Developmental stuttering (DS) is a disturbance of the normal speech flow, characterized by the presence of repetitions, blocks and prolongations, especially in the first part of words and phrases. DS is a multifactorial disorder, due to an atypical development of the neural structures dedicated to the sensorimotor control of language. The standard treatment of DS normally consists in the utilization of behavioral speech therapy, but stuttering can persist into adulthood. For this reason, research is investigating how to optimize the effects of classical treatments, for example by using transcranial electrical stimulation (tES), which can favor exercise-induced neural plasticity. In this manuscript, a preliminary study is proposed in which the supplementary motor area (SMA), a brain region involved in speech motor preparation, was stimulated using two different high-definition tES protocols (transcranial direct current stimulation -tDCS -, transcranial random noise stimulation -tRNS-, and sham stimulation) with the aim of identifying the most effective one in modulating brain activity of people who stutter (in order to improve fluency). To evaluate effects of stimulation, physiological indexes of neural activity were obtained (by means of electroencephalography, i.e."resting-state" EEG), as well as behavioral indexes related to stuttering severity were available. Therefore, this unconventional approach could be useful not only for improving speech fluency, but could also provide new evidence about the pathophysiological mechanisms of stuttering.
La balbuzie evolutiva (BE) si manifesta come un'interruzione del normale flusso dell’eloquio, caratterizzato dalla presenza di ripetizioni, blocchi e prolungamenti, specialmente nella prima parte di parole e frasi. La BE è un disturbo multifattoriale dovuto ad uno sviluppo atipico delle strutture neurali dedicate al controllo sensomotorio del linguaggio. Il trattamento standard della BE consiste nell’utilizzo di tecniche logopediche, ma la balbuzie può persistere in età adulta. Per questo motivo, diversi approcci stanno indagando come ottimizzare gli effetti dei trattamenti classici, per esempio tramite l’utilizzo della stimolazione elettrica transcranica (tES), che può favorire la plasticità neurale indotta dall’esercizio . In questo manoscritto viene proposto uno studio preliminare in cui la corteccia supplementare motoria (SMA), un’area del cervello coinvolta nella preparazione motoria dell’eloquio, è stata stimolata utilizzando due diversi protocolli di tES ad alta definizione (stimolazione transcranica a corrente diretta -tDCS-, stimolazione transcranica a rumore casuale -tRNS- e stimolazione sham) con l’obiettivo di identificare quello maggiormente efficace nel modulare l’attività cerebrale della persona con balbuzie (per migliorarne la fluenza). Per valutare gli effetti della stimolazione, sono stati presi in considerazione indici fisiologici dell’attività neurale ottenuti tramite elettroencefalografia (“resting-state” EEG) e indici comportamentali (legati alla severità della balbuzie). Tale approccio non convenzionale potrebbe perciò essere utile non solo per migliorare la fluenza del linguaggio, ma potrebbe anche fornire nuove evidenze sui meccanismi patofisiologici della balbuzie.
La stimolazione elettrica transcranica come trattamento innovativo della balbuzie evolutiva in età adulta: un esperimento pilota.
BUTERA, SILVIA
2021/2022
Abstract
Developmental stuttering (DS) is a disturbance of the normal speech flow, characterized by the presence of repetitions, blocks and prolongations, especially in the first part of words and phrases. DS is a multifactorial disorder, due to an atypical development of the neural structures dedicated to the sensorimotor control of language. The standard treatment of DS normally consists in the utilization of behavioral speech therapy, but stuttering can persist into adulthood. For this reason, research is investigating how to optimize the effects of classical treatments, for example by using transcranial electrical stimulation (tES), which can favor exercise-induced neural plasticity. In this manuscript, a preliminary study is proposed in which the supplementary motor area (SMA), a brain region involved in speech motor preparation, was stimulated using two different high-definition tES protocols (transcranial direct current stimulation -tDCS -, transcranial random noise stimulation -tRNS-, and sham stimulation) with the aim of identifying the most effective one in modulating brain activity of people who stutter (in order to improve fluency). To evaluate effects of stimulation, physiological indexes of neural activity were obtained (by means of electroencephalography, i.e."resting-state" EEG), as well as behavioral indexes related to stuttering severity were available. Therefore, this unconventional approach could be useful not only for improving speech fluency, but could also provide new evidence about the pathophysiological mechanisms of stuttering.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/32149