Neural correlates of recovery from aphasia after acute stroke

急性中风后失语恢复的神经相关性

• 批准号: 8758212
• 负责人: Stephen M Wilson
• 金额: $ 44.52万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8758212
• 关键词: Acquired Communication Disorders; Acute; Address; Affect; American; Aphasia; Area; Arteriogram; Behavior Therapy; Behavioral; Brain; Brain Injuries; Brain imaging; Brain region; Cell Death; Clinical; Communities; Consent; Contralateral; Data; Data Set; Diffusion Magnetic Resonance Imaging; Evaluation; Functional Imaging; Functional Magnetic Resonance Imaging; Goals; Hour; Image; Impairment; Individual; Infarction; Knowledge; Language; Left; Life; Longitudinal Studies; Machine Learning; Magnetic Resonance Imaging; Maps; Measures; Medical; Modality; Pathologist; Patients; Pattern; Perfusion; Physicians; Process; Protocols documentation; Recovery; Rehabilitation therapy; Reperfusion Therapy; Research; Resolution; Secure; Speech; Spin Labels; Staging; Stroke; Testing; Time; Tissues; acute stroke; aphasic; experience; hemodynamics; hypoperfusion; imaging modality; improved; language onset; language processing; neuroimaging; neuromechanism; outcome forecast; post stroke; prognostic; public health relevance; relating to nervous system; relational database; response; treatment planning; web based interface; white matter; white matter damage

DESCRIPTION (provided by applicant): The overall goal of this project is to identify the neural correlates of recovery from aphasia during the first three months after acute stroke. Aphasia is one of the most common and debilitating consequences of strokes affecting the dominant hemisphere. In the acute and subacute stages, most patients experience some degree of recovery of language function. These first few months after brain damage occurs are critically important because the greatest behavioral gains take place during this time, even when patients do not receive treatment. However the extent of recovery is highly variable: some patients recover most or nearly all language function, while others make few gains and remain chronically aphasic. It is not well understood what neural mechanisms underlie recovery during this period, nor why some patients recover so much better than others. To address these questions, we propose to study individuals with aphasia due to acute left hemisphere stroke. Patients will be examined at four time points after stroke: 24-48 hours, 2 weeks, 1 month, and 3 months. At each time point, a comprehensive yet time-efficient language evaluation will be administered to quantify expressive and receptive language function, and a multimodal brain imaging protocol will be implemented that includes structural imaging (MRI), functional imaging (fMRI), perfusion imaging (arterial spin labeling, ASL) and diffusion tensor imaging (DTI). The proposed research has two specific aims. The first is to identify the neural changes that are associated with successful recovery from aphasia in the acute and subacute periods after a stroke. The second aim is to determine the initial imaging and behavioral variables that are most predictive of the extent of eventual recovery of language function. We hypothesize that the inclusion of fMRI, ASL and DTI in combination with comprehensive language assessments will provide a more complete characterization of the brain's changing state than standard clinical imaging and language measures, and will explain a greater proportion of the variance in recovery patterns. A better understanding of the neural correlates of successful recovery will improve the accuracy of prognoses so as to better plan medical treatments and behavioral interventions.

描述（由申请人提供）：该项目的总体目标是确定急性中风后前三个月失语症恢复的神经相关性。失语症是影响优势半球的中风最常见和最令人衰弱的后果之一。在急性和亚急性阶段，大多数患者的语言功能会得到一定程度的恢复。脑损伤发生后的最初几个月至关重要，因为即使患者没有接受治疗，在此期间也会获得最大的行为收益。然而，恢复的程度差异很大：一些患者恢复了大部分或几乎所有语言功能，而另一些患者则几乎没有恢复并保持长期失语症。目前尚不清楚这一时期恢复的神经机制是什么，也不清楚为什么有些患者恢复得比其他患者好得多。为了解决这些问题，我们建议研究因急性左半球中风而导致失语的个体。患者将在中风后的四个时间点接受检查：24-48小时、2周、1个月和3个月。在每个时间点，将进行全面且省时的语言评估，以量化表达和接受语言功能，并将实施多模式脑成像协议，包括结构成像（MRI）、功能成像（fMRI）、灌注成像（动脉自旋标记（ASL）和扩散张量成像（DTI）。拟议的研究有两个具体目标。首先是确定与中风后急性期和亚急性期失语症成功恢复相关的神经变化。第二个目标是确定最能预测语言功能最终恢复程度的初始成像和行为变量。我们假设，将功能磁共振成像、ASL 和 DTI 与综合语言评估相结合，将比标准临床成像和语言测量更全面地描述大脑变化状态，并将解释恢复模式中更大比例的差异。更好地了解成功康复的神经相关性将提高预后的准确性，从而更好地规划医疗和行为干预。