Neural Predictors of Recovery from Auditory Comprehension Deficits in Aphasia

失语症听觉理解缺陷恢复的神经预测因子

• 批准号: 9032049
• 负责人: Nina F. Dronkers
• 金额: --
• 依托单位: VA NORTHERN CALIFORNIA HEALTH CARE SYS
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-01-01 至 2019-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9032049
• 关键词: Acute; Affect; Anisotropy; Anterior; Aphasia; Area; Auditory; Behavioral; Brain; Brain Injuries; Brain imaging; Brain region; Brodmann' s area; Caregivers; Chronic; Complex; Comprehension; Data; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Exhibits; Family member; Fiber; Future; Homologous Gene; Image; Imagery; Imaging Device; Impairment; Individual; Inferior; Injury; Language; Left; Lesion; Linguistics; Magnetic Resonance Imaging; Maps; Measurement; Measures; Modification; Neurons; Pathway interactions; Patient Care; Patients; Pattern; Play; Positioning Attribute; Recovery; Research; Resolution; Speech; Stroke; Structure; Structure of middle temporal gyrus; Symptoms; Techniques; Temporal Lobe; Time; Veterans; Visual; Work; accurate diagnosis; aphasic; auditory comprehension; base; behavior test; comprehension deficit; comprehension skill; effective therapy; innovation; language comprehension; language impairment; neuroimaging; neuromechanism; novel; novel strategies; outcome forecast; phrases; post stroke; public health relevance; reconstruction; relating to nervous system; skills; success; time interval; treatment strategy; white matter

 DESCRIPTION (provided by applicant): Many types of brain injuries, particularly stroke, can result in serious language impairment. Many veterans with "aphasia" have some degree of difficulty understanding language when they are spoken to, which affects their ability to communicate. Some recover their auditory comprehension skills over time, while some do not. To date, there is no clear-cut explanation as to why this occurs, making it difficult for clinicians to offer a concrete prognosis to their patiets and family members as to the degree of language recovery that can be expected. The proposed study will examine the neural factors associated with recovery from auditory comprehension impairment. Novel neuroimaging techniques will examine the brain structures that affect recovery, particularly the fiber pathways that connect cortical regions to each other. Damage to these fiber tracts will be assessed with the latest in diffusion imaging to visualize and quantify the damage in individual tracts. 45 veteran aphasic patients with auditory comprehension deficits will be assessed at 1 and 12 months post- onset of their stroke to track the degree of comprehension impairment and the course of its recovery. Structural magnetic resonance imaging (MRI) will also be performed at 1 and 12 months post-onset to assess the extent of the damage to cortical areas and whether this damage can predict recovery. High angular resolution diffusion imaging (HARDI), also obtained at the same time intervals, will quantify the extent of the damage to individual white matter pathways, while tractography will provide visual confirmation of each fiber tract in each patient. Finally, white matter integrity will be measured t 1 and 12 months to assess the changes that occur in fiber pathways during the recovery period. The proposed project will examine several aspects of recovery that have not been fully explored. With our expertise in aphasia and neuroimaging and our success in using HARDI tractography to characterize the full extent of the damage in white matter pathways, we are in a unique position to carry out this innovative research. This project will yield information that can directly influence patient care; clinicians will have more accurate information with which to guide their treatment approach, and better inform veterans and caregivers as to how to plan their futures.

 描述（由申请人提供）： 许多类型的脑损伤，尤其是中风，可能会导致严重的语言障碍，许多患有“失语症”的退伍军人在与他们交谈时会出现一定程度的理解语言困难，这会影响他们的沟通能力，随着时间的推移，他们的听觉理解能力会逐渐恢复。虽然有些人没有这样做，但迄今为止，还没有明确的解释为什么会发生这种情况，这使得战士们很难向患者和家人提供关于语言恢复程度的具体预测。拟议的研究将检查与相关的神经因素新型神经影像技术将检查影响恢复的大脑结构，特别是连接皮质区域的纤维通路，将使用最新的扩散成像技术来评估这些纤维束的损伤，以可视化和量化损伤。将在中风发病后 1 个月和 12 个月对 45 名患有听觉理解障碍的老年失语症患者进行结构性磁共振成像评估，以跟踪理解障碍的程度及其恢复过程。还将在发病后 1 个月和 12 个月进行磁共振成像 (MRI)，以评估皮质区域的损伤程度以及这种损伤是否可以预测恢复情况，同样在同一时间间隔进行。将量化个体白质通路的损伤程度，而纤维束描记术将提供每位患者每个纤维束的视觉确认，最后，将测量第 1 个月和第 12 个月的白质完整性，以评估期间纤维通路发生的变化。恢复拟议的项目将研究尚未充分探索的恢复的几个方面，以及我们在使用哈滴纤维束描记术来描述白质通路损伤的全部程度方面的成功，我们处于一个独特的阶段。进行这项创新研究的位置将产生可以的信息。 直接影响患者护理；新来者将获得更准确的信息来指导 他们的治疗方法，并更好地告知退伍军人和护理人员如何规划他们的未来。