Neural correlates of treatment-induced recovery of phonological processing in chronic aphasia

慢性失语症治疗引起的语音处理恢复的神经相关性

• 批准号: 8907444
• 负责人: Andrew T DeMarco
• 金额: $ 3.86万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-01-01 至 2016-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8907444
• 关键词: Address; Aftercare; American; Aphasia; Area; Attention; Award; Behavior; Behavior Therapy; Behavioral; Bilateral; Brain; Brain region; Case Series; Chronic; Clinical Data; Cognitive; Cohort Studies; Competence; Development; Dorsal; Emotional; Enrollment; Evaluation; Evidence based treatment; Faculty; Family; Financial compensation; Functional Magnetic Resonance Imaging; Goals; Image; Impairment; Individual; Intervention; Language; Language Therapy; Lead; Left; Life; Measurement; Measures; Methods; Middle Cerebral Artery Infarction; Noise; Occupational; Parietal; Parietal Lobe; Participant; Performance; Personal Satisfaction; Physiology; Process; Quality of life; Reading; Recovery; Recruitment Activity; Rehabilitation therapy; Research; Research Project Grants; Residual state; Resolution; Resource Allocation; Resources; Scanning; Speech; Speech Sound; Stroke; Task Performances; Testing; Tissues; Treatment Protocols; Writing; aphasia rehabilitation; cognitive function; design; experience; improved; innovation; lexical processing; lexical retrieval; neural correlate; neural patterning; neuroimaging; neuromechanism; phonology; public health relevance; relating to nervous system; response; semantic processing; skills; social; success; syntax; treatment effect; treatment response

 DESCRIPTION (provided by applicant): The overall goal of this project is to identify the neural correlates of treatment-induced recovery of phonology in individuals with chronic aphasia. Deficits in phonology (speech sound processing) are among the most common and persistent impairments in aphasia after left hemisphere stroke, and can have significant functional consequences for spoken and written language. These deficits are typically treated with behavioral therapy involving targeted activities that encourage brain reorganization to support relearning of language skills. While many individuals make considerable gains through treatment, the neural substrates supporting these improvements are poorly understood. Specifically, it is not clear how improved phonological skills are supported when highly specialized left-hemisphere persiylvian language regions are damaged. To address this question, I propose to study changes in regional brain activation associated with a phonological task (pseudoword reading) performed during functional magnetic resonance imaging (fMRI) before and after phonological treatment. Using a case series design across eight individuals who experienced left middle cerebral artery stroke, I will study response accuracy and fMRI activation during pseudoword reading over the course of four scanning sessions (2 before and 2 after treatment). Behavioral improvement in pseudoword reading will be validated by comparison with clinical data collected before, during, and after treatment. The evidence-based treatment protocol will be implemented as part of an ongoing research project (R01DC07646- 09 awarded to the faculty sponsor), lasting approximately fourteen weeks. Differences in pre-post treatment brain activation evoked by the pseudoword reading task will be considered an effect of therapy. It is hypothesized that improvements in pseudoword reading will be associated with reliance on the undamaged (i.e. residual) left persiylvian regions of the language network and perilesional tissue. It is also predicted that a successful treatment response will require increased engagement of attentional resources to support task performance, and this should be evident by increased activation of a bi-hemispheric fronto-parietal network dorsal to the perisylvian language region. The findings from this study are expected to provide a better understanding of the neural mechanisms that support language recovery, and have the potential to inform treatment approaches for aphasia. 1

 描述（由适用提供）：该项目的总体目标是确定慢性失语症患者中治疗引起的语音恢复的神经相关性。语音学（语音处理）的缺陷是左半球中风后失语症中最常见和持续的障碍之一，并且可能对说话和书面语言产生重大功能后果。这些缺陷通常通过行为疗法进行治疗，涉及有针对性的活动，这些活动鼓励大脑重组以支持发展语言技能。尽管许多人通过治疗取得了可观的收益，但支持这些改进的神经底物知之甚少。具体而言，当高度专业化的左hemisphere persiylvian语言区域受损时，尚不清楚如何支持语音技能。为了解决这个问题，我建议研究与语音磁共振成像（fMRI）在语音处理之前和之后进行的与语音任务相关的区域大脑活动的变化（伪读）。使用八个经历过左脑动脉中风的人的案例系列设计，我将在四个扫描课程（治疗前2个）过程中研究伪单元阅读期间的反应准确性和fMRI激活。通过与在治疗之前，期间和治疗后收集的临床数据进行比较，将验证伪造读数的行为改善。基于证据的治疗方案将作为正在进行的研究项目的一部分（R01DC07646-09授予的教师赞助商），持续了大约14周。伪书阅读任务引起的PES治疗前治疗脑部激活的差异将被视为治疗的作用。可以假设的是，伪造读数的改善将与依赖语言网络和周围组织的左Persiylvian区域的依赖（即残留）有关。还可以预测，成功的治疗反应将需要增加注意力资源以支持任务绩效，这应该通过增加双性化的额叶额 - 顶额网络背侧的激活来证明这一点。预计这项研究的发现将更好地了解支持语言恢复的神经机制，并有可能告知治疗方法以进行失语症。 1