auditory feedback area on HD in PD using acoustic analysis of speech.
We used 10 Hz and 1 Hz stimulation protocols and applied rTMS over the left orofacial primary motor area, the right superior temporal gyrus (STG), and over the vertex (a control stimulation site) in 16 PD patients with HD. A cross-over design was used. Stimulation sites and protocols were randomised across subjects and sessions. Acoustic analysis of a sentence reading task performed inside the MR scanner was used to evaluate rTMS-induced effects on motor speech. Acute fMRI changes due to rTMS were also analysed.
The 1 Hz STG stimulation produced significant increases of the relative standard deviation of the 2nd formant (p = 0.019), i.e. an acoustic parameter describing the tongue and jaw movements. The effects were superior to the control site stimulation and were accompanied by increased resting state functional connectivity between the stimulated region and the right parahippocampal gyrus. The rTMS-induced acoustic changes were correlated with the reading task-related BOLD signal increases of the stimulated area (R = 0.654, p = 0.029).
Our results demonstrate for the first time that low-frequency stimulation of the temporal auditory feedback area may improve articulation in PD and enhance functional connectivity between the STG and the cortical region involved in an overt speech control.
运动障碍性构音障碍（HD）是帕金森病（PD）的常见症状，对 PD 治疗反应不佳。我们通过语音声学分析研究了经颅重复磁刺激（rTMS）对 PD 患者 HD 的运动和听觉反馈区的急性影响。
我们使用了 10Hz 和 1Hz 刺激方案，并在 16 名 HD 帕金森病患者的左口面运动区、右颞上回（STG）和顶点（对照刺激部位）上施加 rTMS。采用交叉设计。刺激部位和方案在受试者和会话中随机化。在磁共振扫描仪内进行句子阅读任务的声学分析用于评估 rTMS 对运动言语的诱导效应。还分析了 rTMS 引起的急性 fMRI 变化。
1Hz STG 刺激可显著增加第二共振峰的相对标准偏差（p=0.019），即描述舌和颌运动的声学参数。该效果优于对照部位刺激，并伴有刺激区域与右侧海马旁回之间静息状态功能连接增加。rTMS 诱导的声学变化与刺激区域与阅读任务相关的 BOLD 信号增加呈正相关（R=0.654，p=0.029）。
我们的结果首次证明，颞听觉反馈区的低频刺激可能改善 PD 患者的发音，并增强 STG 与参与言语控制的皮质区域之间的功能连接。
