Neural Mechanisms and Recovery of Language Production Deficits in Aphasia

失语症语言产生缺陷的神经机制和恢复

• 批准号: 10669501
• 负责人: Nina F. Dronkers
• 金额: $ 0.36万
• 依托单位: EAST BAY INSTITUTE FOR RESEARCH AND EDUC
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-09 至 2018-06-01
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10669501
• 关键词: Affect; American; Aphasia; Area; Behavioral; Brain; Brain Injuries; Brain imaging; Brain region; Characteristics; Communication; Contralateral; Craniocerebral Trauma; Diffuse; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Evaluation; Exhibits; Fiber; Image; Imaging Device; Imaging Techniques; Impairment; Individual; Injury; Language; Language Disorders; Lesion; Longitudinal Studies; Magnetic Resonance Imaging; Measurable; Measurement; Measures; Modification; Monitor; Neurologic; Neurons; Outcome; Participant; Pathway interactions; Patients; Pattern; Performance; Persons; Play; Production; Prognosis; Quality of life; Recovery; Resolution; Site; Speech; Stroke; Structure; Symptoms; Techniques; Testing; Thick; Time; accurate diagnosis; base; common symptom; density; disability; effective therapy; gray matter; indexing; insight; morphometry; multimodal neuroimaging; myelination; neuroimaging; neuromechanism; novel; optimal treatments; post stroke; prevent; reconstruction; relating to nervous system; skills; social engagement; stroke-induced aphasia; time interval; tool; tractography; treatment strategy; white matter; white matter damage; Affect; American; Aphasia; Area; Behavioral; Brain; Brain Injuries; Brain imaging; Brain region; Characteristics; Communication; Contralateral; Craniocerebral Trauma; Diffuse; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Evaluation; Exhibits; Fiber; Image; Imaging Device; Imaging Techniques; Impairment; Individual; Injury; Language; Language Disorders; Lesion; Longitudinal Studies; Magnetic Resonance Imaging; Measurable; Measurement; Measures; Modification; Monitor; Neurologic; Neurons; Outcome; Participant; Pathway interactions; Patients; Pattern; Performance; Persons; Play; Production; Prognosis; Quality of life; Recovery; Resolution; Site; Speech; Stroke; Structure; Symptoms; Techniques; Testing; Thick; Time; accurate diagnosis; base; common symptom; density; disability; effective therapy; gray matter; indexing; insight; morphometry; multimodal neuroimaging; myelination; neuroimaging; neuromechanism; novel; optimal treatments; post stroke; prevent; reconstruction; relating to nervous system; skills; social engagement; stroke-induced aphasia; time interval; tool; tractography; treatment strategy; white matter; white matter damage

Aphasia is a common outcome following brain injury and often leads to long-term disability and diminished quality of life. Language production disorders in particular, such as difficulty finding the right word or problems speaking in sentences, are the most common symptoms of aphasia, and significantly hinder communication and social participation. While some people with language production deficits recover well during the first year after injury, others will not, and this discrepancy in outcomes is largely unpredictable. Many factors affect recovery patterns across individuals, one of which is the involvement of different neuroanatomical structures in the resulting impairment and subsequent degree of recovery. Surprisingly, little is known about structural changes in the brain accompanying recovery from language production deficits in aphasia, though preliminary evidence suggests they may be better predictors of recovery than traditionally-used functional change measures. The proposed longitudinal, multimodal neuroimaging study will explore the patterns of recovery in a large group of individuals with aphasia following stroke. By combining a number of novel techniques, we will investigate the contributions of numerous gray and white matter structures to the recovery of language production deficits. Fifty individuals with aphasia will be tested at 1-, 3- and 12-months post stroke on various measures of language production at the word, sentence and discourse level to establish baseline measures of performance and monitor changes across the different stages of recovery. At the same three time points, participants will undergo structural MRI and high angular resolution diffusion imaging (HARDI) to determine lesion site, white matter integrity, and changes in grey and white matter over time. The first main objective of the study is to determine which damaged cortical regions and white matter pathways impede recovery of language production throughout the first year. The second main objective is to measure neuronal changes in gray matter morphometry and white matter integrity that accompany observed behavioral improvement. Evaluating different time periods during the first year post-stroke will enable us to tease out neural indices predicting, impeding, and supporting language recovery at different stages. The proposed project will be the first comprehensive longitudinal study using state-of-the art techniques to examine plasticity within gray matter regions and white matter tracts and their contribution to recovery of different language levels over the course of one full year. In the end, the results of this study will provide important insights into factors contributing to successful recovery of language abilities and enable clinicians to utilize neuroimaging information in prognosis and selection of the most optimal treatments.

失语症是脑损伤后的共同结果，并且经常导致长期残疾和 生活质量降低。特别是语言生产障碍，例如很难找到正确的词 或用句子说话的问题，是失语症的最常见症状，并显着阻碍 沟通和社会参与。虽然有些语言生产缺陷的人康复良好 在受伤后的第一年，其他人也不会，而且结果的差异在很大程度上是无法预测的。许多 因素会影响个人之间的恢复模式，其中之一是不同神经解剖学的参与 最终损害和随后的恢复程度中的结构。令人惊讶的是，对 伴随着大脑的结构变化，伴随着口感中的语言产生缺陷的恢复，但是 初步证据表明，它们可能比传统使用的功能更好地预测恢复的预测指标 更改措施。 拟议的纵向，多模式神经影像学研究将探索A中的恢复模式 中风后大批失语症患者。通过结合多种新技术，我们将 研究许多灰色和白质结构对语言恢复的贡献 生产不足。五十个人失语症将在中风后1，3和12个月进行各种测试 在单词，句子和话语水平上的语言产生量度，以建立基准衡量标准 性能和监视恢复不同阶段的变化。在相同的三个时间点， 参与者将进行结构MRI和高角度分辨率扩散成像（HARDI）以确定 随着时间的流逝，病变部位，白质完整性以及灰质和白质的变化。 该研究的第一个主要目标是确定哪些损坏的皮质区域和白质 途径阻碍了第一年的语言产量恢复。第二个主要目标是 测量观察到的灰质形态学和白质完整性的神经元变化 行为改善。在中风后第一年评估不同的时间段将使我们能够 逗弄神经指标在不同阶段预测，阻碍和支持语言恢复。 拟议的项目将是使用最先进的技术的首次全面的纵向研究 检查灰质地区和白质区内的可塑性及其对恢复的贡献 在整整一年的过程中，语言水平不同。最后，这项研究的结果将提供 对有助于成功恢复语言能力的因素的重要见解，并使临床医生能够 利用神经成像信息在预后和选择最佳治疗方法中。