Brain Health and Aphasia Recovery

大脑健康和失语症恢复

基本信息

批准号：
10617715
负责人：
Leonardo F Bonilha
金额：
$ 16.58万
依托单位：
UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-04-01 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10617715
关键词：
Acute Address Affect Aging Anatomy Aphasia Behavioral Blood Vessels Brain Brain Injuries Brain region Characteristics Chronic Clinical Cognitive Collaborations Compensation Data Diffusion Magnetic Resonance Imaging Elderly Exhibits Fiber Goals Guidelines Hemorrhage Human Image Impairment Individual Injury International Ischemia Language Language Disorders Lead Lesion Linguistics Literature Location Machine Learning Maps Measures Mediating Mediation Medical Metabolic Methods Microvascular Dysfunction Modeling Nervous System Trauma Neurobiology Neurologic Neurons Outcome Pathway interactions Phonetics Predisposition Recovery Reporting Research Residual state Semantics Severities Shapes Stroke Symptoms Testing Tissues Vascular blood supply Work acute symptom aphasia recovery base brain health brain magnetic resonance imaging brain tissue cardiovascular health cardiovascular risk factor cognitive reserve connectome experience innovation language impairment lexical loss of function mind control multimodal neuroimaging multimodality network architecture neural network architecture neuroimaging novel persistent symptom phonology post stroke preservation resilience stroke recovery stroke survivor stroke-induced aphasia synergism white matter

项目摘要

Abstract Language impairments can vary considerably between individuals with aphasia. Our neurobiological models based on the stroke lesion can only partly explain the aphasic symptoms. We hypothesize that the integrity of the residual brain tissue outside the stroke lesion is an important, but not yet fully appreciated, determinant of aphasia severity and recovery. It is well recognized that cardiovascular risk factors lead to cumulative widespread brain damage through small vessel disease (SVD). Outside the aphasia literature, SVD has been strongly associated with poor cognitive reserve and reduced resiliency to various forms of neurological injury. Stroke survivors with aphasia typically have cardiovascular risk factors and they commonly exhibit SVD. However, the impact of SVD is not usually taken into account in our models of recovery, even though the residual brain tissue is responsible for overcoming the loss of function. It follows that higher degrees of SVD outside the lesion may lead to worse aphasic symptoms and less chances of recovery due to reduced capacity to compensate for the stroke injury. Our goal is to directly test this hypothesis. We propose to evaluate how aphasia is shaped by the stroke lesion in combination with residual brain integrity. Neuroimaging (brain MRI) is ideally suited to address this problem. SVD is composed of microangiopathic ischemic changes and microhemorrhages. The ischemic changes from SVD can be measured through white matter hyper intensities using T2-weighted and T2-FLAIR images, and the microhemorrhages can be assessed using susceptibility-weighted images. SVD preferentially affects white matter and diffusion MRI can provide additional measures of white matter microstructural integrity and their relationship with the whole brain neuronal networks architecture (the brain connectome). Using our experience with post-stroke lesion symptom mapping, white matter and connectome imaging we propose a comprehensive study of the neurobiology and impact of SVD in aphasia. Our project will build on international guidelines for SVD assessment (The STandards for ReportIng Vascular changes on nEuroimaging - STRIVE) and it will develop an innovative multimodal machine learning approach to fully assess brain integrity. Brain integrity and language measures will be assessed in the context of chronic (Project 1) and acute (Project 2) aphasia recovery. The behavioral and linguistic assessments will be guided by Project 4. With the neuroimaging core, we will develop and distribute a multimodal neuroimaging approach to quantify the severity and location of SVD. Specific Aim 1 will longitudinally assess the independent impact of SVD, controlling for the brain lesion, on acute and chronic symptoms, as well as acute and chronic language recovery. Specific Aim 2 will evaluate the mechanisms by which SVD leads to language impairments by assessing the impact of SVD and stroke lesions on connectome neural network architecture, loss of associative long-range white matter fibers and its relationship with semantic, lexical-semantic, lexical-phonological, phonological/phonetic deficits.

抽象的语言障碍在失语症之间可能有很大的不同。我们的神经生物学基于中风病变的模型只能部分解释失语症。我们假设中风病变外残留的脑组织的完整性是重要的，但尚未完全理解，失语症严重性和恢复的决定因素。众所周知，心血管危险因素导致累积广泛的脑损伤通过小血管疾病（SVD）。在失语症文献之外，SVD与认知储备差，对各种形式的神经损伤降低了弹性。中风幸存者失语症通常具有心血管危险因素，并且通常表现出SVD。但是，在我们的恢复模型中，通常不考虑SVD，即使残留的脑组织是负责克服功能丧失。因此，病变以外的较高程度的SVD可能导致失语症的症状更严重，并且由于能力降低而恢复的机会较小中风损伤。我们的目标是直接检验这一假设。我们建议评估中风病变与残留大脑结合的失语症的影响正直。神经影像学（脑MRI）非常适合解决此问题。 SVD由微血管病性缺血性变化和微型出血。 SVD的缺血性变化可能是通过白质超强度测量，使用T2加权和T2-Flair图像，以及可以使用易感加权图像来评估微毛发。 SVD优先影响白色物质和扩散MRI可以提供白质微观结构完整性及其的其他措施与整个大脑神经元网络体系结构（大脑连接组）的关系。利用我们在冲程后病变症状映射，白色物质和连接组成像的经验我们提出了一项关于SVD在失语症中的神经生物学和影响的全面研究。我们的项目将基于国际SVD评估指南（报告有关血管变化的标准神经影像学 - 努力），它将开发一种创新的多模式学习方法来完全评估大脑完整性。将在慢性（项目1）和急性的背景下评估大脑完整性和语言措施（项目2）失语症恢复。行为和语言评估将以项目4为指导。神经影像学核心，我们将开发和分发一种多模式神经影像学方法来量化严重性和SVD的位置。特定的目标1将纵向评估SVD的独立影响，控制脑病变，关于急性和慢性症状，以及急性和慢性语言恢复。特定目标2将评估 SVD通过评估SVD和中风的影响而导致语言障碍的机制导致语言障碍的机制有关连接组神经网络体系结构的病变，关联远程白质纤维及其损失及其与语义，词语语义，词语语音，语音/语音缺陷的关系。