Concurrent Validity, Test-Retest Reliability, and Sensitivity to Change of Functional Near-Infrared Spectroscopy for Measuring Language-Related Brain Activity in Post-Stroke Aphasia

功能性近红外光谱测量中风后失语症语言相关大脑活动的同时有效性、重测可靠性和敏感性变化

• 批准号: 10538100
• 负责人: Jeffrey P Johnson
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-10-01 至 2027-09-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10538100
• 关键词: Achievement; Address; Adjuvant; Affect; Aftercare; American; Anatomy; Aphasia; Auditory; Award; Behavioral; Behavioral Research; Brain; Brain imaging; Chronic; Claustrophobias; Clinic; Clinical; Clinical Treatment; Clinical Trials; Clinical Trials Design; Cognitive; Communication; Cross-Sectional Studies; Data; Development; Education; Elderly; Electroencephalography; Environment; Foundations; Functional Magnetic Resonance Imaging; Future; General Population; Generations; Geriatrics; Goals; Gold; Healthcare Systems; Hemoglobin concentration result; Home; Impairment; Individual; Injury; Intervention; Language; Language Disorders; Language Therapy; Linear Regressions; Linguistics; Literature; Maps; Measures; Medical Device; Mentorship; Metals; Methods; Modality; Modeling; Modernization; Names; National Institute on Deafness and Other Communication Disorders; Neurophysiology - biologic function; Participant; Penetration; Persons; Physiological; Population; Prevalence; Protocols documentation; Quality of life; Recording of previous events; Recovery; Rehabilitation therapy; Research; Research Activity; Resolution; Retrieval; Scanning; Science; Scientist; Semantics; Signal Transduction; Speech; Speech Pathologist; Stroke; Structure; System; Task Performances; Technology; Testing; Therapeutic; Time; Training; Training Activity; Treatment outcome; United States National Institutes of Health; Universities; Veterans; aphasia recovery; aphasia rehabilitation; base; broadening participation research; career; clinical care; clinical center; clinically relevant; cost; efficacious treatment; experience; functional MRI scan; functional independence; functional magnetic resonance imaging/electroencephalography; functional near infrared spectroscopy; health related quality of life; improved; interest; language processing; medical implant; neurofeedback; neuroimaging; neurophysiology; neurotransmission; novel; phonology; portability; post stroke; prognostic; programs; response; service delivery; statistics; stroke-induced aphasia; theories; therapy development; tool

More than 2.5 million people in the U.S. have aphasia, a language disorder most often caused by stroke that dramatically affects an individual’s functional independence and quality of life. For several decades, fMRI has critically advanced aphasia research, but it has notable limitations. For example, individuals with conditions that affect many Veterans (e.g., implanted medical devices or a history of injury involving metal) cannot safely be scanned. These individuals have therefore been systematically excluded from fMRI studies of aphasia. Additionally, fMRI is conducted in a noisy, restrictive environment, necessitating the use of artificial experimental paradigms that may not engage the full range of anatomical and physiological mechanisms supporting real-world language and communicative function. In contrast to fMRI, functional near-infrared spectroscopy (fNIRS) has few contraindications, is silent, inexpensive, and can be administered in a standard clinic room with naturalistic language paradigms. Despite these advantages, fNIRS has rarely been used to study aphasia, likely due to a lack of data validating it as compared to fMRI in this specific population. This study will address critical gaps in the evidence that would support fNIRS’ use by investigating its correlation with fMRI for language mapping (Aim 1), its test-retest reliability (Aim 2), and its sensitivity to changes in brain function due to behavioral language treatment (Aim 3) in people with chronic post-stroke aphasia. In part A of this study, 24 people with chronic aphasia (PWA) will be scanned twice over a 3-week interval with both fNIRS and fMRI while performing three language tasks: picture naming and semantic and phonological matching. Concurrent validity will be established by correlating language activation measured by fNIRS with that of fMRI. fNIRS’ test-retest reliability will be assessed by computing intraclass correlation coefficients across the first and second fNIRS scans, with comparable comparisons of the fMRI scans. Twenty- four healthy older adults will complete the same protocols to inform interpretations of the results in PWA. In part B, 12 PWA will complete fNIRS and fMRI scans during language tasks before and after three weeks of intensive language therapy, administered as part of a separate clinical trial of treatment for word-retrieval impairments. Comparisons between pre- and post-treatment fNIRS and fMRI scans will be used to assess fNIRS’ sensitivity to change after intervention, relative to that of fMRI. Behavioral research activities (including intensive language therapy) will be conducted at the VA Pittsburgh Healthcare System (VAPHS). fMRI and fNIRS will be performed at the CMU-Pitt Brain Imaging Data Generation & Education Center and the Brain and Auditory Sciences Research Initiative at the University of Pittsburgh, respectively. The results of this study will help determine the viability of fNIRS for measuring language functions in post-stroke aphasia and may provide a foundation for increased use of fNIRS in aphasia research, broadening participation in neuroimaging studies and increasing the generalizability of their findings. The results may also support the development of novel uses for fNIRS, such as measuring brain responses during everyday language use or aphasia treatment, and using real-time neurofeedback as an adjuvant to behavioral aphasia therapy. The applicant is a VA CDA-1 awardee, research and clinical speech pathologist, and former Advanced Geriatrics Fellow in the Geriatric Research, Education, and Clinical Center at VAPHS, with experience in aphasia rehabilitation and fMRI. During the CDA-2, mentorship and structured training activities in advanced neuroimaging/fNIRS methods, advanced statistics, Bayesian adaptive clinical trials design, and validity theory will facilitate execution and completion of the project and achievement of the applicant’s career goals. These goals include completing a CDA-2 and becoming an independent VA clinician-scientist supported by VA Merit Review and NIH/NIDCD award mechanisms, with a research program focused on improving service delivery and maximizing treatment outcomes for Veterans and others with aphasia.

在美国，有超过 250 万人患有失语症，这是一种最常由中风引起的语言障碍， 几十年来，功能磁共振成像极大地影响了个人的功能独立性和生活质量。 失语症研究非常先进，但它也有明显的局限性，例如，对于有病症的个体。 影响许多退伍军人的因素（例如，植入的医疗设备或涉及金属的伤害史）无法安全地 因此，这些人被系统地排除在失语症的功能磁共振成像研究之外。 此外，功能磁共振成像是在嘈杂、限制性的环境中进行的，需要使用人工 实验范式可能无法涉及全部解剖学和生理学机制 支持现实世界的语言和交流功能与功能磁共振成像相反，功能性近红外。 光谱 (fNIRS) 几乎没有禁忌症，安静，便宜，并且可以在标准中进行管理 尽管有这些优点，但 fNIRS 很少被用于具有自然语言范式的诊所。 研究失语症，可能是由于缺乏验证该特定人群与功能磁共振成像相比的数据。 研究将通过调查其相关性来解决支持 fNIRS 使用的证据中的关键差距 使用 fMRI 进行语言映射（目标 1）、重测可靠性（目标 2）以及对语言变化的敏感性 行为语言治疗（目标 3）对慢性中风后失语症患者的大脑功能产生影响。 在本研究的 A 部分中，24 名慢性失语症 (PWA) 患者将在 3 周的时间内接受两次扫描 同时使用 fNIRS 和 fMRI，同时执行三种语言任务：图片命名和语义和 语音匹配将通过关联语言激活来建立。 fNIRS 与 fMRI 的重测可靠性将通过计算组内相关性进行评估。 第一次和第二次 fNIRS 扫描的系数，以及 20 次 fMRI 扫描的可比比较。 四名健康的老年人将完成相同的方案，以解释 PWA 中的结果。 B 部分，12 PWA 将在三周前后的语言任务中完成 fNIRS 和 fMRI 扫描 强化语言治疗，作为单词检索治疗的单独临床试验的一部分进行 治疗前和治疗后的 fNIRS 和 fMRI 扫描之间的比较将用于评估。 相对于行为研究活动（包括功能磁共振成像），fNIRS 对干预后变化的敏感性。 强化语言治疗）将在 VA 匹兹堡医疗系统 (VAPHS) 进行。 fNIRS 将在 CMU-Pitt 脑成像数据生成和教育中心以及大脑进行 分别是匹兹堡大学的听觉科学研究计划。 这项研究的结果将有助于确定 fNIRS 用于测量语言功能的可行性 中风后失语症，可能为增加 fNIRS 在失语症研究中的使用奠定基础，拓宽 参与神经影像学研究并提高其研究结果的普遍性。 支持 fNIRS 的新用途的开发，例如测量日常语言期间的大脑反应 使用或失语症治疗，并使用实时神经反馈作为行为失语症治疗的辅助手段。 申请人是 VA CDA-1 获奖者、研究和临床言语病理学家、前高级 VAPHS 老年病学研究、教育和临床中心的老年病学研究员，拥有以下方面的经验： 失语症康复和功能磁共振成像在 CDA-2 期间，高级指导和结构化培训活动。 神经影像/fNIRS 方法、高级统计学、贝叶斯自适应临床试验设计和有效性理论 将促进项目的执行和完成以及申请人职业目标的实现。 目标包括完成 CDA-2 并成为由 VA Merit 支持的独立 VA 临床医生-科学家 审查和 NIH/NIDCD 奖励机制，重点是改善服务提供的研究计划 最大限度地提高退伍军人和其他失语症患者的治疗效果。