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

Authors：

WANG Mengyue ^1,2 , LI Chunlin ^1,2 , ZHANG Wenjing ³ , CHEN Renji ³ ,  LI Xia ^1,2

1. School of Biomedical Engineering, Capital Medical University, Beijing 100069, P. R. China;
2. Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Beijing 100069, P. R. China;
3. Beijing Stomatological Hospital, Capital Medical University, Beijing 100191, P. R. China;

Corresponding author：

LI Xia, Email: xiali@ccmu.edu.cn

Keywords：

Rehabilitation training; Cleft lip and palate; Brain activation

DOI：

10.7507/1001-5515.202006068

Video：

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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.

Citation： WANG Mengyue, LI Chunlin, ZHANG Wenjing, CHEN Renji, LI Xia. Study on brain mechanism of rehabilitation training of articulation disorder in cleft lip and palate patients based on functional magnetic resonance imaging. Journal of Biomedical Engineering, 2023, 40(1): 125-132. doi: 10.7507/1001-5515.202006068 Copy

1.	Mossey P A, Little J, Munger R G, et al. Cleft lip and palate. Lancet, 2009, 374(9703): 1773-1785.
2.	Dixon M J, Marazita M L, Beaty T H, et al. Cleft lip and palate: understanding genetic and environmental influences. Nature Reviews Genetics, 2011, 12(3): 167-178.
3.	Conrad A L, Richman L, Nopoulos P, et al. Neuropsychological functioning in children with non-syndromic cleft of the lip and/or palate. Child Neuropsychol, 2009, 15(5): 471-484.
4.	Richman L C, McCoy T E, Conrad A L, et al. Neuropsychological, behavioral, and academic sequelae of cleft: early developmental, school age, and adolescent/young adult outcomes. Cleft Palate Craniofac J, 2012, 49(4): 387-396.
5.	石冰, 李承浩, 李精韬, 等. 中国唇腭裂研究与治疗30年回顾. 中国口腔颌面外科杂志, 2016, 14(5): 385-396.
6.	朱姗姗. 唇腭裂术后的语音治疗. 中国听力语言康复科学杂志, 2010(4): 35-38.
7.	张文婧, 陈仁吉, 杨永懿. 非综合征型唇腭裂患者语言相关脑区结构和功能研究进展. 北京口腔医学, 2017, 25(2): 118-120.
8.	Shinagawa H, Ono T, Honda E, et al. Distinctive cortical articulatory representation in cleft lip and palate: a preliminary functional magnetic resonance imaging study. Cleft Palate-Craniofacial Journal, 2006, 43(5): 620-624.
9.	Sato-Wakabayashi M, Inoue-Arai M S, Ono T, et al. Combined fMRI and MRI movie in the evaluation of articulation in subjects with and without cleft lip and palate. Cleft Palate-Craniofacial Journal, 2008, 45(3): 309-314.
10.	Becker D B, Coalson R S, Sachanandani N S, et al. Functional neuroanatomy of lexical processing in children with cleft lip and palate. Plastic and Reconstructive Surgery, 2008, 122(5): 1371-1381.
11.	Conrad A L, Richman L, Nopoulos P. Reading achievement in boys with non-syndromic cleft palate only: relationship to neuropsychological skill and neurocircuitry. Developmental Neuropsychology, 2015, 40(7-8): 395-406.
12.	Zhang W J, Li C L, Chen L, et al. Increased activation of the hippocampus during a Chinese character subvocalization task in adults with cleft lip and palate palatoplasty and speech therapy. Neuroreport, 2017, 28(12): 739-744.
13.	王国民, 朱川, 袁文化, 等. 汉语语音清晰度测试字表的建立和临床应用研究. 上海口腔医学, 1995, 4(3): 125-127.
14.	Garrett D D, Kovacevic N, McIntosh A R, et al. The importance of being variable. Journal of Neuroscience, 2011, 31(12): 4496-4503.
15.	Power J D, Mitra A, Laumann T O, et al. Methods to detect, characterize, and remove motion artifact in resting state fMRI. Neuroimage, 2014, 84: 320-341.
16.	Della-Maggiore V, Chau W, Peres-Neto P R, et al. An empirical comparison of SPM preprocessing parameters to the analysis of fMRI data. Neuroimage, 2002, 17(1): 19-28.
17.	Calhoun V D, Stevens M C, Pearlson G D, et al. fMRI analysis with the general linear model: removal of latency-induced amplitude bias by incorporation of hemodynamic derivative terms. Neuroimage, 2004, 22(1): 252-257.
18.	Wu H, Ge Y, Tang H, et al. Language modulates brain activity underlying representation of kinship terms. Sci Rep, 2015, 5: 18473.
19.	Gao Q, Wang J, Yu C, et al. Effect of handedness on brain activity patterns and effective connectivity network during the semantic task of Chinese characters. Scientific reports, 2015, 5: 18262.
20.	Wu C Y, Ho M H R, Chen S H A. A meta-analysis of fMRI studies on Chinese orthographic, phonological, and semantic processing. Neuroimage, 2012, 63(1): 381-391.
21.	Booth J R, Lu D, Burman D D, et al. Specialization of phonological and semantic processing in Chinese word reading. Brain Research, 2006, 1071(1): 197-207.
22.	Tan L H, Liu H L, Perfetti C A, et al. The neural system underlying Chinese logograph reading. Neuroimage, 2001, 13(5): 836-846.
23.	Cisek P, Kalaska J F. Neural correlates of reaching decisions in dorsal premotor cortex: specification of multiple direction choices and final selection of action. Neuron, 2005, 45(5): 801-814.
24.	DeWitt I, Rauschecker J P. Wernicke's area revisited: parallel streams and word processing. Brain and language, 2013, 127(2): 181-191.
25.	Price C J, Crinion J T, Macsweeney M. A Generative Model of Speech Production in Broca's and Wernicke's Areas. Front Psychol, 2011, 2: 237.
26.	Maren S. Long-term potentiation in the amygdala: a mechanism for emotional learning and memory. Trends in neurosciences, 1999, 22(12): 561-567.
27.	Ackermann H, Riecker A. The contribution of the insula to motor aspects of speech production: a review and a hypothesis. Brain and Language, 2004, 89(2): 320-328.
28.	Ackermann H, Riecker A. The contribution(s) of the insula to speech production: a review of the clinical and functional imaging literature. Brain Structure & Function, 2010, 214(5-6): 419-433.
29.	Borowsky R, Cummine J, Owen W J, et al. FMRI of ventral and dorsal processing streams in basic reading processes: insular sensitivity to phonology. Brain Topography, 2006, 18(4): 233-239.
30.	Price C J. A review and synthesis of the first 20 years of PET and fMRI studies of heard speech, spoken language and reading. Neuroimage, 2012, 62(2): 816-847.
31.	Alario F X, Chainay H, Lehericy S, et al. The role of the supplementary motor area (SMA) in word production. Brain Res, 2006, 1076(1): 129-143.
32.	Papoutsi M, de Zwart J A, Jansma J M, et al. From phonemes to articulatory codes: an fMRI study of the role of Broca's area in speech production. Cereb Cortex, 2009, 19(9): 2156-2165.
33.	Turner T H, Fridriksson J, Baker J, et al. Obligatory Broca’s area modulation associated with passive speech perception. Neuroreport, 2009, 20(5): 492-496.

1. Mossey P A, Little J, Munger R G, et al. Cleft lip and palate. Lancet, 2009, 374(9703): 1773-1785.
2. Dixon M J, Marazita M L, Beaty T H, et al. Cleft lip and palate: understanding genetic and environmental influences. Nature Reviews Genetics, 2011, 12(3): 167-178.
3. Conrad A L, Richman L, Nopoulos P, et al. Neuropsychological functioning in children with non-syndromic cleft of the lip and/or palate. Child Neuropsychol, 2009, 15(5): 471-484.
4. Richman L C, McCoy T E, Conrad A L, et al. Neuropsychological, behavioral, and academic sequelae of cleft: early developmental, school age, and adolescent/young adult outcomes. Cleft Palate Craniofac J, 2012, 49(4): 387-396.
5. 石冰, 李承浩, 李精韬, 等. 中国唇腭裂研究与治疗30年回顾. 中国口腔颌面外科杂志, 2016, 14(5): 385-396.
6. 朱姗姗. 唇腭裂术后的语音治疗. 中国听力语言康复科学杂志, 2010(4): 35-38.
7. 张文婧, 陈仁吉, 杨永懿. 非综合征型唇腭裂患者语言相关脑区结构和功能研究进展. 北京口腔医学, 2017, 25(2): 118-120.
8. Shinagawa H, Ono T, Honda E, et al. Distinctive cortical articulatory representation in cleft lip and palate: a preliminary functional magnetic resonance imaging study. Cleft Palate-Craniofacial Journal, 2006, 43(5): 620-624.
9. Sato-Wakabayashi M, Inoue-Arai M S, Ono T, et al. Combined fMRI and MRI movie in the evaluation of articulation in subjects with and without cleft lip and palate. Cleft Palate-Craniofacial Journal, 2008, 45(3): 309-314.
10. Becker D B, Coalson R S, Sachanandani N S, et al. Functional neuroanatomy of lexical processing in children with cleft lip and palate. Plastic and Reconstructive Surgery, 2008, 122(5): 1371-1381.
11. Conrad A L, Richman L, Nopoulos P. Reading achievement in boys with non-syndromic cleft palate only: relationship to neuropsychological skill and neurocircuitry. Developmental Neuropsychology, 2015, 40(7-8): 395-406.
12. Zhang W J, Li C L, Chen L, et al. Increased activation of the hippocampus during a Chinese character subvocalization task in adults with cleft lip and palate palatoplasty and speech therapy. Neuroreport, 2017, 28(12): 739-744.
13. 王国民, 朱川, 袁文化, 等. 汉语语音清晰度测试字表的建立和临床应用研究. 上海口腔医学, 1995, 4(3): 125-127.
14. Garrett D D, Kovacevic N, McIntosh A R, et al. The importance of being variable. Journal of Neuroscience, 2011, 31(12): 4496-4503.
15. Power J D, Mitra A, Laumann T O, et al. Methods to detect, characterize, and remove motion artifact in resting state fMRI. Neuroimage, 2014, 84: 320-341.
16. Della-Maggiore V, Chau W, Peres-Neto P R, et al. An empirical comparison of SPM preprocessing parameters to the analysis of fMRI data. Neuroimage, 2002, 17(1): 19-28.
17. Calhoun V D, Stevens M C, Pearlson G D, et al. fMRI analysis with the general linear model: removal of latency-induced amplitude bias by incorporation of hemodynamic derivative terms. Neuroimage, 2004, 22(1): 252-257.
18. Wu H, Ge Y, Tang H, et al. Language modulates brain activity underlying representation of kinship terms. Sci Rep, 2015, 5: 18473.
19. Gao Q, Wang J, Yu C, et al. Effect of handedness on brain activity patterns and effective connectivity network during the semantic task of Chinese characters. Scientific reports, 2015, 5: 18262.
20. Wu C Y, Ho M H R, Chen S H A. A meta-analysis of fMRI studies on Chinese orthographic, phonological, and semantic processing. Neuroimage, 2012, 63(1): 381-391.
21. Booth J R, Lu D, Burman D D, et al. Specialization of phonological and semantic processing in Chinese word reading. Brain Research, 2006, 1071(1): 197-207.
22. Tan L H, Liu H L, Perfetti C A, et al. The neural system underlying Chinese logograph reading. Neuroimage, 2001, 13(5): 836-846.
23. Cisek P, Kalaska J F. Neural correlates of reaching decisions in dorsal premotor cortex: specification of multiple direction choices and final selection of action. Neuron, 2005, 45(5): 801-814.
24. DeWitt I, Rauschecker J P. Wernicke's area revisited: parallel streams and word processing. Brain and language, 2013, 127(2): 181-191.
25. Price C J, Crinion J T, Macsweeney M. A Generative Model of Speech Production in Broca's and Wernicke's Areas. Front Psychol, 2011, 2: 237.
26. Maren S. Long-term potentiation in the amygdala: a mechanism for emotional learning and memory. Trends in neurosciences, 1999, 22(12): 561-567.
27. Ackermann H, Riecker A. The contribution of the insula to motor aspects of speech production: a review and a hypothesis. Brain and Language, 2004, 89(2): 320-328.
28. Ackermann H, Riecker A. The contribution(s) of the insula to speech production: a review of the clinical and functional imaging literature. Brain Structure & Function, 2010, 214(5-6): 419-433.
29. Borowsky R, Cummine J, Owen W J, et al. FMRI of ventral and dorsal processing streams in basic reading processes: insular sensitivity to phonology. Brain Topography, 2006, 18(4): 233-239.
30. Price C J. A review and synthesis of the first 20 years of PET and fMRI studies of heard speech, spoken language and reading. Neuroimage, 2012, 62(2): 816-847.
31. Alario F X, Chainay H, Lehericy S, et al. The role of the supplementary motor area (SMA) in word production. Brain Res, 2006, 1076(1): 129-143.
32. Papoutsi M, de Zwart J A, Jansma J M, et al. From phonemes to articulatory codes: an fMRI study of the role of Broca's area in speech production. Cereb Cortex, 2009, 19(9): 2156-2165.
33. Turner T H, Fridriksson J, Baker J, et al. Obligatory Broca’s area modulation associated with passive speech perception. Neuroreport, 2009, 20(5): 492-496.

Journal of Biomedical Engineering

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

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