Neuroimaging Reveals Treatment-Related Changes in DLD: A Randomized Controlled Trial

神经影像学揭示 DLD 中与治疗相关的变化：一项随机对照试验

• 批准号: 10840617
• 负责人: Karla N Washington
• 金额: $ 44.95万
• 依托单位: UNIVERSITY OF TORONTO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10840617
• 关键词: 3 year old; 5 year old; Address; Adult; Aftercare; Award; Basal Ganglia; Behavioral; Brain region; Businesses; Canada; Child; Child Language; Clinical; Cross-Sectional Studies; Data; Decision Making; Development; Diagnosis; Diffusion; Early Intervention; Enrollment; Environment Design; Evaluation; Future; Geography; Goals; High Prevalence; Hippocampus; Image; Impairment; Infant; Intervention; Investigation; Knowledge; Language; Language Delays; Language Development; Language Development Disorders; Language Disorders; Learning; Maintenance; Memory; Methods; Neurobiology; Ontario; Outcome; Parents; Participant; Performance; Population; Population Heterogeneity; Process; Randomized, Controlled Trials; Recording of previous events; Rehabilitation therapy; Reporting; Research; Scanning; Site; Sleep; Speech; Structural defect; System; Temporal Lobe; Testing; Time; Toddler; Treatment outcome; Vocabulary; age group; base; behavior measurement; behavioral response; design; effective intervention; efficacious treatment; epidemiology study; evidence base; experience; follow up assessment; follow-up; improved; insight; knowledge base; neural; neuroimaging; neuromechanism; novel; parent grant; peer; programs; recruit; success; syntax; therapy design; tool

Project Summary/Abstract Late talking represents one of the most common reasons children under 3-years of age are referred for speech-language evaluations, impacting about 10%-20% of children in this age-group. Late talkers (LT) also share similarities with children diagnosed with developmental language disorder (DLD) at 4 – 5 years of age, endorsing the notion that shared neurobiological underpinnings might exist between these two clinical groups. However, little is known about the neural basis of late talking, yet is needed to better inform the design of efficacious therapies that address hallmark delays in syntax and vocabulary. For the DLD population, domain- general processes relating memory and language are being investigated in the parent grant, offering valuable testing ground for also advancing the current knowledge base regarding LT. The Procedural circuit Deficit Hypothesis (PDH) posits that relative strengths and weaknesses exist between procedural (impaired) and declarative (less impaired) memory systems. Structural abnormalities in connections between frontal brain regions and basal ganglia, with underactivation and reduced connectivity also evident. However, cortical and subcortical regions in the temporal lobes, including hippocampus, might be impaired to a lesser degree. This proposed research will use diffusion imaging to describe the neural basis (structural connectivity) of late talking and treatment-related change by way of the PDH. We will gather data regarding LT before, after, and following a break in a well-known parent-led therapy (Target WordTM-The Hanen Program® for Parents of Children who are LT: LT treatment; “business as usual”: LT no treatment) as part of a highly feasible RCT that leverages existing pipelines. We will also include typically developing (TD) peers to inform development vs late talking. Our central hypothesis is that treatment designed to improve syntax and vocabulary will change procedural and declarative networks in association with increases in language function and the degree of improvement may be associated with the underlying neurobiology of baseline syntax and vocabulary deficits. Building on a robust history of recruitment and treatment of toddlers by The Hanen Centre®, and our successful imaging partner, we will enroll 30 LT (n=15 treatment; n=15 controls) and 15 TD peers. Aim 1 will establish the structural connectivity in LT and their TD peers between regions in the procedural learning and declarative networks. In Aim 2, we will establish the neurobiological basis of treatment-related changes in LT only. We examine potential changes in structural connectivity between regions of the procedural learning and declarative memory networks, and investigate whether treatment-related changes occur into the typical range (LT, TD). To meet our scientific goals, we pair behavioral tools (syntax and vocabulary) with neuroimaging to describe co-occurring behavioral performance underlying learning and outcome, while also gathering parental and clinican qualitative data regarding treatment outcomes. This research will contribute novel insights into mechanisms underlying learning and impairment to offer a groundbreaking shift in our understanding of LT.

项目摘要/摘要 迟到代表了3岁以下儿童的最常见原因之一 语音语言评估影响了大约10％-20％的儿童。已故谈话者（LT） 与4至5岁时诊断为发育语言障碍（DLD）的儿童有相似之处 认可这两个临床组之间可能存在共同的神经生物学基础的观念。 但是，关于迟到的神经基础知之甚少，但需要更好地告知设计 解决标志性延迟语法和词汇量的有效疗法。对于DLD人群，领域 - 与记忆和语言有关的一般过程正在父母赠款中进行研究，提供价值 测试基础，还可以推进有关LT的当前知识库。程序电路赤字 假设（PDH）认为程序（受损）和 声明性（较少受损）内存系统。额脑之间连接的结构异常 区域和基本神经节，基础和降低的连通性也证据。但是，皮质和 包括海马在内的临时裂片中的皮质下区域可能会受到较小程度的损害。 这项拟议的研究将使用扩散成像来描述神经元基础（结构连接） 通过PDH的最近说话和与治疗有关的变化。我们将在之前，之后收集有关LT的数据 并在众所周知的父母主导疗法中休息（Target WordTM- HanenProgram® LT：LT治疗的孩子； “照常业务”：lt否治疗）作为高度可行的RCT的一部分 利用现有管道。我们还将包括通常开发（TD）的同行，以告知开发与迟到 说。我们的中心假设是旨在改善语法和词汇的治疗将改变 程序和声明性网络与语言功能的增加以及程度 改善可能与基线语法和词汇缺陷的潜在神经生物学有关。 建立在HanenCentre®和我们的 成功的成像伙伴，我们将招募30 LT（n = 15处理； n = 15个对照组）和15 TD对等。目标1意志 在程序学习和 声明性网络。在AIM 2中，我们将建立与治疗相关的LT变化的神经生物学基础 仅有的。我们研究了程序学习区域之间结构连通性的潜在变化， 声明性记忆网络，并研究是否发生了与治疗相关的变化 （LT，TD）。为了满足我们的科学目标，我们将行为工具（语法和词汇）与神经影像融为一 描述学习和成果的共同出现的行为表现，同时还收集父母 以及有关治疗结果的临床定​​性数据。这项研究将促进新颖的见解 学习和障碍的基础机制，可以使我们对LT的理解产生开创性的转变。