■脆性X综合征(FXS)是遗传性智力障碍的主要原因。在FXS个体的神经行为功能障碍中,语言发展和识字受到损害。最近的证据假设,兴奋性谷氨酸能和GABA能抑制性神经传递平衡的破坏可能是认知功能受损的原因。在这项研究中,我们第一次评估,安全,耐受性,经颅经颅直流刺激(tDCS)联合标准言语治疗增强FXS患者语言功能的疗效。
■总共,16名成人FXS患者入组。参与者接受45分钟的阳极tDCS联合言语治疗5周(每周3次)。使用语法接受测试2(TROG-2)和意大利语语言考试的子测试(EsamedelLinguaggio-II,EDL-II)。在基线和治疗后收集左右背外侧前额叶皮质经颅磁刺激和并发脑电图(TMS-EEG)记录,以评估皮质反应性和连通性变化。
■联合治疗5周后,我们观察到写作有显著改善(7.5%),读数(20.3%),重复(13.3%),和TROG-2(10.2%)测试。与临床改变平行,TMS-EEG结果显示,与基线(0.18±0.84μV)相比,治疗后左额叶皮层的TMS诱发电位振幅(-0.73±0.87μV)存在显着差异。
■我们的研究提供了新的证据,表明左阳极前额叶tDCS结合标准言语治疗可以有效增强FXS患者的语言功能,主要通过诱导功能失调的前额叶皮质兴奋性的再平衡。
UNASSIGNED: Fragile X syndrome (
FXS) is the leading cause of genetic intellectual disability. Among the neurobehavioral dysfunctions in
FXS individuals, language development and literacy are compromised. Recent evidence hypothesized that the disruption of excitatory glutamatergic and GABAergic inhibitory neurotransmission balance might be responsible for impairment in cognitive function. In this study, we evaluated for the first time, the safety, tolerability, and efficacy of anodal prefrontal transcranial direct current stimulation (tDCS) combined with standard speech therapy to enhance language function in
FXS patients.
UNASSIGNED: In total, 16 adult
FXS patients were enrolled. Participants underwent 45 min of anodic tDCS combined with speech therapy for 5 weeks (3 times per week). Language function was evaluated using the Test for Reception of Grammar-Version 2 (TROG-2) and subtests of the Italian Language Examination (Esame del Linguaggio - II, EDL-II). Right and left dorsolateral prefrontal cortex transcranial magnetic stimulation and concurrent electroencephalography (TMS-EEG) recordings were collected at baseline and after the treatment to evaluate cortical reactivity and connectivity changes.
UNASSIGNED: After 5 weeks of combined therapy, we observed a significant improvement in the writing (7.5%), reading (20.3%), repetition (13.3%), and TROG-2 (10.2%) tests. Parallelly with clinical change, TMS-EEG results showed a significant difference in TMS-evoked potential amplitude over the left frontal cortex after treatment (-0.73 ± 0.87 μV) compared to baseline (0.18 ± 0.84 μV).
UNASSIGNED: Our study provides novel evidence that left anodal prefrontal tDCS combined with standard speech therapy could be effective in enhancing language function in
FXS patients, mainly by inducing a rebalance of the dysfunctional prefrontal cortical excitability.