基于功能磁共振成像的唇腭裂患者构音障碍康复训练脑机制研究

Study on brain mechanism of rehabilitation training of articulation disorder in cleft lip and palate patients based on functional magnetic resonance imaging

唇腭裂(CLP)是口腔颌面部最常见的先天性缺陷。本研究采集23名未接受康复训练、存在构音障碍的CLP患者(Bclp组)和23名经康复训练后恢复构音清晰度的CLP患者(Aclp组)在执行汉字发音任务时的功能磁共振成像数据,进行激活脑区分析,探索CLP患者经过构音障碍康复训练后脑机制的变化。研究发现,Aclp组的运动皮层、布罗卡(Broca)区、韦尼克(Wernicke)区、小脑等脑区明显激活,Bclp组的运动皮层等脑区仅表现出微弱激活,激活范围小。本文比较了具有组间差异的脑区和共同激活脑区的脑活动水平变化,发现康复训练使负向激活的脑区(小脑、左侧运动区、Wernicke区等)活动水平提升到正向;同时提升了微弱激活脑区(右侧运动区和Broca区等)的活动水平。本文研究结果提示,对CLP患者实施康复训练可提高CLP患者与构音清晰度相关脑区的活动水平,构音清晰度相关脑区的激活强度值可作为一种可量化的客观评价指标来评估康复训练效果,对康复训练方案的制定具有重要意义。

The cleft lip and palate(CLP) is one of the most common craniofacial malformations in humans. We collected functional magnetic resonance data of 23 CLP patients before rehabilitation training(Bclp) and 23 CLP patients after rehabilitation training(Aclp), who were performing Chinese character pronunciation tasks, and performed brain activation analysis to explore the changes of brain mechanism in CLP patients after articulation disorder rehabilitation training. The study found that Aclp group had significant activation in the motor cortex, Broca area, Wernicke area and cerebellum. While the Bclp group had weak activation in the motor cortex with a small activation range. By comparing the differences and co-activated brain regions between the two groups, we found that rehabilitation training increased the activity level of negatively activated brain areas(cerebellum, left motor area, Wernicke area, etc.) to a positive level. At the same time, the activity level of weakly activated brain areas(right motor area, Broca area, etc.) was also increased.Rehabilitation training promoted the activity level of articulation-related brain regions. So that the activation intensity of articulation-related brain regions can be used as a quantifiable objective evaluation index to evaluate the effect of rehabilitation training, which is of great significance for the formulation of rehabilitation training programs.