《中国康复理论与实践》

中国康复理论与实践 >

2019 , Vol. 25 >Issue 8: 930 - 935

DOI: https://doi.org/10.3969/j.issn.1006-9771.2019.08.009

综述

神经调控技术在失语症治疗中的应用进展

  • 陈韵佳 ,
  • 陈柱 ,
  • 朱燕 ,
  • 单春雷
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  • 1.上海市第二康复医院，上海市 200441
    2.上海中医药大学康复医学研究所，上海市 201210
陈韵佳(1989-)，女，汉族，上海市人，主管技师，主要研究方向：脑卒中后言语、语言吞咽康复

收稿日期: 2019-04-16

  修回日期: 2019-05-28

  网络出版日期: 2019-08-16

基金资助

1.上海市宝山区卫计委重点建设项目(No. BSZK-2018-A01)；2.上海市中医药三年行动计划项目[No. ZY(2018-2020)-FWTX-8002; No. ZY(2018-2020)-CCCX-2004-05]

收起

Application of Neuromodulation Technique in Treatment of Aphasia (review)

  • CHEN Yun-jia ,
  • CHEN Zhu ,
  • ZHU Yan ,
  • SHAN Chun-lei
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  • 1.The Second Rehabilitation Hospital of Shanghai, Shanghai 200441, China
    2.Institute of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201210, China

Received date: 2019-04-16

  Revised date: 2019-05-28

  Online published: 2019-08-16

Supported by

Supported by Shanghai Baoshan Committee on Health and Family Planning Key Program (No. BSZK-2018-A01) and Three-year action plan of Shanghai Traditional Chinese Medicine (No. ZY (2018-2020) -FWTX-8002, No. ZY (2018-2020) -CCCX-2004-05)

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摘要

失语症是脑卒中后最常见的一种语言交流障碍，对患者的工作、生活以及社交影响巨大。失语症大脑恢复机制主要是通过调控大脑的突触可塑性进行语言功能区域的网络重塑，从而恢复语言功能。基于脑网络重塑的神经调控技术在失语症的早期以及恢复期的治疗中均被证明有效。经颅直流电刺激(tDCS)、经颅磁刺激(TMS)和镜像神经元治疗(MNT)是近年来快速发展的3项神经调控技术，可通过电或化学方式直接或间接作用于大脑皮质，引起相关语言功能区的皮质兴奋性改变，从而达到改善失语患者语言功能(听理解、图片命名、复述、日常交流等方面)的目的。tDCS作为一种新的安全性高、携带方便且无创的神经调控技术，可通过不同电流、不同电极放置来调节大脑神经元活动治疗失语症，且治疗效果具有后续效应。TMS技术安全无创，通过选择不同的频率、不同的刺激部位，激活相应大脑区域皮质及皮质下神经元轴突，改善失语症患者的语言功能。镜像神经元区域与重要的语言功能区位置吻合，通过激活患者镜像神经元，可辅助修复和重塑受损语言网络，从而改善患者命名、复述和听理解等语言功能。且镜像神经元与运动、感觉和语言的关系都可作为失语症治疗的切入点。神经调控技术与神经电生理学和神经影像学的交互应用也成为失语症治疗发展的新方向。

关键词： 失语症; 经颅直流电刺激; 经颅磁刺激; 镜像神经元; 综述

本文引用格式

陈韵佳 , 陈柱 , 朱燕 , 单春雷 . 神经调控技术在失语症治疗中的应用进展[J]. 中国康复理论与实践, 2019 , 25(8) : 930 -935 . DOI: 10.3969/j.issn.1006-9771.2019.08.009

Abstract

Aphasia is the most common language communication disorder after stroke, which has a great impact on the work, life and social interaction of patients. The mechanism of brain recovery in aphasia is mainly to restore language function by regulating the synaptic plasticity of the brain and remolding the network of language function areas. Neuromodulation techniques based on brain network remodeling have been shown to be effective at the early and recovery stages of aphasia. Transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS) and mirror neuron therapy (MNT) are neuromodulation techniques that have been developed rapidly in recent years. They can directly or indirectly affect the cerebral cortex by electrical or chemical means, causing cortical excitability changes in the relevant language functional areas, so as to improve the language function of aphasic patients (listening comprehension, picture naming, repetition, daily communication, etc.). tDCS, as a safe, convenient and non-invasive neuro-regulation technology, can regulate the activity of brain neurons through different currents and electrode placement to treat aphasia, and the effect has remained in the follow-up. TMS technology is safe and non-invasive. Through the selection of different frequencies, stimulation sites, it can activate the corresponding cerebral cortex and subcortical axons, and improve the language function of aphasia patients. The damaged language network can be repaired and reshaped by activating mirror neurons, so as to improve the language functions of patients, such as naming, repetition, listening and comprehension. The relationship between mirror neurons and motor, sensation and language can be used as entry point for treatment of aphasia. The application of neuromodulation techniques to neuroelectrophysiology and neuroimaging has become a new direction in treatment of aphasia.

Key words： aphasia; transcranial direct current stimulation; transcranial magnetic stimulation; mirror neuron; review

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