Functional Connectivity Correlates of Subacute to Early Chronic Post-Stroke Aphasia Recovery

亚急性至早期慢性中风后失语症恢复的功能连接相关性

• 批准号: 10515857
• 负责人: Erin Lynn Meier
• 金额: $ 18.99万
• 依托单位: NORTHEASTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-03 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10515857
• 关键词: Acquired Language Disorders; Address; Adult; Affect; American; Aphasia; Area; Behavior; Brain; Chronic; Chronic Phase; Cognitive deficits; Communication; Data; Disease; Dorsal; Exhibits; Foundations; Functional Imaging; Functional Magnetic Resonance Imaging; Home; Image; Impairment; Individual; Injury; Knowledge; Language; Language Disorders; Language Tests; Left; Lesion; Linguistics; Logistics; MRI Scans; Magnetic Resonance Imaging; Measures; Modality; Modeling; Modernization; Nature; Neurobiology; Neuronal Plasticity; Participant; Patients; Pattern; Persons; Phase; Phenotype; Process; Prognosis; Protocols documentation; Quality of life; Recovery; Research; Residual state; Rest; Sampling; Semantics; Site; Stream; Stroke; Structure; System; Testing; Time; Time Study; Work; acute stroke; aphasia recovery; base; behavior change; brain behavior; chronic stroke; cognitive skill; cost; data integrity; design; disability; early onset; experience; flexibility; functional near infrared spectroscopy; imaging study; improved; indexing; individual patient; insight; inter-individual variation; language impairment; language outcome; multimodality; noninvasive brain stimulation; novel; phonology; portability; post stroke; predictive modeling; public health priorities; relating to nervous system; skills; social situation; source localization; stroke recovery; stroke survivor; stroke-induced aphasia; trait

Project Summary Aphasia, an acquired language disorder, is a common post-stroke condition that devastates patients’ ability to engage in social situations, participate in preferred activities, and often regain a high quality of life after a stroke. Aphasia recovery is often greatest during the subacute post-stroke phase (~ 2 weeks to 6 months post- stroke) due to neuroplasticity (i.e., reorganization of brain function and behavior relationships). Yet, the extent of subacute aphasia recovery varies widely between individuals, and current predictive models based on demographic and lesion data do not fully account for inter-individual variability in recovery. Early post-stroke recovery predictions are likely to improve with the inclusion of information about brain network function, yet very little is currently known about the functional connectivity correlates of language changes that occur over the subacute phase in people with aphasia (PWA). This research aims to address this gap. Twenty-five PWA in the subacute phase (£ 3 months post-stroke onset at study entry) and 25 neurotypical controls will participate in the proposed research. At study entry, all participants will complete language testing, resting-state functional Near- Infrared Spectroscopy (rs-fNIRS), and structural MRI. PWA will complete testing and rs-fNIRS again at the onset of the early chronic phase (~ 6-8 months post-stroke). fNIRS will be used in this research to index brain network function as it is a flexible, portable alternative to fMRI that is more accessible to patients in early post-stroke stages. Language impairments will be captured by measures of semantics and phonology, linguistic domains that underlie receptive and expressive language deficits in PWA and provide more specific information than global language measures regarding impairment locus. Through three study aims, we will determine the subacute rs-fNIRS functional connectivity patterns that (1) are associated with subacute language deficits, (2) change over time and are related to longitudinal language changes, and (3) predict language gains by the early chronic stroke stage. Across aims, we predict that stronger/increased left intra- and inter-hemispheric connectivity will be associated with better/improved language skills in PWA, consistent with prior subacute stroke fMRI work. We additionally hypothesize that relationships between functional connectivity and language will be spatially localized to ventral stream regions for semantics and dorsal stream regions for phonology, consistent with modern models of the neurobiology of language. By achieving these aims, this project will advance our understanding of the nature of beneficial neural reorganization of language during the crucial subacute to early chronic post-stroke recovery window. This line of work will provide a foundation for building computational recovery models that incorporate multimodal brain function and brain structure data in PWA. Integration of these types of data will also guide decisions regarding the timing and type of language and non-invasive brain stimulation therapies patients should receive to maximize their recovery during the subacute stroke phase.

项目概要 失语症是一种后天性语言障碍，是一种常见的中风后病症，会破坏患者的能力 参与社交场合，参加喜欢的活动，并且通常在一段时间后重新获得高质量的生活 中风后失语症的恢复通常在亚急性阶段（约 2 周至 6 个月）最为明显。 中风）归因于神经可塑性（即大脑功能和行为关系的重组）然而，其程度。 亚急性失语症的恢复因人而异，目前的预测模型基于 人口统计和病变数据并不能完全解释中风后早期恢复的个体间差异。 通过包含有关大脑网络功能的信息，恢复预测可能会得到改善，但也可能会改善 目前对于语言变化的功能连接相关性知之甚少。 这项研究旨在解决失语症患者亚急性期的二十五个 PWA 问题。 亚急性期（研究开始时中风发作后 3 个月）和 25 名神经正常对照将参加 在研究开始时，所有参与者都将完成语言测试、静息态功能近邻测试。 红外光谱 (rs-fNIRS) 和结构 MRI 将在开始时再次完成测试和 rs-fNIRS。 本研究将使用 fNIRS 来索引大脑网络。 功能磁共振成像的功能，因为它是功能磁共振成像的一种灵活、便携式的替代方案，更适合中风后早期患者使用 语言障碍将通过语义和音系、语言领域的测量来捕获。 这是 PWA 中接受性和表达性语言缺陷的基础，并提供比 通过三个研究目标，我们将确定有关损伤位点的全球语言测量。 亚急性 rs-fNIRS 功能连接模式 (1) 与亚急性语言缺陷相关，(2) 随着时间的推移而变化，并且与纵向语言变化有关，并且（3）通过早期预测语言增益 在慢性中风阶段，我们预测左半球内和半球间的运动会更强/增加。 连接性将与 PWA 中更好/改进的语言技能相关，这与之前的亚急性中风一致 我们还努力解决功能连接和语言之间的关系。 语义上空间定位于腹侧流区域，语音上定位于背侧流区域，一致 通过实现这些目标，这个项目将推进我们的语言神经生物学模型。 了解在关键的亚急性到早期阶段有益的语言神经重组的本质 慢性中风后恢复窗口这一系列工作将为构建计算提供基础。 将多模式大脑功能和大脑结构数据整合到 PWA 中的恢复模型。 数据类型还将指导有关语言和非侵入性大脑的时间和类型的决策 患者在亚急性中风阶段应接受刺激治疗，以最大限度地恢复。