Reorganization of visual function in patients with posterior cortical research: Selectivity and plasticity

后皮质研究患者视功能的重组：选择性和可塑性

• 批准号: 10375012
• 负责人: Marlene Behrmann
• 金额: $ 3.4万
• 依托单位: CARNEGIE-MELLON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10375012
• 关键词: Adopted; Age; Attention; Automobile Driving; Basic Science; Behavioral; Biography; Brain; Brain region; Categories; Cerebral Dominance; Cerebral hemisphere; Child; Childhood; Clinical; Competence; Data; Development; Dorsal; Epilepsy; Excision; Exhibits; Face; Foundations; Frequencies; Functional Magnetic Resonance Imaging; Funding; Goals; Grain; Hemispherectomy; Heterogeneity; Individual; Individual Differences; Intervention; Investigation; Left; Light; Lobectomy; Methods; Nature; Neuronal Plasticity; Normalcy; Operative Surgical Procedures; Parietal; Patients; Pattern; Population; Predictive Factor; Procedures; Property; Protocols documentation; Psychophysics; Recovery; Recovery Support; Recovery of Function; Rehabilitation therapy; Research; Residual state; Resistance; Role; Seizures; Side; Structure; Temporal Lobe; Time; Translational Research; Vision; Visual; Visual Cortex; Visual Pathways; Visual system structure; Work; brain behavior; clinical application; cognitive function; common treatment; data acquisition; design; early childhood; extrastriate visual cortex; innovation; insight; movie; neural correlate; neuroimaging; novel; patient population; patient subsets; pediatric patients; preservation; relating to nervous system; response; therapy design; translational applications

Summary Lobectomy (resection of a portion of a cortex) or hemispherectomy (removal of a hemisphere) is an increasingly common treatment for seizure management in individuals with pharmaco-resistant epilepsy. Despite the removal of a considerable amount of visual cortex, these patients typically exhibit a remarkable degree of recovery of visuo-cognitive function, particularly if the resection is performed in early childhood. This restitution of function is all the more surprising given the distinct patterns of lateralization of the two cerebral hemispheres in the normal brain. The proposed research undertakes a systematic examination of the extent and nature of the recovery of visual abilities following cortical resection in children. Comparisons to matched typical controls and to children with non-visual cortex resection are made both at the group- level and for each individual, an important focus given the heterogeneity of this rare population. Cutting- edge psychophysical and neuroimaging procedures, and novel analytic approaches, elucidate the nature and changes in the cortical visual system pre- and post-surgery, and longitudinally thereafter, as well as the mechanisms that give rise to recovery, potential modulatory effects of brain regions outside the visual system, and possible biographical factors predicting recovery (e.g., age, side and size of resection). A first aim is to characterize the time-course of recovery in patients longitudinally and in detail, by collecting neural and behavioral data pre-surgery and 6, 12, and 18 months post-surgery, characterizing the changes in cortical selectivity, spatial topography, morphometric structure and behavioral competence in the patients. A second aim examines with precision the integrity of the brain and behavior, assessing fine- grained neural representations and a set of well-established computational properties exhibited by the normal visual system. A final aim involves acquiring whole brain data driven in response to a naturalistic movie viewing paradigm, to evaluate changes outside of the visual system that might influence and interact with the observed recovery at the group and individual levels. Alternative theoretical accounts for recovery of function are evaluated throughout. Little systematic research has targeted the patterns of visual deficits and their recovery following surgical resection in children, and even less attention has been devoted to determining the underlying factors that support (or potentially enhance) this plasticity. The study of an under-explored pediatric patient population, and the use of detailed behavioral and neuroimaging data acquisition, breaks new ground in both the basic and translational science of the visual system. Tracking these changes longitudinally with fine-grained methods provides unprecedented insights into the nature of plasticity in the visual system, and may, ultimately, inform the design of clinical interventions that facilitate functionally relevant cortical reorganization.

概括 肺切除术（切除皮质的一部分）或半球切除术（去除半球）是 耐药性癫痫患者的癫痫发作管理越来越普遍。 尽管去除了相当多的视觉皮层，但这些患者通常表现出显着的 视觉认知功能的恢复程度，尤其是在童年时期进行切除的情况下。 考虑到两者的偏侧化模式，这种功能的恢复更加令人惊讶 正常大脑中的脑半球。拟议的研究对 儿童皮质切除后视觉能力恢复的程度和性质。比较 要匹配典型的对照和非视觉皮层切除的儿童，这两者都在 鉴于这个罕见人群的异质性，水平和每个人都有一个重要的重点。切割- 边缘心理物理和神经影像学程序以及新颖的分析方法，阐明了性质和 皮质视觉系统的术前和手术后的变化，此后纵向的变化以及 引起恢复的机制，视觉系统之外的大脑区域的潜在调节作用， 以及可能预测恢复的传记因素（例如，切除的年龄，侧面和大小）。 第一个目的是通过纵向和详细地表征患者的康复时间。 在手术前收集神经和行为数据，以及手术后的6、12和18个月，表征了 皮质选择性，空间形态，形态计量结构和行为能力的变化 病人。第二个目标以精确的大脑和行为的完整性进行了检查，评估了精细的 粒度神经表示和一组正常的良好的计算特性 视觉系统。最终目的涉及获取响应自然电影的全脑数据 查看范式，以评估视觉系统之外的变化，可能影响并与 观察到小组和个体级别的恢复。恢复功能的替代理论说明 在整个过程中进行评估。 很少有系统的研究针对视觉缺陷的模式及其恢复 儿童的手术切除，甚至更少的关注都致力于确定基本因素 支持（或潜在地增强）这种可塑性。对小儿患者人群爆炸不足的研究， 以及详细的行为和神经影像学数据获取的使用，在基本和 视觉系统的翻译科学。用细粒的方法纵向跟踪这些变化 提供对视觉系统可塑性本质的前所未有的见解，最终可能会告知 临床干预措施的设计，促进功能相关的皮质重组。