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）：基于 15 年对先天性左半球或右半球损伤儿童的语言和认知结果的研究，我们建议对从出生到 5 岁的早期脑损伤和语言发展之间的关系进行前瞻性、纵向研究。 （主要由于产前或围产期中风），使用最先进的方法进行结构成像和病变症状绘图。后者包括我们实验室开发的一种称为基于体素的病变症状图（VLSM，Bates 等人，自然：神经科学，2003）的新方法，该方法允许对行为测量和病变部位之间的关系进行分级彩色图，应用于第一次给有病变的孩子。新的扩散张量成像（DTI）方法将用于检查可能归因于早期脑损伤和随后的重组的连接变化。语言和相关非语言功能的纵向研究将在 8 至 60 个月龄期间进行，这是获得大部分语言的时期，从最初的牙牙学语到掌握语法和话语。我们之前的研究表明，这一时期是一个“可塑性窗口”，大多数早期单侧损伤的儿童在开始时都会出现严重的延迟，但在语言测量方面会进入正常至低正常范围。在患有先天性单侧病变的儿童中，我们将尝试扩展一系列重要且令人惊讶的发现，涉及与牙牙学语、单词理解、手势、词语产生和语法的初始延迟相关的特定病变部位，并检查语言的轨迹和早期局灶性脑损伤儿童的视觉空间发育。将基于 3 维病变重建、VLSM 和 DTI 建立里程碑、轨迹、延迟和延迟恢复的神经解剖学相关性。对于所有患有脑损伤的儿童，将在两个时间点进行扫描：进入研究时（6 至 36 个月之间）和 5 岁时。这两个数据点将允许对系统的初始状态进行受试者内分析，其中神经解剖学的任何变化可能与病变类型和/或语言发展的成功或失败程度有关。还将在 5 岁时对年龄和性别匹配的对照进行扫描，以便评估由于早期损伤和随后的重组而导致的结构改变，这些改变也可能与语言成功的程度和时间相关。从这些研究中获得的新信息将增强我们对神经系统发育中可塑性相关变化时间的理解，以及定义语言和视觉空间发育中的关联和分离。这项研究中获得的知识可能为更有效的干预措施奠定基础，以帮助改善未来脑损伤儿童的神经发育结果。