Brain networks for reading in stroke alexia and typical aging

项目总结/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 失读症可能在任何特定时间影响超过一百万美国人，并导致许多日常生活困难 功能协调发展的为了提高失读症的诊断和治疗，我们必须了解失读症的神经认知基础， 中风后的阅读缺陷。然而，先前的小规模研究使用广泛的诊断类别和更老的诊断类别。 神经影像学方法仅产生失读症中的一般损伤-行为关联。在这里，我们建议 迄今为止对老年人失读症和典型阅读的最大研究，使用详细的阅读测量 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 阅读模型还没有纳入我们对这些网络的理解的最新进展。我们 提出了一种新的阅读与语音和语义集成的模型（RISS），提供了一个更具体的 阅读的神经认知结构。我们假设特定RISS的病变 网络处理器和连接解释了中风后特定的阅读缺陷模式， 受损RISS通路的恢复或未受损通路的补偿是失读症恢复的基础。 尽管阅读的大脑网络已经在典型和非典型的年轻人中广泛地绘制出来， 在老年人群中，中风往往发生在大脑老化和低教育和社会经济地位的人群中。 (SES)他们经常被排除在认知神经科学研究之外。失读症患者阅读的病理模式 在典型的读者中也观察到了较小程度的影响，年龄，教育和SES都是众所周知的影响因素。 阅读能力。因此，失读症只能通过检查这些因素如何与 典型老年人的阅读行为和大脑，并将阅读缺陷与个人背景联系起来。 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，以及沿着 在100名人口统计学上与卒中幸存者相匹配的老年人中进行高级多模式MRI。我们将测试 基于RISS的假设，并研究年龄，教育和SES如何与行为和大脑相关。 我们将免费传播所有测试材料以及行为和成像数据，以促进进一步的研究。 在这个领域的研究。在第二项研究中，我们将在200名慢性中风患者中进行相同的行为测试 根据新的成像数据库中的数千例患者的病变属性前瞻性选择幸存者， 中风幸存者我们将模拟病变对RISS中处理器和连接的影响，并测试 脑行为假说使用病变网络映射分析。在第三项研究中，我们将收集详细的 50名卒中幸存者在亚急性期和12个月内的行为数据和多模式MRI 后来测试的失读症的恢复机制的基础上RISS的假设。该项目将大大 推进我们对失读症和典型衰老中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.