Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.
Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany; FH Münster University of Applied Sciences, Münster School of Health (MSH), Münster, Germany.
Neuroimage. 2021 Dec 15;245:118736. doi: 10.1016/j.neuroimage.2021.118736. Epub 2021 Nov 16.
Fluency-shaping enhances the speech fluency of persons who stutter, yet underlying conditions and neuroplasticity-related mechanisms are largely unknown. While speech production-related brain activity in stuttering is well studied, it is unclear whether therapy repairs networks of altered sensorimotor integration, imprecise neural timing and sequencing, faulty error monitoring, or insufficient speech planning. Here, we tested the impact of one-year fluency-shaping therapy on resting-state fMRI connectivity within sets of brain regions subserving these speech functions. We analyzed resting-state data of 22 patients who participated in a fluency-shaping program, 18 patients not participating in therapy, and 28 fluent control participants, measured one year apart. Improved fluency was accompanied by an increased connectivity within the sensorimotor integration network. Specifically, two connections were strengthened; the left inferior frontal gyrus showed increased connectivity with the precentral gyrus at the representation of the left laryngeal motor cortex, and the left inferior frontal gyrus showed increased connectivity with the right superior temporal gyrus. Thus, therapy-associated neural remediation was based on a strengthened integration of the command-to-execution pathway together with an increased auditory-to-motor coupling. Since we investigated task-free brain activity, we assume that our findings are not biased to network activity involved in compensation but represent long-term focal neuroplasticity effects.
流畅性塑造可以提高口吃者的言语流畅性，但潜在的条件和神经可塑性相关机制在很大程度上尚不清楚。虽然口吃者的言语产生相关脑活动已经得到了很好的研究，但尚不清楚治疗是否可以修复改变的感觉运动整合、不精确的神经计时和排序、错误监控故障或不足的言语计划的网络。在这里，我们测试了为期一年的流畅性塑造疗法对口吃者言语功能相关脑区的静息态 fMRI 连接的影响。我们分析了 22 名参加流畅性塑造计划的患者、18 名未参加治疗的患者和 28 名流利对照组参与者的静息态数据，时间间隔为一年。流畅性的提高伴随着感觉运动整合网络内连接的增加。具体来说，有两个连接得到了增强；左侧额下回与代表左喉运动皮层的中央前回之间的连接增强，左侧额下回与右侧颞上回之间的连接增强。因此，与治疗相关的神经修复是基于命令-执行通路的增强整合以及听觉-运动耦合的增加。由于我们研究了无任务的大脑活动，我们假设我们的发现不受涉及补偿的网络活动的影响，而是代表长期的焦点神经可塑性效应。
