SPEECH DISORDERS IN CHILDREN WITH CEREBRAL PALSY
Keywords:
cerebral palsy, speech disorders, dysarthria, speech phenotype, neuroplasticity, BDNF, electroencephalography (EEG), functional connectivity, neurorehabilitation, neuromodulationAbstract
Speech and communication disorders are among the most significant manifestations of cerebral palsy (CP), limiting a child’s learning, social adaptation, and quality of life. Their clinical structure is heterogeneous and includes motor speech, apraxic, phonetic-phonological, language, and mixed disorders. The contemporary approach to rehabilitation involves not only the clinical identification of the predominant speech phenotype but also the objective assessment of the functional state of the central nervous system and its capacity for neuroplastic reorganization. Promising areas of research include the investigation of neurophysiological parameters, functional connectivity of brain networks, and potential biological markers, including brain-derived neurotrophic factor (BDNF). This review examines the clinical and neurophysiological mechanisms underlying speech disorders in CP, methods for their objective assessment, current concepts of neuroplasticity, and the potential use of neuroplasticity-related markers to assess and predict rehabilitation outcomes. Particular attention is given to a phenotype-oriented approach that involves selecting therapeutic targets based on the structure of the speech impairment and individual characteristics of the neuroplastic response. The review also presents prospects for integrating functional speech training with adjunctive neuromodulation technologies into personalized neurorehabilitation programs for children with CP.
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