Neural Correlates of Aphasia Treatment and Recovery: fMRI Investigations

描述（由申请人提供）：本提案中描述的工作目标是提供基于神经影像学的失语症治疗和恢复机制检查。我们建议使用功能磁共振成像与结构和灌注磁共振成像作为工具，跟踪，记录和评估大脑行为的变化与治疗为基础的变化在四个实验。我们建议系统地检查行为和（相关）神经的治疗效果，同时操纵几个关键的基于患者和基于治疗的变量，已被假设为相关的失语症恢复。我们将研究的患者相关变量包括前部与后部病变患者、卒中后早期与卒中后晚期（慢性）恢复阶段的病变部位和程度。我们建议研究治疗（与安慰剂治疗）对这些患者的影响，重点是句子水平处理中的理解和生产缺陷，比较：两种不同的治疗强度时间表（强化与扩展）和两种不同的治疗复杂性条件（训练复杂到简单与简单到复杂的结构）。我们对后一个变量的关注是基于我们以前的工作，表明前者（复杂到简单的训练）与后者相比具有更高的治疗效果和泛化效果。此外，我们提出的行为研究，扩展到语言处理的新领域和新的人群（后病变与韦尼克失语症患者）检查这种“治疗的复杂性”的假设。总的来说，我们建议采用（和复制）治疗方法与先前证明的行为疗效，以便提供一个坚实的基础，检查（通过神经影像学）与一系列关键的基于患者和治疗的变量在治疗过程中的大脑为基础的变化。此外，我们建议研究理论上的动机扩展的复杂性方法的语言治疗的新领域。

DESCRIPTION (provided by applicant): The goal of the work described in this proposal is to provide a neuroimaging-based examination of the mechanisms of aphasia treatment and recovery. We propose to use functional magnetic resonance imaging together with structural and perfusion MR imaging as tools for tracking, recording and evaluating brain behavior changes linked to treatment-based changes in four experiments. We propose to systematically examine both behavioral and (correlated) neural effects of treatment while manipulating several critical patient-based and treatment-based variables that have been hypothesized to be relevant to aphasia recovery. The patient-related variables we will study include site and extent of lesion, in patients with anterior vs. posterior lesions, in early post-stroke vs. late post-stroke (chronic) stages of recovery. We propose to study the effects of treatment (vs. placebo-treatment) for these patients with a focus on both comprehension and production deficits in sentence level processing, comparing: two different treatment-intensity schedules (intensive vs. extended) and two different complexity-of-treatment conditions (training complex-to-simple vs. simple-to-complex structures). Our focus on this latter variable is based on our previous work showing that the former (complex-to-simple training) results in greater efficacy of treatment and generalization effects as compared to the latter. Additionally, we propose behavioral studies that extend examination of this 'complexity-of treatment' hypothesis into new domains of language processing and new populations (posteriorly lesioned patients with Wernicke's aphasia). Overall, we propose to employ (and replicate) treatment methods with previously demonstrated behavioral efficacy so as to provide a solid basis for examining (via neuroimaging) brain-based changes associated with a range of critical patient-based and treatment-based variables during treatment. Additionally, we propose to examine theoretically motivated extensions of the complexity method to new domains of language treatment.