Most Parkinson’s disease patients struggle with speech problems. New research by Stanford Medicine scientists uncovers the brain connections that could be essential to preserving speech.
大多的帕金森氏症患者，皆受到言的困。美史丹佛大院，科家的新研究揭露了，保留言能力至重要的大。
Research by Stanford Medicine scientists may explain why some treatments for Parkinson’s — developed mainly to target motor symptoms — can improve speech impairments while other treatments make them worse.
由史丹佛大院，科家行的研究可以解，何帕金森氏症的一些法(主要定肌肉症的)能改善言障，而其他法使其更化。
Parkinson’s disease is most well-known and well-studied for its motor impairments — tremors, stiffness and slowness of movement. But less visible symptoms such as trouble with memory, attention and language, which also can profoundly impact a person’s quality of life, are less understood.
帕金森氏症以其肌肉障(、僵硬及行慢)，被熟知且充分被研究。不，少具有如力、注意力及言障等，也度影一人，生活品的而易症。
A new study by Stanford Medicine researchers reveals the brain mechanisms behind one of the most prevalent, yet often overlooked, symptoms of the disease — speech impairment.
一由史丹佛大院，研究人行的新研究揭露了，疾病最常，不常被忽的症之一，言障背後的大制。
Based on brain imaging from Parkinson’s patients, the researchers identified specific connections in the brain that may determine the extent of speech difficulties.
根自帕金森氏症患者的大造影，此些研究人了，於大中，能定言困程度的特定。
The findings, reported May 20 in the Proceedings of the National Academy of Sciences, could help explain why some treatments for Parkinson’s — developed mainly to target motor symptoms — can improve speech impairments while other treatments make them worse.
此些(2024年)5月20日，於《美家科院院刊》的研究，可能有助於解，何帕金森氏症的一些法(主要定肌肉症的)，能改善言障，而其他法使其化。
“Parkinson’s disease is a very common neurological disorder, but it’s mostly considered a motor disorder,” said Weidong Cai PhD, clinical associate professor of psychiatry and behavioral sciences and the lead author of the new study.
新研究首要撰文人，精神病暨行科床副教授，Weidong Cai博士宣：「帕金森氏症是一，常的神病疾病。不，它通常被是一，肌肉障。
“There’s been lots of research on how treatments such as medications and deep brain stimulation can help improve motor function in patients, but there was limited understanding about how these treatments affect cognitive function and speech.”
一直有多攸如，物及深部大刺激等，法如何助改善，於患者中之肌肉功能的研究。不有此些法，如何影知功能及言能力的解有限。」
Over 90% of people with Parkinson’s experience difficulties with speech, an intricate neurological process that requires motor and cognitive control. Patients may struggle with a weak voice, slurring, mumbling and stuttering.
超90%帕金森氏症患者具有，言困的。是一，需要肌肉及知控制之的神病程。患者扎面，音微弱、模糊、咕及口吃。
“Speech is a complex process that involves multiple cognitive functions, such as receiving auditory feedback, organizing thoughts and producing the final vocal output,” Cai said.
Cai宣：「音是一，涉及如接收回、思想及生最音出之多知功能的程。」
The senior author of the study is Vinod Menon, PhD, professor of psychiatry and behavioral sciences and director of the Stanford Cognitive and Systems Neuroscience Laboratory.
研究深撰文人是，史丹佛大精神病及行科教授，兼知暨系神科室主任，Vinod Menon博士。
he researchers set out to study how levodopa, a common Parkinson’s drug that replaces the dopamine lost from the disease, affects overall cognitive function. They focused on the subthalamic nucleus, a small, pumpkin-seed-shaped region deep within the brain.
此些研究人著手研究，左旋多巴(一取代，因疾病失去多巴胺的常帕金森氏症物)如何影整知功能。他著重於，大深一南瓜籽小域的丘底核。
The subthalamic nucleus is known for its role in inhibiting motor activity, but there are clues to its involvement in other functions. For example, deep brain stimulation, which uses implanted electrodes to stimulate the subthalamic nucleus, has proven to be a powerful way to relieve motor symptoms for Parkinson’s patients — but a common side effect is worsened speech impairment.
丘底核，因其在抑制肌肉活上的角色，人所熟知。不，有多其涉及其他功能的索。譬如，使用植入，刺激丘底核的深部大，已被明是解，帕金森氏症患者肌肉症的一有效方法。不，常的副作用是言障化。
In the new study, 27 participants with Parkinson’s disease and 43 healthy controls, all older than 60, took standard tests of motor and cognitive functioning. The participants with Parkinson’s took the tests while on and off their medication.
As expected, the medication improved motor functioning in the patients, with those having the most severe symptoms improving the most.
在新研究中，27名罹患帕金森氏症的者及43名健康的照者(年全超60)，接受了肌肉及知功能的。罹患帕金森症的者，在其服及停，接受了此些。如期般，在此些患者中，物改善了肌肉功能。以那些具有最重症的患者，改善最多。
The test for cognitive functioning offered a surprise. The test, known as the Symbol Digit Modalities Test, is given in two forms — oral and written. Patients are provided with nine symbols, each matched with a number — a plus sign for the number 7, for example. They are then asked to translate a string of symbols into numbers, either speaking or writing down their answers, depending on the version of the test.
知功能提供了一喜。，被通符字模式，以口及面形式被施予。患者被提供九符，每符匹配一字。例如，加字7。然後，他被要求，一串符翻成字，取於的版本，不是出就是下，他的答案。
As a group, the patients’ performance on both versions of the cognitive test was little affected by medication. But taking a closer look, the researchers noticed that the subset of patients who performed particularly poorly on the spoken version of the test without medication improved their spoken performance on the medication. Their written test scores did not changesignificantly.
管一群，患者在版本的知中，表少受到物影。
不，更一步，此些研究人注意到，服用物，在口版本中，表特差的患者子群，在物治中，改善了他的口表。不，他的情，著化。
“It was quite interesting to find this dissociation between the written and oral version of the same test,” Cai said.
Cai宣：「同一，在面及口版本之的，是十分令人感趣的。」
The dissociation suggested that the medication was not enhancing general cognitive functions such as attention and working memory, but it was selectively improving speech. “Our research unveiled a previously unrecognized impact of dopaminergic drugs on the speech function of Parkinson’s patients,” Menon said.
暗示，物增如，注意力及活等，一般的知功能。不，它性改善言能力。Menon宣：「我的研究揭露了，多巴胺能的物，帕金森氏症患者言功能，一先前未被知的影。」
Next, the researchers analyzed fMRI brain scans of the participants, looking at how the subthalamic nucleus interacted with brain networks dedicated to various functions, including hearing, vision, language and executive control. They found that different parts of the subthalamic nucleus interacted with different networks.
接下，此些研究人分析了，些者之功能性磁共振造影(fMRI：functional Magnetic Resonance Imaging)的部描，探究丘底核，包括力、、言及行控制等，各功能之大的相互作用。他，丘底核的不同部分不同的相互作用。
In particular, they discovered that improvements on the oral version of the test correlated with better functional connectivity between the right side of the subthalamic nucleus and the brain’s language network.
特是，他了，口版本的改善和，在丘底核右大的言之，更佳的功能相。
Using a statistical model, they could even predict a patient’s improvement on the oral test based on changes in their brain’s functional connectivity.
使用模型，他甚至能根，於患者大功能的化，患者在口上的改善。
“Here we’re not talking about an anatomical connection,” Cai explained. Rather, functional connectivity between brain regions means the activity in these regions is closely coordinated, as if they are talking to each other.
Cai解：「在此，我不是一，解剖上的。」反而是，在大域之，意味著，於此些域中之活，如同它互相交般，密切的功能。
“We discovered that these medications influence speech by altering the functional connectivity between the subthalamic nucleus and crucial language networks,” Menon said. “This insight opens new avenues for therapeutic interventions tailored specifically to improve speech without deteriorating other cognitive abilities.”
Menon宣：「我，此些物藉由改，在丘底核言路之的功能，影言能力。此深入解，用於改善言能力，而不化其他知能力的治介入，了新途。」
This newly identified interaction between the subthalamic nucleus and the language network could serve as a biological indicator of speech behavior — in Parkinson’s as well as other speech disorders like stuttering.
新近之丘底核言之的相互作用，除了如口吃等，其他言障之外，在帕金森氏症中，也可能充一，言行的生物指。
Such a biomarker could be used to monitor treatment outcomes and inspire new therapies. “Of course, you can directly observe the outcome of a medication by observing behavior, but I think to have a biomarker in the brain will provide more useful information for the future development of drugs,” Cai said.
生物可能被用，治果及致新法。Cai宣：「然，能藉由察行，直接察物的果。不我，在大中，有生物能未物的，提供更多有用的。」
The findings also provide a detailed map of the subthalamic nucleus, which could guide neurosurgeons performing deep brain stimulation in avoiding damage to an area critical to speech function.
此些研究也提供了一，可能指神外科生，在行深部大刺激，避免言功能至重要域，造成之丘底核的。
“By identifying key neural maps and connections that predict speech improvement, we can craft more effective treatment plans that are both precise and personalized for Parkinson’s disease patients,” Menon said.
Menon宣：「藉由，改善言能力的神及。我能帕金森氏症患者精心制定，兼具精且人化的更有效治。」
The study received funding from the National Institutes of Health and the Alzheimer’s Association.
研究得了，自美家生研究院及阿海默症的助。
址：https://med.stanford.edu/news/all-news/2024/05/parkinsons-speech.html
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