Concurrent Validity, Test-Retest Reliability, and Sensitivity to Change of Functional Near-Infrared Spectroscopy for Measuring Language-Related Brain Activity in Post-Stroke Aphasia

功能性近红外光谱测量中风后失语症语言相关大脑活动的同时有效性、重测可靠性和敏感性

• 批准号: 10709585
• 负责人: Jeffrey P Johnson
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-10-01 至 2027-09-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10709585
• 关键词: Acceleration; Achievement; Address; Adjuvant; Affect; Aftercare; American; Anatomy; Aphasia; Auditory; Award; Behavioral; Behavioral Research; Brain; Brain imaging; Chronic; Claustrophobias; Clinic; Clinical; Clinical Treatment; Clinical Trials; Clinical Trials Design; Cognitive; Communication; Cross-Sectional Studies; Data; Development; Education; Elderly; Electroencephalography; Environment; Exclusion; Foundations; Functional Magnetic Resonance Imaging; Future; General Population; Generations; Geriatrics; Goals; Healthcare Systems; Hemoglobin concentration result; Home; Impairment; Individual; Injury; Intervention; Language; Language Disorders; Language Therapy; Linear Regressions; Linguistics; Literature; Maps; Measures; Medical Device; Mentorship; Metals; Methods; Modality; Modeling; Modernization; Names; National Institute on Deafness and Other Communication Disorders; Neurophysiology - biologic function; Participant; Penetration; Persons; Physiological; Population; Prevalence; Protocols documentation; Quality of life; Recording of previous events; Recovery; Rehabilitation therapy; Research; Research Activity; Resolution; Retrieval; Scanning; Science; Scientist; Semantics; Signal Transduction; Sorting; Speech; Speech Pathologist; Stroke; Structure; System; Task Performances; Technology; Testing; Therapeutic; Time; Training; Training Activity; Treatment outcome; United States National Institutes of Health; Universities; Veterans; aphasia recovery; aphasia rehabilitation; broadening participation research; career; clinical care; clinical center; clinically relevant; cost; efficacious treatment; experience; functional MRI scan; functional independence; functional magnetic resonance imaging/electroencephalography; functional near infrared spectroscopy; health related quality of life; improved; interest; language processing; medical implant; neurofeedback; neuroimaging; neurophysiology; neurotransmission; novel; phonology; portability; post stroke; prognostic; programs; response; service delivery; statistics; stroke-induced aphasia; theories; therapy development; tool

More than 2.5 million people in the U.S. have aphasia, a language disorder most often caused by stroke that dramatically affects an individual’s functional independence and quality of life. For several decades, fMRI has critically advanced aphasia research, but it has notable limitations. For example, individuals with conditions that affect many Veterans (e.g., implanted medical devices or a history of injury involving metal) cannot safely be scanned. These individuals have therefore been systematically excluded from fMRI studies of aphasia. Additionally, fMRI is conducted in a noisy, restrictive environment, necessitating the use of artificial experimental paradigms that may not engage the full range of anatomical and physiological mechanisms supporting real-world language and communicative function. In contrast to fMRI, functional near-infrared spectroscopy (fNIRS) has few contraindications, is silent, inexpensive, and can be administered in a standard clinic room with naturalistic language paradigms. Despite these advantages, fNIRS has rarely been used to study aphasia, likely due to a lack of data validating it as compared to fMRI in this specific population. This study will address critical gaps in the evidence that would support fNIRS’ use by investigating its correlation with fMRI for language mapping (Aim 1), its test-retest reliability (Aim 2), and its sensitivity to changes in brain function due to behavioral language treatment (Aim 3) in people with chronic post-stroke aphasia. In part A of this study, 24 people with chronic aphasia (PWA) will be scanned twice over a 3-week interval with both fNIRS and fMRI while performing three language tasks: picture naming and semantic and phonological matching. Concurrent validity will be established by correlating language activation measured by fNIRS with that of fMRI. fNIRS’ test-retest reliability will be assessed by computing intraclass correlation coefficients across the first and second fNIRS scans, with comparable comparisons of the fMRI scans. Twenty- four healthy older adults will complete the same protocols to inform interpretations of the results in PWA. In part B, 12 PWA will complete fNIRS and fMRI scans during language tasks before and after three weeks of intensive language therapy, administered as part of a separate clinical trial of treatment for word-retrieval impairments. Comparisons between pre- and post-treatment fNIRS and fMRI scans will be used to assess fNIRS’ sensitivity to change after intervention, relative to that of fMRI. Behavioral research activities (including intensive language therapy) will be conducted at the VA Pittsburgh Healthcare System (VAPHS). fMRI and fNIRS will be performed at the CMU-Pitt Brain Imaging Data Generation & Education Center and the Brain and Auditory Sciences Research Initiative at the University of Pittsburgh, respectively. The results of this study will help determine the viability of fNIRS for measuring language functions in post-stroke aphasia and may provide a foundation for increased use of fNIRS in aphasia research, broadening participation in neuroimaging studies and increasing the generalizability of their findings. The results may also support the development of novel uses for fNIRS, such as measuring brain responses during everyday language use or aphasia treatment, and using real-time neurofeedback as an adjuvant to behavioral aphasia therapy. The applicant is a VA CDA-1 awardee, research and clinical speech pathologist, and former Advanced Geriatrics Fellow in the Geriatric Research, Education, and Clinical Center at VAPHS, with experience in aphasia rehabilitation and fMRI. During the CDA-2, mentorship and structured training activities in advanced neuroimaging/fNIRS methods, advanced statistics, Bayesian adaptive clinical trials design, and validity theory will facilitate execution and completion of the project and achievement of the applicant’s career goals. These goals include completing a CDA-2 and becoming an independent VA clinician-scientist supported by VA Merit Review and NIH/NIDCD award mechanisms, with a research program focused on improving service delivery and maximizing treatment outcomes for Veterans and others with aphasia.

美国有超过250万人患有失语症，这种语言障碍通常是由中风引起的 龙影响个人的功能独立性和生活质量。几十年来，fMRI拥有 至关重要的失语症研究，但具有明显的局限性。例如，有条件的人 影响许多退伍军人（例如，植入的医疗设备或受伤史金属的历史）无法安全 被扫描。因此，这些人被系统地排除在fmri失语症研究之外。 此外，fMRI是在嘈杂的，限制性的环境中进行的，用于使用人工 实验性范例可能不吸引各种解剖和物理机制 支持现实世界的语言和通信功能。与fMRI相反，功能性近红外 光谱法（FNIRS）几乎没有禁忌症，无声，廉价，可以以标准管理 具有自然语言范式的诊所室。尽管有这些优势，但FNIRS很少习惯 研究失语症，可能是由于缺乏数据验证数据的原因与该特定人群中的fMRI相比。这 研究将解决有关通过研究其相关性支持FNIRS使用的证据的关键差距 使用fMRI进行语言映射（AIM 1），其重测的可靠性（AIM 2）及其对变化的敏感性 由于行为语言治疗而引起的大脑功能（AIM 3）在慢性触诊后失语症患者中。 在本研究的A部分中，将在3周的间隔内两次扫描慢性失语症（PWA）（PWA） 执行三个语言任务时，使用FNIRS和fMRI：图片命名和语义和语义和 语音匹配。并发有效性将通过将语言激活相关联确定 fnirs与fMRI的fnirs。 FNIRS的测试可靠性将通过计算影响相关性评估 在第一和第二FNIRS扫描中进行了比较，并与fMRI扫描进行了可比的比较。二十- 四名健康的老年人将完成相同的方案，以告知PWA结果的解释。在 B部分，12个PWA将在三周之前和之后完成语言任务期间完成FNIRS和fMRI扫描 强化语言疗法，作为单独的文字恢复治疗临床试验的一部分 障碍。治疗前和后FNIRS和FMRI扫描之间的比较将用于评估 FNIRS对干预后的变化敏感性相对于fMRI的敏感性。行为研究活动（包括 强化语言疗法将在VA Pittsburgh Healthcare System（VAPHS）进行。 fMRI和 FNIRS将在CMU-PITT脑成像数据生成与教育中心和大脑中进行 和匹兹堡大学的听觉科学研究计划。 这项研究的结果将有助于确定fnirs的生存能力 触诊后失语症，可能为增加FNIRS的使用奠定了基础 参与神经影像学研究并提高其发现的普遍性。结果也可能 支持开发FNIRS的新颖用途，例如在每天的语言中测量大脑反应 使用或失语症治疗，并使用实时神经反馈作为可调节行为失语疗法。 申请人是VA CDA-1获奖者，研究和临床言语病理学家，并且前高级 老年医学研究员在vaphs的老年研究，教育和临床中心，拥有经验 失语症康复和fMRI。在CDA-2期间，高级训练和结构化培训活动 神经成像/FNIRS方法，高级统计，贝叶斯自适应临床试验设计和有效性理论 将有助于执行和完成项目以及申请人职业目标的实现。这些 目标包括完成CDA-2并成为由VA优点支持的独立VA临床科学家 审查和NIH/NIDCD奖励机制，其研究计划的重点是改善服务交付 并最大化退伍军人和其他失语症的治疗结果。