Brain networks for reading in stroke alexia and typical aging

中风失读症和典型衰老患者的大脑网络阅读

• 批准号: 10502771
• 负责人: RHONDA B FRIEDMAN
• 金额: $ 66.3万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10502771
• 关键词: Address; Affect; Age; Aging; Alexia; American; Architecture; Area; Atlases; Behavior; Behavioral; Brain; Brain imaging; Categories; Characteristics; Chronic; Clinical; Cognitive; Data; Databases; Diagnosis; Diagnostic; Disease; Education; Elderly; Ensure; Financial compensation; Free Will; Functional Magnetic Resonance Imaging; Goals; Hospitals; Image; Knowledge; Language; Language Tests; Left; Lesion; Life; Magnetic Resonance Imaging; Maps; Materials Testing; Measures; Methods; Modeling; Modernization; Neurocognitive; Neurosciences Research; Pathologic; Pathway interactions; Pattern; Performance; Persons; Population; Positioning Attribute; Process; Reader; Reading; Recovery; Recovery Support; Research; Resources; Sample Size; Sampling; Semantics; Societies; Socioeconomic Status; Speech; Stroke; Syndrome; System; Testing; Time; Translating; Vision; Work; acute stroke; age related; aging brain; base; brain behavior; chronic stroke; cognitive neuroscience; cohort; imaging study; improved; injured; invention; loss of function; multidisciplinary; multimodal neuroimaging; multimodality; neural patterning; neurocognitive test; neuroimaging; novel strategies; phonology; post stroke; predictive test; prospective; reading ability; reading difficulties; recruit; restoration; speech processing; stroke risk; stroke survivor; support network

PROJECT SUMMARY/ABSTRACT The ability to read is fundamental to living in modern society. Loss of reading ability due to stroke, called alexia, likely affects over a million Americans at any given time and causes difficulty performing many daily life functions. To improve diagnosis and treatment of alexia, we must understand the neurocognitive basis of reading deficits after stroke. However, prior small-scale studies using broad diagnostic categories and older neuroimaging methods have yielded only general lesion-behavior associations in alexia. Here, we propose the largest study to date of both alexia and typical reading in older adults, using detailed measures of reading ability and the most advanced multimodal neuroimaging methods available to test a new neurocognitive model. Reading relies on brain networks that evolved for speech and language processes, but neurocognitive models of reading have not yet incorporated recent advances in our understanding of these networks. We propose a new model of Reading Integrated with Speech and Semantics (RISS) that provides a more specific neurocognitive architecture for reading than prior models. We hypothesize that lesions of specific RISS network processors and connections account for specific reading deficit patterns after stroke, and that restoration of the injured RISS pathways or compensation in uninjured pathways underlie alexia recovery. Although brain networks for reading have been extensively mapped in typical and atypical young populations, stroke tends to occur in the aging brain and in people of low education and socioeconomic status (SES) who are too often left out of cognitive neuroscience research. Pathological patterns of reading in alexia are also observed to a lesser degree in typical readers, and age, education and SES are all known to affect reading abilities. Therefore, alexia can only be fully understood by examining how these factors relate to reading behavior and the brain in typical older adults, and referencing reading deficits to this personal context. In the first study of this project, we will collect an extensive battery of reading and language tests along with advanced multimodal MRIs in 100 older adults demographically matched to stroke survivors. We will test hypotheses based on RISS and examine how age, education, and SES relate to both behavior and the brain. We will freely disseminate all testing materials and both behavioral and imaging data to facilitate further research in this area. In the second study, we will perform the same behavioral battery in 200 chronic stroke survivors prospectively selected based on lesion attributes from a new imaging database of thousands of stroke survivors. We will model the effects of the lesions on processors and connections in RISS and test brain-behavior hypotheses using lesion-network mapping analyses. In the third study, we will collect detailed behavioral data and multimodal MRIs in 50 stroke survivors during the subacute period and again 12 months later to test hypotheses regarding mechanisms of alexia recovery based on RISS. This project will substantially advance our understanding of the neurocognitive basis of reading in both alexia and typical aging.

项目概要/摘要 阅读能力是现代社会生活的基础。由于中风而丧失阅读能力，称为 失读症可能在任何特定时间影响超过一百万美国人，并导致许多日常生活困难 功能。为了改善失读症的诊断和治疗，我们必须了解失读症的神经认知基础 中风后的阅读障碍。然而，之前的小规模研究使用广泛的诊断类别和较旧的 神经影像学方法仅得出失读症的一般病变与行为关联。在此，我们建议 迄今为止针对老年人失读症和典型阅读的最大研究，使用详细的阅读测量 能力和最先进的多模式神经影像方法可用于测试新的神经认知模型。 阅读依赖于为语音和语言过程而进化的大脑网络，但神经认知 阅读模型尚未纳入我们对这些网络的理解的最新进展。我们 提出了一种新的与语音和语义相结合的阅读模型（RISS），该模型提供了更具体的 与之前的模型相比，用于阅读的神经认知架构。我们假设特定 RISS 的病变 网络处理器和连接解释了中风后特定的阅读缺陷模式，并且 受损的 RISS 通路的恢复或未受损通路的补偿是失读症恢复的基础。 尽管用于阅读的大脑网络已在典型和非典型年轻人中被广泛绘制 在人群中，中风往往发生在大脑老化以及教育程度和社会经济地位较低的人群中 （SES）经常被排除在认知神经科学研究之外。亚历克西亚阅读的病理模式 在典型读者中也观察到较小程度的影响，众所周知，年龄、教育程度和社会经济地位都会影响 阅读能力。因此，只有通过检查这些因素与失读症的关系，才能充分理解失读症。 典型老年人的阅读行为和大脑，并将阅读缺陷与个人背景联系起来。 在该项目的第一项研究中，我们将收集大量的阅读和语言测试以及 对 100 名与中风幸存者在人口统计学上相匹配的老年人进行了先进的多模态 MRI 扫描。我们将测试 基于 RISS 的假设，并研究年龄、教育和社会经济地位与行为和大脑的关系。 我们将免费传播所有测试材料以及行为和影像数据，以进一步促进 该领域的研究。在第二项研究中，我们将对 200 名慢性中风患者进行相同的行为训练 根据来自数千个新成像数据库的病变属性前瞻性地选择幸存者 中风幸存者。我们将在 RISS 中模拟损伤对处理器和连接的影响并进行测试 使用病变网络映射分析的大脑行为假设。在第三次研究中，我们将收集详细的 50 名中风幸存者在亚急性期和 12 个月内的行为数据和多模态 MRI 随后测试基于 RISS 的有关失读症恢复机制的假设。该项目将大大 增进我们对失读症和典型衰老中阅读的神经认知基础的理解。