Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy.
CSIRO, Health and Biosecurity, Australian E-Health Research Centre, Brisbane, Australia.
J Child Neurol. 2021 Oct;36(11):958-967. doi: 10.1177/08830738211015800. Epub 2021 Jul 28.
We report a case series of children with childhood apraxia of speech, by describing behavioral and white matter microstructural changes following 2 different treatment approaches.Five children with childhood apraxia of speech were assigned to a motor speech treatment (PROMPT) and 5 to a language, nonspeech oral motor treatment. Speech assessment and brain MRI were performed pre- and post-treatment. The ventral (tongue/larynx) and dorsal (lips) corticobulbar tracts were reconstructed in each subject. Mean fractional anisotropy and mean diffusivity were extracted. The hand corticospinal tract was assessed as a control pathway. In both groups speech improvements paralleled changes in the left ventral corticobulbar tract fractional anisotropy. The PROMPT treated group also showed fractional anisotropy increase and mean diffusivity decrease in the left dorsal corticobulbar tract. No changes were detected in the hand tract. Our results may provide preliminary support to the possible neurobiologic effect of a multimodal speech motor treatment in childhood apraxia of speech.
我们报告了一系列儿童言语失用症的病例，通过描述两种不同治疗方法后行为和白质微观结构的变化。将 5 名儿童言语失用症患者分配到运动言语治疗（PROMPT）组，5 名患者分配到语言、非言语口腔运动治疗组。治疗前后进行言语评估和脑 MRI 检查。在每个受试者中重建了腹侧（舌/喉）和背侧（唇）皮质脊髓束。提取平均各向异性分数和平均扩散系数。手皮质脊髓束作为对照通路进行评估。在两组中，言语改善与左侧腹侧皮质脊髓束各向异性分数的变化平行。PROMPT 治疗组还显示左侧背侧皮质脊髓束各向异性分数增加和平均扩散系数降低。手部通路未检测到变化。我们的结果可能初步支持了一种多模态言语运动治疗在儿童言语失用症中的潜在神经生物学效应。
