Brain networks for reading in stroke alexia and typical aging

项目摘要/摘要 阅读能力是现代社会生活的基础。中风导致的阅读能力丧失，称为 亚力克斯病在任何时候都可能影响100多万美国人，并导致许多日常生活困难 功能。为了提高失读症的诊断和治疗水平，我们必须了解失读症的神经认知基础 中风后的阅读障碍。然而，之前的小规模研究使用了广泛的诊断类别和更早的 神经成像方法只能得出失读症患者的一般病变行为关联。在这里，我们建议 迄今为止对失读症和老年人典型阅读的最大规模研究，使用了详细的阅读测量 能力和最先进的多模式神经成像方法可用于测试新的神经认知模型。 阅读依赖于为语音和语言过程而进化的大脑网络，但神经认知 阅读模式还没有纳入我们对这些网络理解的最新进展。我们 提出了一种新的结合语音和语义的阅读模型(RISS)，它为阅读提供了更具体的 与以前的模型相比，阅读的神经认知结构。我们假设特定RISS的损伤 网络处理器和连接是中风后特定的阅读障碍模式的原因， 修复受伤的Riss通路或补偿未受伤的通路是Alexia恢复的基础。 尽管阅读的大脑网络在典型和非典型青少年中得到了广泛的映射 在人群中，中风往往发生在老化的大脑和低教育程度和社会经济地位的人中 (SE)认知神经科学研究经常被排除在外的人。失读症患者的阅读病理模式 在典型读者中的观察程度也较低，众所周知，年龄、教育程度和社会经济状况都会影响 阅读能力。因此，只有研究这些因素如何与失读症相关，才能完全理解失读症 典型老年人的阅读行为和大脑，并将阅读缺陷与这一个人背景联系起来。 在这个项目的第一个研究中，我们将收集大量的阅读和语言测试，以及 100名老年人中的高级多模式磁共振成像在人口统计学上与中风幸存者相匹配。我们将测试 基于RISS的假设，并研究了年龄、教育程度和SES与行为和大脑的关系。 我们将免费传播所有测试材料以及行为和成像数据，以便于进一步 这方面的研究。在第二项研究中，我们将对200名慢性中风患者进行同样的行为测试 幸存者是根据病变属性从数千个新的成像数据库中前瞻性地选择出来的 中风幸存者。我们将在RISS和测试中模拟损害对处理器和连接的影响 使用病变网络图分析的大脑行为假说。在第三项研究中，我们将收集详细的 50名卒中幸存者亚急性期和12个月的行为数据和多模式磁共振成像 随后根据RISS对失读症康复机制的假说进行检验。这个项目将极大地 促进我们对失读症和典型衰老阅读的神经认知基础的理解。

PROJECT SUMMARY/ABSTRACT The ability to read is fundamental to living in modern society. Loss of reading ability due to stroke, called alexia, likely affects over a million Americans at any given time and causes difficulty performing many daily life functions. To improve diagnosis and treatment of alexia, we must understand the neurocognitive basis of reading deficits after stroke. However, prior small-scale studies using broad diagnostic categories and older neuroimaging methods have yielded only general lesion-behavior associations in alexia. Here, we propose the largest study to date of both alexia and typical reading in older adults, using detailed measures of reading ability and the most advanced multimodal neuroimaging methods available to test a new neurocognitive model. Reading relies on brain networks that evolved for speech and language processes, but neurocognitive models of reading have not yet incorporated recent advances in our understanding of these networks. We propose a new model of Reading Integrated with Speech and Semantics (RISS) that provides a more specific neurocognitive architecture for reading than prior models. We hypothesize that lesions of specific RISS network processors and connections account for specific reading deficit patterns after stroke, and that restoration of the injured RISS pathways or compensation in uninjured pathways underlie alexia recovery. Although brain networks for reading have been extensively mapped in typical and atypical young populations, stroke tends to occur in the aging brain and in people of low education and socioeconomic status (SES) who are too often left out of cognitive neuroscience research. Pathological patterns of reading in alexia are also observed to a lesser degree in typical readers, and age, education and SES are all known to affect reading abilities. Therefore, alexia can only be fully understood by examining how these factors relate to reading behavior and the brain in typical older adults, and referencing reading deficits to this personal context. In the first study of this project, we will collect an extensive battery of reading and language tests along with advanced multimodal MRIs in 100 older adults demographically matched to stroke survivors. We will test hypotheses based on RISS and examine how age, education, and SES relate to both behavior and the brain. We will freely disseminate all testing materials and both behavioral and imaging data to facilitate further research in this area. In the second study, we will perform the same behavioral battery in 200 chronic stroke survivors prospectively selected based on lesion attributes from a new imaging database of thousands of stroke survivors. We will model the effects of the lesions on processors and connections in RISS and test brain-behavior hypotheses using lesion-network mapping analyses. In the third study, we will collect detailed behavioral data and multimodal MRIs in 50 stroke survivors during the subacute period and again 12 months later to test hypotheses regarding mechanisms of alexia recovery based on RISS. This project will substantially advance our understanding of the neurocognitive basis of reading in both alexia and typical aging.