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Supplementary Material for: Changes in White Matter Integrity following Intensive Voice Treatment (LSVT LOUD®) in Children with Cerebral Palsy and Motor Speech Disorders
<p>Preliminary evidence suggests that intensive voice and speech
treatment based on activity-dependent neuroplasticity principles holds
promise for affecting positive change in children with cerebral palsy
(CP) and motor speech disorders. Diffusion tensor imaging (DTI) allows
researchers to make inferences about the integrity of white matter
tracks and provides a sensitive measure of neuroplasticity. Previous
treatment studies looking at the effects of training on white matter
integrity have shown positive results, but these studies have been
limited to gross motor function. Eight children with motor speech
disorders and CP (3 females; age 8-16 years) and an age- and sex-matched
group of typically developing (TD) children participated. Each child
with CP completed a full dose of LSVT LOUD® and a 12-week maintenance
program. Participants attended 3 recording sessions: before and after
treatment, and after the maintenance period. TD children were tested at
the same 3 time points. Recording sessions for both groups of children
included measures of white matter integrity using DTI and acoustic
measures of voice and speech. Fractional anisotropy (FA) was measured
for 2 motor tracts and 5 association tracts. In children with CP, we
observed an increase in FA in several motor and association tracts
immediately following treatment and 12 weeks after treatment. Acoustic
data on untrained tasks were correlated with changes in FA detected
immediately following treatment and after the 12-week maintenance
program. These findings suggest that long-term practice of skills
attained during the treatment phase enhances white matter tract
integrity in speech production networks.</p