Language Development Following Early Focal Brain Injury

早期局灶性脑损伤后的语言发展

• 批准号: 6868978
• 负责人: DORIS A TRAUNER
• 金额: $ 34.58万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-04-01 至 2009-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6868978
• 关键词: brain injury; cerebral hemorrhage; clinical research; developmental disease /disorder; human subject; infant human (0-1 year); language development; longitudinal human study; magnetic resonance imaging; neural plasticity; paralinguistic behavior; patient oriented research; preschool child (1-5); stroke; verbal learning

DESCRIPTION (provided by applicant): We propose prospective, longitudinal studies of the relationship between early brain injury and language development from birth to age 5, building on 15 years of research on language and cognitive outcomes in children with congenital left- or right hemisphere injuries (due primarily to pre- or perinatal stroke), using state-of-the-art methods for structural imaging and lesion-symptom mapping. The latter include a new method called Voxel-based Lesion Symptom Mapping (VLSM, Bates et al., Nature: Neuroscience, 2003) developed in our laboratories, which permits graded color maps of the relationship between behavioral measures and lesion sites, applied for the first time to children with lesions. New diffusion-tensor imaging (DTI) methods will be used to examine changes in connectivity that may be attributable to early brain injury and subsequent reorganization. Longitudinal studies of language and related non-linguistic functions will be conducted from 8 to 60 months of age, the period in which most of language is acquired, from the first signs of babbling to the mastery of grammar and discourse. Our previous studies suggest that this period is a "window of plasticity", in which most children with early unilateral injuries start with serious delays, but move into the normal to low-normal range on language measures. In children with congenital, unilateral lesions, we will attempt to extend a series of important and surprising findings regarding the specific lesion sites associated with initial delays in babbling, word comprehension, gesture, word production, and grammar, and to examine the trajectories of language and visual spatial development in children with early focal brain damage. Neuroanatomical correlates of milestones, trajectories, delays and recovery from delay will be established based on 3-dimensional lesion reconstruction, VLSM and DTI. For all children with brain injuries, scans will be obtained at two points: on entry into the study (between 6 and 36 months), and at 5 years of age. These two data points will permit within-subject analyses of the initial state of the system with any changes in neuroanatomy that may be related to lesion type and/or to degrees of success or failure in language development. Scans will also be obtained for age- and gender-matched controls at age 5, permitting an assessment of structural alterations due to early injury and subsequent reorganization, alterations which also may correlate with degree and timing of success in language. The new information gained from these studies will enhance our understanding of the timing of changes associated with plasticity in the developing nervous system, as well as defining associations and dissociations in linguistic and visual spatial development. Knowledge gained in this study may form the basis for more effective interventions to help improve neurodevelopmental outcome of children with brain damage in the future.

描述（由申请人提供）：我们提出了对从出生到5岁的早期脑损伤与语言发展之间关系的前瞻性，纵向研究，这是基于先天性左或右半球损伤儿童的语言和认知结果的15年研究（主要归因于前或周期性疾病），并使用统一方法进行结构图像和LESAPPTICSIOMSION和LESAPPTION和LESIOMSIOMSIONS-SEMPTING和LOMPTENT。后者包括一种新方法，称为基于体素的病变症状图（VLSM，Bates等人，自然：Neuroscience，2003年，2003年），在我们的实验室中开发了，该方法允许首次应用于儿童病情的行为措施和病变部位之间关系的分级颜色图。新的扩散调整成像（DTI）方法将用于检查连通性的变化，这可能归因于早期脑损伤和随后的重组。语言和相关非语言功能的纵向研究将从8到60个月大，这是获得大多数语言的时期，从bab缩的第一个迹象到掌握语法和话语。我们以前的研究表明，这一时期是一个“可塑性窗口”，其中大多数单侧受伤的儿童始于严重的延误，但在语言措施上进入正常到低正常范围。在先天性，单侧病变的儿童中，我们将尝试扩展一系列有关与早期局灶性大脑损害儿童的语言和视觉空间发展的特定病变部位有关的特定病变部位的重要发现。将基于3维病变重建，VLSM和DTI建立里程碑，轨迹，延迟和从延迟中恢复的神经解剖学相关性。对于所有患有脑损伤的儿童，将在两点进行扫描：进入研究时（6到36个月），在5岁时进行扫描。这两个数据点将允许对系统的初始状态进行主题内分析，并具有与病变类型和/或与语言发展的成功或失败程度有关的神经解剖学的任何变化。还将在5岁时获得年龄和性别匹配的对照的扫描，允许评估由于早期受伤和随后的重组而导致的结构变化，这可能与语言成功的程度和成功时间有关。从这些研究中获得的新信息将增强我们对发展中神经系统可塑性变化的时机的理解，并定义语言和视觉空间发展中的关联和解离。这项研究中获得的知识可能构成更有效的干预措施的基础，以帮助改善未来脑损伤儿童的神经发育结果。