言语治疗结合经颅磁刺激用于腭裂言语障碍康复的可行性分析

The role of transcranial magnetic stimulation combined with speech therapy in rehabilitation of cleft palate speech disorders

腭裂言语障碍(CPSD)发病率较高,严重影响患者的交流及生活质量。以往的研究认为,其特殊语音主要是由于患者固有的解剖学缺陷,但神经影像学检查发现异常的代偿性发音习惯可能源自患者的大脑结构及相关功能网络异常。这一发现可以作为重复经颅磁刺激(rTMS)治疗CPSD的理论依据。rTMS的作用方式是通过一定频率的磁脉冲作用于大脑皮层的特定区域,改变相关脑区的神经兴奋性,并使大脑产生神经可塑性变化,从而重新调整语言网络。因此,rTMS在许多语言和言语相关疾病的康复治疗中起重要的辅助作用。本综述首先总结了CPSD的特点及其神经影像学机制、言语治疗的神经影像学原理,以及经颅磁刺激的原理及其在言语康复中的应用,然后综合上述理论探索言语治疗结合重复经颅磁刺激治疗CPSD的可行性,以期为CPSD患者的康复治疗提供一种全新的手段,并为CPSD康复治疗方案的制定提供新的理论依据。

The incidence of cleft palate speech disorders(CPSD)is relatively high,which seriously affects patients′communication and quality of life.Previous studies revealed that the phonological features are mainly due to the patients′anatomical defects,but neuroimaging examinations found that compensatory pronunciation may originate from abnormalities in the patients′brain structure and functional networks.This finding could be theoretical basis for the treatment of CPSD with repetitive transcranial magnetic stimulation(rTMS).The mechanism of rTMS is to adopt magnetic pulses with certain frequency on specific regions of brain,thus changing the neural excitability of relevant brain areas and causing neuroplastic changes,thereby re-adjusting the language network.Therefore,rTMS plays an important auxiliary role in the rehabilitation treatment of many language and speech-related diseases.Our review summarized the characteristics and neuroimaging mechanism of cleft palate speech disorder,speech therapy,and transcranial magnetic stimulation and its application in speech rehabilitation.Then we explored the feasibility of the cranial magnetic stimulation combined with speech therapy in treatment of cleft palate speech disorder,hoping to provide a new theoretical basis and method of rehabilitation treatment for patients with cleft palate speech disorder.