tDCS通过注意力-听觉平衡补偿促进PD言语障碍恢复的作用及脑机制

Speech disorder (SD) is one of the major dysfunctions of Parkinson’s disease (PD). At present, however, there is little advantageous intervention on PD-associated SD. In the previous studies, we have already demonstrated that attention could positively heighten the motor speech processing modulated by auditory feedback, via the functional link of balance compensation between attention and central auditory system. Our pilot study found that tDCS could change the amount of some neurotransmitter by activating inferior parietal lobe (IPL). Additionally, we also found an enhancement of attention and an improvement of motor speech after tDCS targeting IPL, within a short period. In accord, we speculate that tDCS may promote the recovery of PD-associated SD by means of the balance compensation of auditory attention, resulting from activation of inferior parietal lobe. Furthermore, the neural mechanism underlying tDCS-derived recovery of PD-associated SD may lie in neuroplastic repairs of the neural networks and key cortical areas belonging to modulation of motor speech, by virtue of amount changes of some neurotransmitter. Therefore, we plan to carry out the present study using rehabilitation evaluations, electrophysiological test, as well as neural imaging, in order to explore the rehabilitation effect and detailed neural mechanism underlying tDCS-induced balance compensation of auditory attention for the recovery of PD-associated SD, in a multi-dimension manner including macroscopic, mesoscopic and micorcosmic levels. Our present study intends to illuminate the detailed therapeutic advantage and neural mechanism underlying tDCS-derived neuroplastic repairs for PD-associated SD, in a novel insight. Moreover, we also aim to provide some new theoretical evidence on tDCS-associated translational medical application to PD-associated SD.

言语障碍（SD）是帕金森病（PD）主要功能障碍之一，目前尚无有效干预手段。我们前期研究发现，注意力可通过平衡补偿增强听觉反馈对言语运动的控制；并在预实验中观察到，tDCS激活下顶叶（IPL）可改变脑内多种神经递质含量，可在短期内增强PD患者注意力水平，改善言语运动功能。据此，我们推测，tDCS激活IPL可通过注意力-听觉平衡补偿促进SD恢复，其机制在于调节神经递质代谢而促进言语运动调控神经网络和关键脑区的可塑性修复。本项目拟采用康复评定、电生理及MRI成像等方法，从宏观-介观-微观层面，多维度探索tDCS通过注意力-听觉平衡补偿促进SD恢复的康复效应及其作用机制。本研究不但揭示tDCS促进PD言语障碍恢复新的作用机理，也为tDCS在PD言语障碍干预领域的临床转化奠定理论基础。