Longitudinal multi-modality imaging in progressive apraxia of speech

进行性言语失用症的纵向多模态成像

• 批准号: 8499542
• 负责人: Jennifer Louise Whitwell
• 金额: $ 32.13万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8499542
• 关键词: Address; Affect; Aphasia; Autopsy; Basal Ganglia; Biological Markers; Brain; Brain Diseases; Brain Pathology; Brain Stem; Brain region; Broca' s area; Characteristics; Clinic; Clinical; Clinical Treatment; Clinical Trials; Collaborations; Data; Dementia; Development; Diffusion Magnetic Resonance Imaging; Discipline of Nuclear Medicine; Disease; Disease Progression; Evaluation; Functional Magnetic Resonance Imaging; Functional disorder; Future; Glucose; Goals; Grant; Grouping; Histology; Image; Inferior; Language; Language Disorders; Lead; Magnetic Resonance Imaging; Measures; Modality; Modeling; Motor; Movement Disorders; Nerve Degeneration; Neurocognitive Deficit; Neurodegenerative Disorders; Neurologic; Neurons; Outcome; Pathology; Patient Care; Patients; Performance; Positron-Emission Tomography; Prefrontal Cortex; Principal Investigator; Psychometrics; Research; Resources; Rest; Scientist; Severities; Specialist; Speech; Speech Development; Speech Disorders; Speech Pathology; Symptoms; Synapses; Testing; Time; Work; base; brain metabolism; brain tissue; cohort; experience; fluorodeoxyglucose positron emission tomography; frontal lobe; imaging modality; improved; motor impairment; neuroimaging; neuropsychological; outcome forecast; protein TDP-43; public health relevance; tau Proteins; treatment trial; white matter

DESCRIPTION (provided by applicant): Apraxia of speech (AOS) is a disorder affecting the motor planning of speech and can be associated with neurodegenerative diseases. It can occur in isolation or in the presence of a language disorder whereby patients have problems with grammar and spoken language, known as non-fluent aphasia (NFA). It is unclear how longitudinal structural and functional changes in the brain are related to the heterogeneous clinical features of the disorder. Characterizing progression in neurodegenerative AOS will be critical for patient prognosis and for further defining these disorders for future research and clinical trials. The objectives of the studies outlined in this application are to determine the relationship between structural and functional changes in the brain and progression of speech and language, neurological and neuropsychological features in patients with AOS. To accomplish our aims we will utilize a well characterized cohort of neurodegenerative AOS subjects that were evaluated at the Mayo Clinic, Rochester MN, and have undergone standardized speech and language, neurological and neuropsychological evaluations, a magnetic resonance imaging (MRI) scan and a [18-F]-fluoro-deoxy-glucose (FDG) positron emission tomography (PET) scan. In this study, we will perform two additional serial assessments of each patient, with the first performed 2.5 years after their original assessment, and the second performed one year later. Each assessment will include identical speech and language, neurological and neuropsychological evaluations and an MRI and FDG-PET scan. Therefore, three serial assessments will be available for analysis in this study. We will assess the rate of brain tissue loss, and examine which specific brain regions and white matter tracts change over time. Changes in brain metabolism and functional connectivity will also be assessed. We will then investigate associations between these imaging measures and different aspects of clinical decline, as well as develop imaging-based models that predict clinical outcomes, such as worsening of AOS and the development of NFA in patients with isolated AOS. Importantly, since we would have followed patients for a number of years, we anticipate that some subjects will die during the study and hence we will be able to perform brain autopsies to determine what disease(s) are present in the brain and develop neuroimaging models to predict brain pathology. The application focuses on neuroimaging and will be led by a Principal Investigator with 10 years experience in neuroimaging research involving these neurodegenerative disorders. She will also have support from a team of world renowned scientists including dementia, movement disorders and speech pathology specialists, a nuclear medicine scientist, neuropsychologists, and biostatisticians. The long term goal of our research is to develop neuroimaging biomarkers in neurodegenerative AOS and provide results that will help improve predictions about the course of clinical decline.

描述（由申请人提供）：言语失用症（AOS）是一种影响言语运动规划的疾病，可能与神经退行性疾病相关。它可以发生在孤立或存在语言障碍的情况下，即患者有语法和口语问题，称为非流利性失语症（NFA）。目前尚不清楚大脑中的纵向结构和功能变化如何与该疾病的异质性临床特征相关。表征神经退行性AOS的进展对于患者预后以及进一步定义这些疾病以用于未来的研究和临床试验至关重要。本申请中概述的研究目的是确定AOS患者大脑结构和功能变化与言语和语言进展、神经学和神经心理学特征之间的关系。为了实现我们的目标，我们将利用在罗切斯特明尼苏达州马约诊所评价的一组特征良好的神经退行性AOS受试者，并进行了标准化的言语和语言、神经学和神经心理学评价、磁共振成像（MRI）扫描和[18-F]-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）。在这项研究中，我们将对每名患者进行两次额外的系列评估，第一次在最初评估后2.5年进行，第二次在一年后进行。每次评估将包括相同的言语和语言，神经和神经心理学评估以及MRI和FDG-PET扫描。因此，本研究将提供3项系列评估用于分析。我们将评估脑组织损失的速度，并检查哪些特定的大脑区域和白色物质束随时间发生变化。还将评估脑代谢和功能连接的变化。然后，我们将研究这些成像测量与临床衰退的不同方面之间的关联，并开发基于成像的模型来预测临床结果，例如孤立性AOS患者的AOS恶化和NFA的发展。重要的是，由于我们已经对患者进行了多年的随访，我们预计一些受试者将在研究期间死亡，因此我们将能够进行脑尸检，以确定大脑中存在何种疾病，并开发神经成像模型来预测大脑病理学。该应用程序侧重于神经影像学，将由一名在涉及这些神经退行性疾病的神经影像学研究方面具有10年经验的主要研究者领导。她还将得到世界知名科学家团队的支持，包括痴呆症，运动障碍和语言病理学专家，核医学科学家，神经心理学家和生物统计学家。我们研究的长期目标是开发神经退行性AOS的神经影像学生物标志物，并提供有助于改善临床衰退过程预测的结果。