Recovery of Affective Prosody after Stroke

中风后情感韵律的恢复

• 批准号: 10194446
• 负责人: Argye E. Hillis
• 金额: $ 61.99万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10194446
• 关键词: Acoustics; Affective; Age; Amygdaloid structure; Anatomy; Anterior; Antidepressive Agents; Area; Bathing; Behavior Therapy; Blood flow; Brain; Brain region; Cognitive; Cognitive deficits; Combined Modality Therapy; Communication; Communication impairment; Cues; Data Set; Disease; Dorsal; Dose; Education; Emotions; Empathy; Evidence based intervention; Evidence based treatment; Expressed Emotion; Foundations; Future; Goals; Health; Hour; Impairment; Infarction; Inferior; Insula of Reil; Interpersonal Relations; Intervention; Laboratories; Lesion; Leukoaraiosis; Loudness; Measurement; Measures; Mental Depression; Methodological Studies; Methodology; Methods; Modeling; Motor; Multimodal Imaging; Natural History; Outcome; Outcomes Research; Patients; Perception; Performance; Perfusion; Pharmaceutical Preparations; Process; Production; Prognosis; Quality of life; Recovery; Reperfusion Therapy; Research; Semantics; Social Functioning; Social Interaction; Societies; Speech; Stream; Stress; Stroke; Structure; Structure of inferior temporal gyrus; Structure-Activity Relationship; Superior temporal gyrus; Testing; Time; Tissues; Voice; Walking; acute stroke; base; brain behavior; cingulate gyrus; cognitive function; cognitive performance; comorbidity; design; emotional functioning; evidence base; feeding; hypoperfusion; imaging study; improved; improved functioning; individual variation; longitudinal analysis; motor deficit; neural circuit; neural correlate; neural network; neuromechanism; novel; post stroke; post stroke depression; putamen; recruit; relating to nervous system; response; showing emotion; social; sound; stroke outcome; stroke recovery; stroke survivor; support network; therapy design; treatment planning; treatment trial

Research on stroke outcomes has focused almost exclusively on recovery of very basic functions, such as feeding oneself, bathing, walking, and speaking. However, impairments in social function, including impaired recognition and expression of emotions, are also common consequences of stroke. Diminished affective prosody (understanding and conveying emotion through vocal intonation, rate, pauses, and stress), is a particularly common impairment after right hemisphere stroke, and can be misinterpreted as loss of empathy, apathy, or depression (problems that can also be important consequences of stroke, but require different management). Appropriate expression and recognition of prosody is also critical for effective social interaction. Despite the impact of diminished affective prosody on quality of life and function in society, these disorders are understudied, and there are few evidence-based treatments for these disorders. To design effective and efficient interventions that will improve quality of life and facilitate full participation in society, and to plan treatment trials to evaluate the interventions, we first need to lay the groundwork. We need to identify the perceptual, cognitive, and motor deficits that can disrupt affective prosody; characterize the natural history of recovery and variables that influence recovery of these deficits; and identify the neural networks that support these functions and their recovery. Identifying the networks that support these processes will allow us to select interventions that will help recruit these networks to augment behavioral therapy. In this project we will integrate: 1) detailed longitudinal analysis of the impaired perceptual, cognitive, and motor processes underlying prosody in each patient at four time points over the first year after stroke, and (2) detailed longitudinal analysis of the structural and functional lesions (e.g., in right ventral and dorsal streams) and functional connectivity between critical regions in each patient at the same four time points over the first year after stroke, and (3) analyses of variables (such as timing and doses of antidepressants) and co-morbidities (such as depression) that influence recovery. By integrating these methods, we will have a better understanding of the natural recovery trajectories and the neural basis of both the impairments and their recovery. Combining these datasets will allow us to test specific hypotheses about the perceptual, cognitive, and motor processes and their neural mechanisms underlying affective prosody and about recovery of these process after disruption due to focal lesions. Furthermore, by building linear mixed effect models to identify the potential impact of independent variables on outcomes, we will be able to prognosticate and identify variables that modify prognosis. These three sets of data will also provide a foundation for designing treatments that combine behavioral therapy with medications or neurally-targeted interventions such as transcranial direct current stimulation. Integration of these datasets will also provide evidence to guide who needs treatment, when to treat, and where in the brain to treat these functions.

关于中风结果的研究几乎完全集中在非常基本功能的恢复上，例如 自己吃饭、洗澡、走路和说话。然而，社会功能受损，包括受损 情绪的识别和表达也是中风的常见后果。情感减弱 韵律（通过语调、语速、停顿和重音理解和传达情感） 右半球中风后特别常见的损伤，并且可能被误解为失去同理心， 冷漠或抑郁（这些问题也可能是中风的重要后果，但需要不同的治疗方法 管理）。适当的韵律表达和识别对于有效的社交互动也至关重要。 尽管情感韵律减弱对生活质量和社会功能产生影响，但这些疾病 对这些疾病的研究不足，而且很少有基于证据的治疗方法。设计有效且 有效的干预措施将改善生活质量并促进充分参与社会，并制定计划 为了评估干预措施的治疗试验，我们首先需要奠定基础。我们需要识别 知觉、认知和运动缺陷可能会扰乱情感韵律；描述自然历史的特征 复苏以及影响这些赤字恢复的变量；并识别支持的神经网络 这些功能及其恢复。识别支持这些过程的网络将使我们能够选择 干预措施将有助于招募这些网络来增强行为治疗。在这个项目中我们将 整合：1）对受损的知觉、认​​知和运动过程进行详细的纵向分析 每位患者在中风后第一年的四个时间点的基本韵律，以及（2）详细 结构和功能病变的纵向分析（例如，右腹侧和背侧流）和 第一年相同四个时间点每位患者关键区域之间的功能连接 中风后，(3) 变量分析（例如抗抑郁药的服用时间和剂量）和合并症 （如抑郁症）影响康复。通过整合这些方法，我们将得到更好的结果 了解自然恢复轨迹以及损伤及其产生的神经基础 恢复。结合这些数据集将使我们能够测试有关感知、认知、 和运动过程及其情感韵律背后的神经机制以及这些的恢复 由于局灶性病变而中断后的过程。此外，通过建立线性混合效应模型来识别 自变量对结果的潜在影响，我们将能够预测和识别变量 改变预后。这三组数据也将为设计治疗方法提供基础 将行为疗法与药物或神经靶向干预措施（例如经颅直接疗法）相结合 电流刺激。这些数据集的整合还将提供证据来指导谁需要治疗， 何时治疗以及在大脑的哪个部位治疗这些功能。

项目成果

Explicit Training to Improve Affective Prosody Recognition in Adults with Acute Right Hemisphere Stroke.

• DOI: 10.3390/brainsci11050667
• 发表时间: 2021-05-20
• 期刊: Brain sciences
• 影响因子: 3.3
• 作者: Durfee AZ;Sheppard SM;Meier EL;Bunker L;Cui E;Crainiceanu C;Hillis AE
• 通讯作者: Hillis AE

That's right! Language comprehension beyond the left hemisphere.

这是正确的！

• DOI: 10.1093/brain/awy291
• 发表时间: 2018
• 期刊: Brain : a journal of neurology
• 作者: Sheppard,ShannonM;Hillis,ArgyeE
• 通讯作者: Hillis,ArgyeE

Lesion loci of impaired affective prosody: A systematic review of evidence from stroke.

• DOI: 10.1016/j.bandc.2021.105759
• 发表时间: 2021-08
• 期刊: Brain and cognition
• 影响因子: 2.5
• 作者: Durfee AZ;Sheppard SM;Blake ML;Hillis AE
• 通讯作者: Hillis AE

Right hemisphere ventral stream for emotional prosody identification: Evidence from acute stroke.

用于情感韵律识别的右半球腹侧流：来自急性中风的证据。

• DOI: 10.1212/wnl.0000000000008870
• 发表时间: 2020
• 期刊: Neurology
• 影响因子: 9.9
• 作者: Sheppard,ShannonM;Keator,LynseyM;Breining,BonnieL;Wright,AmyE;Saxena,Sadhvi;Tippett,DonnaC;Hillis,ArgyeE
• 通讯作者: Hillis,ArgyeE