The aim of this paper is to integrate different bodies of research including brain traveling waves, brain neuromodulation, neural field modeling and post-stroke language disorders in order to explore the opportunity of implementing model-guided, cortical neuromodulation for the treatment of post-stroke aphasia. Worldwide according to WHO, strokes are the second leading cause of death and the third leading cause of disability. In ischemic stroke, there is not enough blood supply to provide enough oxygen and nutrients to parts of the brain, while in hemorrhagic stroke, there is bleeding within the enclosed cranial cavity. The present paper focuses on ischemic stroke. We first review accumulating observations of traveling waves occurring spontaneously or triggered by external stimuli in healthy subjects as well as in patients with brain disorders. We examine the putative functions of these waves and focus on post-stroke aphasia observed when brain language networks become fragmented and/or partly silent, thus perturbing the progression of traveling waves across perilesional areas. Secondly, we focus on a simplified model based on the current literature in the field and describe cortical traveling wave dynamics and their modulation. This model uses a biophysically realistic integro-differential equation describing spatially distributed and synaptically coupled neural networks producing traveling wave solutions. The model is used to calculate wave parameters (speed, amplitude and/or frequency) and to guide the reconstruction of the perturbed wave. A stimulation term is included in the model to restore wave propagation to a reasonably good level. Thirdly, we examine various issues related to the implementation model-guided neuromodulation in the treatment of post-stroke aphasia given that closed-loop invasive brain stimulation studies have recently produced encouraging results. Finally, we suggest that modulating traveling waves by acting selectively and dynamically across space and time to facilitate wave propagation is a promising therapeutic strategy especially at a time when a new generation of closed-loop cortical stimulation systems is about to arrive on the market.

中文翻译：

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缺血性卒中后失语症的皮质刺激：向模型指导的电神经调节。

本文的目的是整合包括脑行波，脑神经调节，神经场建模和中风后语言障碍在内的不同研究领域，以探索实施模型指导的皮质神经调节治疗中风后的机会。失语症。根据世界卫生组织的数据，中风是导致死亡的第二大原因，也是导致残疾的第三大原因。在缺血性中风中，血液供应不足，无法为大脑的一部分提供足够的氧气和营养。而在出血性中风中，封闭的颅腔内有出血。本文着重于缺血性中风。我们首先回顾在健康受试者以及脑部疾病患者中自发发生或由外部刺激触发的行波的累积观察结果。我们检查了这些波的推定功能，并着重于脑语言网络变得支离破碎和/或部分沉默时观察到的中风后失语，从而扰乱了病灶周围区域行波的进程。其次，我们集中在基于该领域当前文献的简化模型上，并描述皮质行波动力学及其调制。该模型使用描述距离分布和突触耦合的神经网络（产生行波解）的生物物理现实积分微分方程。该模型用于计算波参数（速度，振幅和/或频率），并指导重建扰动波。模型中包含刺激项，以将波传播恢复到合理的水平。第三，考虑到闭环侵入性脑刺激研究最近产生了令人鼓舞的结果，我们研究了与实施模型指导的神经调节治疗中风后失语有关的各种问题。最后，我们建议通过在空间和时间上选择性和动态地起作用以促进波的传播来调节行波是一种有前途的治疗策略，尤其是在新一代闭环皮层刺激系统即将上市时。