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: 9206902
• 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/9206902
• 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; Diffuse; 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; 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; tractography; 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，可能导致严重的语言障碍。许多具有“失语症”的退伍军人在与语言交谈时都有一定程度的理解，这会影响他们的交流能力。有些人会随着时间的推移恢复他们的听觉理解能力，而有些则没有。迄今为止，还没有明确的解释说明为什么会发生这种情况，这使得临床医生很难就可以预期的语言恢复程度向他们的pate和家人提供具体的预后。拟议的研究将检查与听觉理解障碍中恢复相关的神经元因素。新型的神经影像学技术将检查影响恢复的大脑结构，尤其是将皮质区域相互连接的纤维途径。将对这些纤维区域的损害进行最新的扩散成像评估，以可视化和量化单个区域的损害。 45个具有听觉理解定义的老将失语症患者将在中风后1和12个月进行评估，以跟踪理解障碍的程度及其康复过程。结构磁共振成像（MRI）也将在结束后1和12个月进行，以评估皮质区域损害的程度以及该损害是否可以预测恢复。高角度分辨率扩散成像（HARDI）也以相同的时间间隔获得，将量化对单个白质途径的损坏程度，而拖拉术将视觉确认每个患者的每个纤维道。最后，将测量1和12个月的白质完整性，以评估恢复期间纤维途径中发生的变化。拟议的项目将检查恢复的几个方面，这些方面尚未得到充分探讨。凭借我们在失语症和神经影像学方面的专业知识，以及我们在使用Hardi Tractography来表征白质途径损害范围的成功方面的成功，我们处于独特的位置，可以进行这项创新的研究。该项目将产生可以 直接影响患者护理；临床医生将有更多准确的信息来指导 他们的治疗方法，更好地告知退伍军人和看护者如何计划未来。