经颅直流电刺激对失语症的治疗作用及神经网络机制研究

Aphasia greatly impairs the ability of communication. The therapeutic effect is not satisfactory especially for patients with severe brain injuries and those reaching the plateau period. Domestic and international studies have shown that aphasia could be improved through activating the excitability of cortical cell in regions of interest with transcranial direct current stimulation (tDCS). Moreover, our preliminary study also demonstrated that cortical electrical activities related to language tasks could be detected via EEG nonlinear dynamics analysis (NDA) and the states of cortical excitability related to language played an important role in the treatment of tDCS on aphasia. Therefore, we hypothesized that improvement of aphasia closely related with the states of cortical excitability and interconnections of cortical networks related to language, quantitative evaluation with NDA and specific treatment with tDCS. In this study, we would investigate the neural network mechanism and effect of tDCS on aphasic patients and establish an effective treatment plan for aphasia with NDA and tDCS. This study would clarify the importance of language related cortical excitability and interconnections of cortical networks, and elucidate the significance of neural network mechanism during aphasia treatment. The final goal is to establish an optimal treatment for different types of aphasia with tDCS directed by NDA.

失语症的存在极大地影响了患者的语言交流能力。目前失语症的治疗效果难以令人满意，尤其是损伤较重或到达平台期的患者。国内外研究显示：经颅直流电刺激（tDCS）刺激感兴趣区皮层神经细胞可以达到改善失语症的效果。我们的前期研究发现：脑电非线性分析（NDA）可以观察到与语言任务相关的皮层电活动，语言相关皮层的兴奋性状态对于失语症的tDCS治疗起着重要的作用；据此我们提出失语症改善与语言功能区皮层兴奋性状态及语言相关神经网络的相互联系变化有关，通过NDA量化、tDCS针对性治疗的假设。我们将研究tDCS治疗失语症患者的疗效和神经网络机制，建立失语症的NDA评估和tDCS治疗的成熟方案。本研究将对明确语言相关皮层的兴奋性状态以及神经网络的相互联系变化在失语症的治疗中起着关键性作用，以及阐明失语症恢复过程中皮层兴奋性变化的神经网络机制有重要的意义，最终建立NDA指导tDCS治疗不同类型失语症的最佳方案。

失语症极大地影响了患者的语言交流能力。目前失语症的治疗效果难以令人满意，尤其是损伤较重或到达平台期的患者。国内外研究显示：经颅直流电刺激（tDCS）刺激感兴趣区皮层神经细胞可以达到改善失语症的效果。我们的前期研究发现：脑电非线性分析（NDA）可以观察到与语言任务相关的皮层电活动，语言相关皮层的兴奋性状态对于失语症的tDCS治疗起着重要的作用；据此我们提出失语症改善与语言功能区皮层兴奋性状态及语言相关神经网络的相互联系变化有关，通过NDA量化、tDCS针对性治疗的假设，我们将研究tDCS治疗失语症患者的疗效和神经网络机制，建立失语症的NDA评估和tDCS治疗的成熟方案。.我们应用NDA，观察tDCS刺激感兴趣区皮层神经细胞，对失语症患者皮层兴奋性改变与语言功能改善的关系进行了研究。我们发现经左Wernicke区阳极tDCS治疗后，失语症患者的名词和动词命名均有明显的改善；脑电非线性分析结果显示不仅刺激区，非刺激语言相关脑区皮层兴奋也增高，患者言语功能的改善与广泛的左侧半球和部分的右侧半球兴奋性增高有关；tDCS不仅能够调节刺激区皮层的兴奋性，而且能够影响语言相关皮层网络的兴奋性。而且，我们在国际上首次报道了对原发性进行性失语症应用tDCS短期治疗，取得显著疗效。这些研究结果提示，tDCS可能失语症治疗的有效手段之一。