Brain activations in speech recovery process after intra-oral surgery: an fMRI study

International audienceThis study aims at describing cortical and subcortical activation patterns associated with functional recovery of speech production after reconstructive mouth surgery. Our ultimate goal is the understanding of how the brain deals with altered relationships between motor commands and auditory/orosensory feedback, and establishes new inter-articulatory coordination to preserve speech communication abilities. A longitudinal sparse-sampling fMRI study involving orofacial, vowel and syllable production tasks on 9 patients and in three different sessions (one week before, one month and three months after surgery) was conducted. Healthy subjects were recorded in parallel. Results show that for patients in the pre-surgery session, activation patterns are in good agreement with the classical speech production network. Crucially, lower activity in sensorimotor control brain areas during orofacial and speech production movements is observed for patients in all sessions. One month after surgery, the superior parietal lobule is more activated for simple vowel production suggesting a strong involvement of a multimodal integration process to compensate for loss of tongue motor control. Altogether, these results indicate both altered and adaptive sensorimotor control mechanisms in these patients. Index Terms: Neurophonetics, fMRI, speech recovery, motor control, glossectomy, whole-brain analysis, sparse-sampling

Evolution des activations cérébrales lors de la production de parole après exérèse au niveau de la cavité orale

International audienceUsing functional MRI, acoustic data and motor oral assessment, brain correlates of speech recovery after dramatic structural changes in the vocal tract have been investigated during three tasks: orofacial movements and speech production (vowels and syllables). Eleven patients were recorded during three sessions, preoperatively and postoperatively, 1 month and 3 months after surgery (for seven of them also 9 months after surgery). Eleven healthy subjects were recorded in parallel. A "whole brain" group analysis (patients/healthy subjects) reveals a specific activation pattern for patients, in particular during vowel task, which is session-dependent. Moreover, global lower brain activation compared to healthy subjects was found for all tasks in primary, secondary and integrative sensorimotor regions. Differences are interpreted in relation with the emergence of new speech motor goals and changes in the internal models.A partir de données d'IRM fonctionnelle, acoustiques et praxiques, nous avons étudié les corrélats cérébraux de l'adaptation de la parole après une modification structurelle importante du conduit vocal lors de trois tâches : mouvements oro-faciaux silencieux, voyelles et syllabes. Onze patients ont été enregistrés lors de trois sessions, pré-opératoire et post-opératoire à 1 mois et 3 mois (pour sept d'entre eux aussi à 9 mois). Onze sujets contrôles ont été enregistrés en parallèle. Une analyse de groupe (patients/contrôles) " cerveau entier " révèle des patrons d'activation spécifiques aux patients au cours des différentes sessions en particulier pour la tâche de production de voyelles. De plus, une moindre activation cérébrale par rapport aux sujets sains a été observée pour toutes les tâches dans des régions motrices, sensorielles et d'intégration sensori-motrice. Nous interprétons ces résultats en relation avec la redéfinition des buts de parole et l'adaptation de modèles internes du système moteur périphérique

Les dermohypodermites bactériennes nécrosantes avec fasciite nécrosante de la face (revue générale à propos de quatre cas)

ST ETIENNE-BU Médecine (422182102) / SudocSudocFranceF

Neural correlates of speech recovery after intra-oral surgery

International audienceThis study aims at better understanding the reorganization process at the cortical and subcortical levels underlying the functional recovery of speech after mouth surgery (i.e. carcinologic resection of mobile tongue and/or mouth floor). In order to determine how the brain integrates new relationships between motor commands, auditory and orosensory feedbacks and new inter-articulators coordination, we designed a longitudinal sparse-sampling fMRI study based on orofacial, vocalic and syllabic production tasks on 10 patients one week before, one month and three months after surgery. Before surgery, less neural activity was observed in sensorimotor regions in patients compared to healthy subjects while, one month after intra-oral resection, an increase of activity was observed in the supplementary motor area and in the cingulate cortex (both involved in selection and initiation process suggesting more competitive mechanisms between motor strategies after surgery). Additional patients are still currently recruited and we expect the speech recovery process to be also associated with significant activity changes in the cerebellum in relation with changes in motor plant

Brain activations in speech recovery process after intra-oral surgery: an fMRI study

International audienceThis study aims at describing cortical and subcortical activation patterns associated with functional recovery of speech production after reconstructive mouth surgery. Our ultimate goal is the understanding of how the brain deals with altered relationships between motor commands and auditory/orosensory feedback, and establishes new inter-articulatory coordination to preserve speech communication abilities. A longitudinal sparse-sampling fMRI study involving orofacial, vowel and syllable production tasks on 9 patients and in three different sessions (one week before, one month and three months after surgery) was conducted. Healthy subjects were recorded in parallel. Results show that for patients in the pre-surgery session, activation patterns are in good agreement with the classical speech production network. Crucially, lower activity in sensorimotor control brain areas during orofacial and speech production movements is observed for patients in all sessions. One month after surgery, the superior parietal lobule is more activated for simple vowel production suggesting a strong involvement of a multimodal integration process to compensate for loss of tongue motor control. Altogether, these results indicate both altered and adaptive sensorimotor control mechanisms in these patients. Index Terms: Neurophonetics, fMRI, speech recovery, motor control, glossectomy, whole-brain analysis, sparse-sampling

Cortical networks involved in speech recovery after intra-oral surgery: an fMRI study

International audienceSpeech production after intra-oral surgery often requires the patient to go through a long speech recovery process. This study aims at better understanding the reorganization process of the control underlying the functional recovery of speech in patients after resection in the vocal tract region (i.e. carcinologic resection of mobile tongue, mouth floor and lips). In order to determine how the brain integrates new relationships between motor commands, auditory and oro-sensory feedbacks, we designed a longitudinal sparse-sampling fMRI study on 5 patients one week before and one month after surgery. One month after intra-oral resection, an increase of activity was observed in the supplementary motor area, the cingulate cortex, the globus pallidus (both involved in selection and initiation process suggesting more competitive mechanisms between motor strategies after surgery), the superior parietal lobule (somatosensory-motor control), the somatosensory and primary motor cortices (for proprioception and execution of movement). Additional patients are currently recruited and we expect the speech recovery process to be also associated with also significant activity changes in the cerebellum in relation with changes in motor plant. In our view and based on previous studies on internal models, cerebellar activity should be stronger during the first part of the process, as the results of the learning, before returning to a normal level in the second part. These preliminary results contribute to better understand the neural reorganization of sensory-motor structures associated with the speech production recovery process and brain mechanisms involved in relearning speech with a focus on internal model development and perceptuo-motor coupling