ABSTRACT
@#Objective:To explore the kinematics characteristics of articulators (including lips, tongue and jaw) during articulation in dysarthric individuals post brain injury by using electromagnetic articulography (electromagnetic articulography, EMA). Methods:From October, 2017 to October, 2018, six eligible individuals with dysarthria were recruited as dysarthria group, and ten age-gender matched healthy adults were recruited as healthy control group. Both groups received EMA assessment, and the dysarthria group was assessed with Chinese modified version of Frenchay Dysarthria Assessment before EMA assessment. To track and record kinematic parameters data (including duration, velocity, acceleration, distance) and displacement movement trajectories, a series of sensors were attached on the participant's lips, tongue (tip, blade and back of tongue) and jaw, the reference sensor was attached on the bridge of nose, all of the sensors were along midsagittal plane. During EMA assessment, each participant was received syllable repetition task, which containing consonants (/d/, /t/, /j/, /q/, /g/, /k/, /b/, /p/) at word initial position and vowels (/a/, /ia/, /iu/), to produce the single word with the Chinese linguistic meaning, every syllable produced was repeated three times. Then Praat software and Matlab software were used to process acoustic and kinematic data, so as to compare the differences of articulatory kinematic performance between two groups. Results:The outcome of the Frenchay Dysarthria Assessment indicated that the severity of dysarthria was from moderate to extreme severe. EMA assessment demonstrated that, compared with the healthy control group, the dysarthria group showed a reduction of velocity, acceleration and distance of tongue and lip movement (<italic>t</italic> > 2.422, <italic>P</italic> < 0.05), and longer duration of tongue tip, tongue back and jaw movement (<italic>t</italic> > 3.369, <italic>P</italic> < 0.05). There was no statistical difference in duration of tongue blade and lip movement (<italic>t</italic> < 2.146, <italic>P</italic> > 0.05), the same as the velocity, acceleration and distance of jaw movement between two groups (<italic>t</italic> < 1.016, <italic>P</italic> > 0.05). Image analysis of kinematics parameters and synchronous audio data showed that, compared with the healthy control group, the dysarthria group varied unstably in velocity and acceleration, and the audio data showed that, when repeated /da/ three times, the duration of each syllable was not equal. The coordination of articulation movement displacement in the anterior-posterior dimension and inferior-superior dimension was poor, there were significant differences in visual inspection of movement trajectories between two groups, and a smaller displacement was found in the anterior-posterior dimension in the dysarthric group. Conclusion:EMA assessment has significant advantages in evaluating kinematics parameters quantitatively, which could reveal the kinematics characteristics of articulators.
ABSTRACT
Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the brain functional reorga-nization of aphasia after stroke, with functional magnetic resonance imaging (fMRI). Methods From January, 2017 to February, 2018, six eligible stroke patients with aphasia were recruited in experimental group, and nine age-gender matched healthy adults were recruited in healthy control group. Subjects in both groups received task-fMRI, and the experimental group was assessed with Chinese version of Western Aphasia Battery (WAB) examination before and after rTMS treatment. Four patients underwent rTMS at the right inferior frontal gyri pars triangularis marked by neuro-navigation-guided system, 1 Hz, five times per week for two weeks. The fMRI data were processed by SPM 12. The differences of brain activation and voxel changes be-tween two groups were compared. The fMRI data including the differences in brain activation, voxel volume and activation voxel indices (AVI) and WAB scores were analyzed before and after rTMS. Results The cerebral hemisphere activation in the experimental group was higher than that of the healthy control group, including the regions of interest (ROI) such as bilateral supplementary motor area and middle frontal gyrus, and the non-ROI (n-ROI) such as left praecuneus, left postcentral gyrus, right hippocampus, right paracingulate cor-tex, etc., while the activation reduced in the areas of left pars triangularis and n-ROI such as left calcarine fissure cortex, left gyrus lingualis, the right anterior cingulate and the paracingulate cortex. Cases 1 and 2 had shorter course of disease, smaller lesion volume, and activation increased in bilateral cerebral hemispheres before treat-ment. AVI showed that their hemispheric dominance was right, and activation reduced in bilateral cerebral hemi-sphere after treatment, but the high-efficiency language function area of ROI, such as the left pars triangularis, turned from inactive to active, and the hemispheric dominance lateralized from right to left, with the improve-ment of language function. For the case 3 and case 4, the disease courses were longer, the lesions sizes were larg-er, and both cerebral hemisphere activations were reduced before treatment. AVI showed that the hemispheric dominance of case 3 was right and was left in case 4. After treatment, bilateral cerebral hemispheres were activat-ed more than before, and the hemispheric dominance of language function was in the right hemisphere; the left middle frontal gyrus and right middle temporal gyrus were activated from no activation before treatment in case 3. The activation of the supplemental motor area on the right side was increased. In case 4, there was no activa-tion in ROI before treatment. After treatment, the bilateral supplementary motor area, right pars opercularis, and the right middle temporal gyrus were activated. Conclusion Low-frequency rTMS could improve the language function by optimizing bilateral cerebral hemisphere brain areas related with language function in patients with aphasia after stroke.