Language and cognition after perinatal stroke

围产期卒中后的语言和认知

• 批准号: 10527367
• 负责人: WILLIAM Davis GAILLARD
• 金额: $ 59.42万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-12-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10527367
• 关键词: Adult; Affect; Age; Area; Automobile Driving; Behavior Therapy; Biological; Birth; Brain; Brain Injuries; Cerebral Palsy; Child; Cognition; Cognitive; Comprehension; Data; Development; Emotions; Environmental Risk Factor; Exhibits; Face; Focal Brain Injuries; Foundations; Functional Magnetic Resonance Imaging; Future; Hemiplegia; Human; Impaired cognition; Impairment; Individual; Infrastructure; Injury; Language; Language Development; Language Tests; Left; Life; Linguistics; Literature; Longitudinal Studies; Maps; Methods; Middle Cerebral Artery Infarction; Modeling; Names; Neuropsychological Tests; Outcome; Patient Recruitments; Pattern; Performance; Perinatal; Perinatal Brain Injury; Pharmacologic Substance; Population; Printing; Process; Production; Property; Recovery; Research; Research Personnel; Schools; Stroke; System; Techniques; Teenagers; Temporal Lobe; Testing; Variant; Visual; Work; behavior test; cognitive ability; cognitive function; cognitive testing; developmental plasticity; examination questions; flexibility; functional outcomes; improved; language impairment; language outcome; middle cerebral artery; motor impairment; neural; neural patterning; object recognition; optimal treatments; perinatal injury; perinatal ischemic stroke; perinatal stroke; post stroke; recruit; skills; stroke recovery; young adult

PROJECT SUMMARY It has long been argued that the brain is most plastic during early development and that after brain injury, children reorganize cortical functions to healthy areas; but there is little understanding of these processes. Many investigators have shown that, when the left hemisphere (LH) is damaged, language can be subserved by the right hemisphere (RH). Here we ask how the linguistic functions of LH and RH are organized after LH injury and how well this atypical organization supports linguistic abilities. We also investigate the complementary questions regarding how these functions are organized after RH injury. We will study the long-term outcomes after ischemic perinatal stroke (IPS), due to its relatively clean properties for scientific analysis. IPS occurs in 1/4000 births and is the leading known cause of cerebral palsy. Many children with LH perinatal stroke develop near-normal language and cognitive abilities, but a substantial number show later language and cognitive impairments. Most literature shows that, after early LH stroke, language `reorganizes' to homotopic RH areas. Our pilot data suggest that, under these circumstances, typical LH and RH language functions divide up the RH cortical territory in new ways. We hypothesize that these functions develop best when different language functions find distinct RH localizations; overlap of linguistic functions will lead to more impaired performance. We will test this hypothesis by investigating language after LH perinatal injuries. We will also ask the same questions after RH perinatal injuries. We will recruit 30 teenagers and young adults who have had a LH perinatal stroke involving the middle cerebral artery and 30 who have had a similar RH perinatal stroke, compared with 30 healthy controls matched in age and SES. While IPS is rare, our research team is ideal for successful recruiting. We have developed our tasks and tested 16 children with perinatal strokes. We will administer a battery of behavioral and neuropsychological tests and 5 fMRI tasks. Two fMRI tasks (examining naming and sentence processing) test language functions that activate LH language areas in healthy controls. Two fMRI tasks (examining vocal emotion and intonation) test functions ordinarily controlled by the RH. Together these tasks examine how language abilities are affected when they develop in one hemisphere. An additional fMRI task examines specific object recognition (word recognition, ordinarily in LH VWFA, and face recognition, ordinarily in RH FFA) to ask if these functions are altered when their typical neural substrates are intact but language is shifted. Our behavioral tests assess how well all of these skills operate when neural organization is atypical. These studies will contribute to our understanding of the flexibility and limitations of early brain plasticity. In the future our findings can also help to provide a foundation for developing techniques to stimulate the most successful types of functional organization after early brain injuries.

项目概要 长期以来，人们一直认为大脑在早期发育期间最具可塑性，而在脑损伤后， 儿童将皮质功能重新组织到健康区域；但人们对这些过程了解甚少。 许多研究人员表明，当左半球（LH）受损时，语言功能会受到损害 由右半球（RH）。这里我们问LH和RH的语言功能在 LH 损伤以及这种非典型组织对语言能力的支持程度。我们还调查了 关于 RH 损伤后这些功能如何组织的补充问题。 我们将研究缺血性围产期卒中（IPS）后的长期结局，因为其相对干净 用于科学分析的属性。 IPS 发生在 1/4000 的新生儿中，是已知的脑瘫的主要原因。 许多患有 LH 围产期中风的儿童发展出接近正常的语言和认知能力，但 数字显示后来的语言和认知障碍。大多数文献表明，在早期 LH 卒中后， 语言“重组”为同伦 RH 区域。我们的试点数据表明，在这种情况下， 典型的左侧和右侧语言功能以新的方式划分右侧皮质区域。我们假设 当不同的语言函数找到不同的 RH 本地化时，这些函数会得到最好的发展；的重叠 语言功能会导致表现更加受损。我们将通过调查来检验这个假设 LH 围产期损伤后的语言。我们也会在 RH 围产期损伤后提出同样的问题。 我们将招募 30 名患有 LH 围产期中风（涉及中段）的青少年和年轻人。 脑动脉和 30 名患有类似 RH 围产期卒中的人，与 30 名健康对照者相比 年龄和社会经济地位相匹配。虽然 IPS 很少见，但我们的研究团队是成功招聘的理想选择。我们有 我们制定了任务并对 16 名患有围产期中风的儿童进行了测试。我们将管理一系列行为 和神经心理学测试和 5 项功能磁共振成像任务。两项功能磁共振成像任务（检查命名和句子处理） 测试激活健康对照组 LH 语言区域的语言功能。两项功能磁共振成像任务（检查声音 情绪和语调）测试通常由 RH 控制的功能。这些任务一起检查如何 当语言能力在一个半球发育时，就会受到影响。另一项功能磁共振成像任务检查 特定对象识别（文字识别，通常在 LH VWFA 中，以及面部识别，通常在 RH 中） FFA）询问当它们的典型神经基质完好但语言发生变化时，这些功能是否会改变。 我们的行为测试评估当神经组织非典型时所有这些技能的运作情况。 这些研究将有助于我们理解早期大脑可塑性的灵活性和局限性。 将来，我们的研究结果还可以帮助为开发刺激最大程度的技术奠定基础。 早期脑损伤后成功的功能组织类型。

项目成果

Revisiting Lenneberg's Hypotheses About Early Developmental Plasticity: Language Organization After Left-Hemisphere Perinatal Stroke.

重温伦伯格关于早期发育可塑性的假设：左半球围产期中风后的语言组织。

• 发表时间: 2017
• 期刊: Biolinguistics
• 影响因子: 0.6
• 作者: Newport,ElissaL;Landau,Barbara;Seydell-Greenwald,Anna;Turkeltaub,PeterE;Chambers,CatherineE;Dromerick,AlexanderW;Carpenter,Jessica;Berl,MadisonM;Gaillard,WilliamD
• 通讯作者: Gaillard,WilliamD

In Memoriam: Alexander W. Dromerick Jr, MD, July 1, 1958-August 21, 2021.

悼念：Alexander W. Dromerick Jr，医学博士，1958年7月1日至2021年8月21日。

• DOI: 10.1161/strokeaha.122.039909
• 发表时间: 2022
• 期刊: Stroke
• 影响因子: 8.3
• 作者: Savitz,SeanI;Newport,ElissaL;Edwards,Dorothy
• 通讯作者: Edwards,Dorothy

The neural basis of language development: Changes in lateralization over age.

• DOI: 10.1073/pnas.1905590117
• 发表时间: 2020-09-22
• 期刊: Proceedings of the National Academy of Sciences of the United States of America
• 影响因子: 11.1
• 作者: Olulade OA;Seydell-Greenwald A;Chambers CE;Turkeltaub PE;Dromerick AW;Berl MM;Gaillard WD;Newport EL
• 通讯作者: Newport EL

Interpreting the CPASS Trial: Do Not Shift Motor Therapy to the Subacute Phase.

解读 CPASS 试验：不要将运动治疗转移到亚急性阶段。

• DOI: 10.1177/15459683221143461
• 发表时间: 2023
• 期刊: Neurorehabilitation and neural repair
• 影响因子: 4.2
• 作者: Edwardson,MatthewA;Brady,Kathaleen;Giannetti,MargotL;Geed,Shashwati;Barth,Jessica;Mitchell,Abigail;Tan,MingT;Zhou,Yizhao;Bregman,BarbaraS;Newport,ElissaL;Edwards,DorothyF;Dromerick,AlexanderW
• 通讯作者: Dromerick,AlexanderW

Treatment Practices and Outcomes in Continuous Spike and Wave during Slow Wave Sleep: A Multicenter Collaboration.

• DOI: 10.1016/j.jpeds.2021.01.032
• 发表时间: 2021-05
• 期刊: The Journal of pediatrics
• 作者: Baumer FM;McNamara NA;Fine AL;Pestana-Knight E;Shellhaas RA;He Z;Arndt DH;Gaillard WD;Kelley SA;Nagan M;Ostendorf AP;Singhal NS;Speltz L;Chapman KE
• 通讯作者: Chapman KE