Functional Language Organization in Childhood Stroke

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DESCRIPTION (provided by applicant): This Career Development Award proposal is designed to allow the candidate to develop the skills necessary to become an independent investigator in the area of neurocognitive development and disorders using functional neuroimaging techniques. The proposal focuses on the development of language after childhood stroke. Its specific objectives are to: (1) develop expertise in functional imaging task design and implementation as well as the statistical analysis of functional data; and (2) design empirical studies of the effects of neurologic disease on cognitive development. The candidate proposes a five- year training program with mentors from a pediatric research department. Her primary mentor is a functional neuroimaging researcher whose work has focused on the use of fMRI in children. Other mentors represent the disciplines of biostatistics, neurology, psychology, and radiology, which are directly relevant to the research and career development plan. The plan describes activities focused on enhancing the knowledge required to effectively design and implement fMRI techniques that will provide useful clinical and scientific information in pediatric patient populations. These activities will include coursework, independent study, and specific training rotations. Training in the responsible conduct of pediatric research and maundered experiences in the preparation of grant proposals for independent research support are also included in the planned program. The proposal research involves the study of the effects of early and later disruption of neurologic development on the cognitive domain of language. Specific aims include: (1) Map language activation patterns and determine language lateralization of children with early (perinatal) stroke of the left middle cerebral artery (MCA) compared to those of children with late (occurring between 5 and 18 years of same age) left MCA stroke and compare these patterns to those of normal children of the same age and gender. (2) Examine the pattern of functional reorganization of language to determine whether such reorganization reflects a shift of lateralization or an intra- hemisphere redistribution of language. (3) Track the changes in language activation patterns and language lateralization that occur over time in children with late left MCA stroke. The findings will contribute to the understanding of brain plasticity, language development, and assessment and treatment of language disorders.