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一种新型言语支持应用程序对脑卒中后失语症患者强化言语治疗及功能性脑连接变化的影响

Effects of a new speech support application on intensive speech therapy and changes in functional brain connectivity in patients with post-stroke aphasia.

作者信息

Katsuno Yuta, Ueki Yoshino, Ito Keiichi, Murakami Satona, Aoyama Kiminori, Oishi Naoya, Kan Hirohito, Matsukawa Noriyuki, Nagao Katashi, Tatsumi Hiroshi

机构信息

Department of Rehabilitation Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan.

Department of Rehabilitation Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

出版信息

Front Hum Neurosci. 2022 Sep 22;16:870733. doi: 10.3389/fnhum.2022.870733. eCollection 2022.

Abstract

Aphasia is a language disorder that occurs after a stroke and impairs listening, speaking, reading, writing, and calculation skills. Patients with post-stroke aphasia in Japan are increasing due to population aging and the advancement of medical treatment. Opportunities for adequate speech therapy in chronic stroke are limited due to time constraints. Recent studies have reported that intensive speech therapy for a short period of time or continuous speech therapy using high-tech equipment, including speech applications (apps, can improve aphasia even in the chronic stage. However, its underlying mechanism for improving language function and its effect on other cognitive functions remains unclear. In the present study, we investigated whether intensive speech therapy using a newly developed speech support app could improve aphasia and other cognitive functions in patients with chronic stroke. Furthermore, we examined whether it can alter the brain network related to language and other cortical areas. Thus, we conducted a prospective, single-comparison study to examine the effects of a new speech support app on language and cognitive functions and used resting state functional MRI (rs-fMRI) regions of interest (ROI) to ROI analysis to determine changes in the related brain network. Two patients with chronic stroke participated in this study. They used the independent speech therapy system to perform eight sets of 20 randomly presented words/time (taking approximately 20 min), for 8 consecutive weeks. Their language, higher cognitive functions including attention function, and rs-fMRI, were evaluated before and after the rehabilitation intervention using the speech support app. Both patients had improved pronunciation, daily conversational situations, and attention. The rs-fMRI analysis showed increased functional connectivity of brain regions associated with language and attention related areas. Our results show that intensive speech therapy using this speech support app can improve language and attention functions even in the chronic stage of stroke, and may be a useful tool for patients with aphasia. In the future, we will conduct longitudinal studies with larger numbers of patients, which we hope will continue the trends seen in the current study, and provide even stronger evidence for the usefulness of this new speech support app.

摘要

失语症是一种在中风后出现的语言障碍,会损害听力、说话、阅读、写作和计算能力。由于人口老龄化和医疗水平的提高,日本中风后失语症患者的数量正在增加。由于时间限制,慢性中风患者获得充分言语治疗的机会有限。最近的研究报告称,短时间的强化言语治疗或使用高科技设备(包括言语应用程序)进行的持续言语治疗,即使在慢性阶段也能改善失语症。然而,其改善语言功能的潜在机制及其对其他认知功能的影响仍不清楚。在本研究中,我们调查了使用新开发的言语支持应用程序进行强化言语治疗是否能改善慢性中风患者的失语症和其他认知功能。此外,我们检查了它是否能改变与语言和其他皮质区域相关的脑网络。因此,我们进行了一项前瞻性、单组对照研究,以检验一种新的言语支持应用程序对语言和认知功能的影响,并使用静息态功能磁共振成像(rs-fMRI)感兴趣区域(ROI)到ROI分析来确定相关脑网络的变化。两名慢性中风患者参与了本研究。他们使用独立的言语治疗系统,每次随机呈现20个单词,共进行8组(约20分钟),连续进行8周。在使用言语支持应用程序进行康复干预前后,对他们的语言、包括注意力功能在内的高级认知功能以及rs-fMRI进行了评估。两名患者的发音、日常对话情况和注意力都有所改善。rs-fMRI分析显示,与语言和注意力相关区域的脑区功能连接增加。我们的结果表明,使用这种言语支持应用程序进行强化言语治疗即使在中风慢性阶段也能改善语言和注意力功能,可能是失语症患者的一种有用工具。未来,我们将对更多患者进行纵向研究,希望能延续本研究中观察到的趋势,并为这种新的言语支持应用程序的有效性提供更有力的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/019b/9535658/d74e06501eb3/fnhum-16-870733-g0001.jpg

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