Neural correlates of treatment-induced recovery of phonological processing in chronic aphasia

慢性失语症治疗引起的语音处理恢复的神经相关性

• 批准号: 8907444
• 负责人: Andrew T DeMarco
• 金额: $ 3.86万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-01-01 至 2016-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8907444
• 关键词: Address; Aftercare; American; Aphasia; Area; Attention; Award; Behavior; Behavior Therapy; Behavioral; Bilateral; Brain; Brain region; Case Series; Chronic; Clinical Data; Cognitive; Cohort Studies; Competence; Development; Dorsal; Emotional; Enrollment; Evaluation; Evidence based treatment; Faculty; Family; Financial compensation; Functional Magnetic Resonance Imaging; Goals; Image; Impairment; Individual; Intervention; Language; Language Therapy; Lead; Left; Life; Measurement; Measures; Methods; Middle Cerebral Artery Infarction; Noise; Occupational; Parietal; Parietal Lobe; Participant; Performance; Personal Satisfaction; Physiology; Process; Quality of life; Reading; Recovery; Recruitment Activity; Rehabilitation therapy; Research; Research Project Grants; Residual state; Resolution; Resource Allocation; Resources; Scanning; Speech; Speech Sound; Stroke; Task Performances; Testing; Tissues; Treatment Protocols; Writing; aphasia rehabilitation; cognitive function; design; experience; improved; innovation; lexical processing; lexical retrieval; neural correlate; neural patterning; neuroimaging; neuromechanism; phonology; public health relevance; relating to nervous system; response; semantic processing; skills; social; success; syntax; treatment effect; treatment response

 DESCRIPTION (provided by applicant): The overall goal of this project is to identify the neural correlates of treatment-induced recovery of phonology in individuals with chronic aphasia. Deficits in phonology (speech sound processing) are among the most common and persistent impairments in aphasia after left hemisphere stroke, and can have significant functional consequences for spoken and written language. These deficits are typically treated with behavioral therapy involving targeted activities that encourage brain reorganization to support relearning of language skills. While many individuals make considerable gains through treatment, the neural substrates supporting these improvements are poorly understood. Specifically, it is not clear how improved phonological skills are supported when highly specialized left-hemisphere persiylvian language regions are damaged. To address this question, I propose to study changes in regional brain activation associated with a phonological task (pseudoword reading) performed during functional magnetic resonance imaging (fMRI) before and after phonological treatment. Using a case series design across eight individuals who experienced left middle cerebral artery stroke, I will study response accuracy and fMRI activation during pseudoword reading over the course of four scanning sessions (2 before and 2 after treatment). Behavioral improvement in pseudoword reading will be validated by comparison with clinical data collected before, during, and after treatment. The evidence-based treatment protocol will be implemented as part of an ongoing research project (R01DC07646- 09 awarded to the faculty sponsor), lasting approximately fourteen weeks. Differences in pre-post treatment brain activation evoked by the pseudoword reading task will be considered an effect of therapy. It is hypothesized that improvements in pseudoword reading will be associated with reliance on the undamaged (i.e. residual) left persiylvian regions of the language network and perilesional tissue. It is also predicted that a successful treatment response will require increased engagement of attentional resources to support task performance, and this should be evident by increased activation of a bi-hemispheric fronto-parietal network dorsal to the perisylvian language region. The findings from this study are expected to provide a better understanding of the neural mechanisms that support language recovery, and have the potential to inform treatment approaches for aphasia. 1

 描述（由申请人提供）：该项目的总体目标是确定慢性失语症患者治疗诱导的语音恢复的神经相关性。语音学缺陷（言语声音处理）是左半球中风后失语症中最常见和最持久的障碍之一，并且可以对口语和书面语言产生显著的功能后果。这些缺陷通常用行为疗法治疗，包括有针对性的活动，鼓励大脑重组，以支持语言技能的再学习。虽然许多人通过治疗取得了相当大的收益，但支持这些改善的神经基质却知之甚少。具体来说，目前尚不清楚如何改善语音技能的支持时，高度专业化的左半球波斯语区域受损。为了解决这个问题，我建议研究与语音任务（pseudoword阅读）在功能磁共振成像（fMRI）之前和之后的语音治疗过程中进行的区域脑激活的变化。使用病例系列设计，在8个人谁经历了左大脑中动脉中风，我将研究响应的准确性和fMRI激活在pseudoword阅读的过程中，四个扫描会话（2治疗前和2治疗后）。将通过与治疗前、治疗期间和治疗后收集的临床数据进行比较，验证假词阅读的行为改善。循证治疗方案将作为正在进行的研究项目（R 01 DC 07646 - 09授予教师赞助商）的一部分实施，持续约14周。由伪词阅读任务诱发的治疗前后脑激活的差异将被视为治疗效应。据推测，假词阅读的改善将与依赖于语言网络和病灶周围组织的未受损（即残留）的左大脑外侧裂区域有关。它还预测，一个成功的治疗反应将需要更多的参与注意力资源，以支持任务的性能，这应该是显而易见的，增加激活的双半球额顶叶网络背侧的perisylvian语言区域。这项研究的结果有望更好地了解支持语言恢复的神经机制，并有可能为失语症的治疗方法提供信息。1