Neural Correlates of Aphasia Treatment and Recovery: fMRI Investigations

失语症治疗和恢复的神经相关性：功能磁共振成像研究

• 批准号: 7089900
• 负责人: CYNTHIA K THOMPSON
• 金额: $ 52.34万
• 依托单位: NORTHWESTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7089900
• 关键词: aphasia; behavior test; bioimaging /biomedical imaging; brain mapping; clinical research; frontal lobe /cortex; functional magnetic resonance imaging; human subject; human therapy evaluation; language; neuroimaging; neuropsychology; patient oriented research; perfusion; stroke; stroke therapy

DESCRIPTION (provided by applicant): The goal of the work described in this proposal is to provide a neuroimaging-based examination of the mechanisms of aphasia treatment and recovery. We propose to use functional magnetic resonance imaging together with structural and perfusion MR imaging as tools for tracking, recording and evaluating brain behavior changes linked to treatment-based changes in four experiments. We propose to systematically examine both behavioral and (correlated) neural effects of treatment while manipulating several critical patient-based and treatment-based variables that have been hypothesized to be relevant to aphasia recovery. The patient-related variables we will study include site and extent of lesion, in patients with anterior vs. posterior lesions, in early post-stroke vs. late post-stroke (chronic) stages of recovery. We propose to study the effects of treatment (vs. placebo-treatment) for these patients with a focus on both comprehension and production deficits in sentence level processing, comparing: two different treatment-intensity schedules (intensive vs. extended) and two different complexity-of-treatment conditions (training complex-to-simple vs. simple-to-complex structures). Our focus on this latter variable is based on our previous work showing that the former (complex-to-simple training) results in greater efficacy of treatment and generalization effects as compared to the latter. Additionally, we propose behavioral studies that extend examination of this 'complexity-of treatment' hypothesis into new domains of language processing and new populations (posteriorly lesioned patients with Wernicke's aphasia). Overall, we propose to employ (and replicate) treatment methods with previously demonstrated behavioral efficacy so as to provide a solid basis for examining (via neuroimaging) brain-based changes associated with a range of critical patient-based and treatment-based variables during treatment. Additionally, we propose to examine theoretically motivated extensions of the complexity method to new domains of language treatment.

描述（由申请人提供）：本提案中描述的工作目标是提供基于神经影像学的失语症治疗和恢复机制的检查。我们建议在四个实验中使用功能性磁共振成像以及结构和灌注磁共振成像作为跟踪、记录和评估与基于治疗的变化相关的大脑行为变化的工具。我们建议系统地检查治疗的行为和（相关）神经效应，同时操纵几个关键的基于患者和基于治疗的变量，这些变量被假设与失语症恢复相关。我们将研究的患者相关变量包括病变部位和范围、前部病变与后部病变的患者、中风后早期与中风后（慢性）恢复阶段。我们建议研究治疗（与安慰剂治疗）对这些患者的影响，重点关注句子级处理中的理解和表达缺陷，比较：两种不同的治疗强度计划（强化与扩展）和两种不同的复杂性治疗条件（训练复杂到简单与简单到复杂的结构）。我们对后一个变量的关注是基于我们之前的工作，该工作表明，与后者相比，前者（从复杂到简单的训练）会产生更大的治疗效果和泛化效果。此外，我们提出了行为研究，将对这种“治疗复杂性”假设的检验扩展到语言处理的新领域和新人群（患有韦尼克失语症的后部病变患者）。总体而言，我们建议采用（并复制）先前已证明行为功效的治疗方法，以便为检查（通过神经影像学）治疗期间与一系列基于患者和基于治疗的关键变量相关的大脑变化提供坚实的基础。此外，我们建议研究复杂性方法在语言处理新领域的理论上的扩展。