Neurobiology of Language Recovery in Aphasia: Natural History and Treatment-Ind*

描述（由申请人提供）：本临床研究中心（P50）提案的重点是提供一种基于神经影像学的检查，用于检查中风所致慢性失语症患者的语言恢复情况。该中心的目标是汇集临床研究人员的专业知识，共同的科学兴趣和互补的专业知识，了解中风引起的语言恢复的认知和神经相关性，语言治疗对这些过程的影响，以及语言/大脑恢复的认知和神经因素（生物标志物）。该提案包括三个子项目，分别研究三个语言领域的语言恢复，每个子项目的专家担任PI：失语症中口语命名恢复的神经生物学，Swathi Kiran（波士顿大学）和大卫卡普兰（哈佛，MGH）;子项目2。获得性书写困难中书面命名恢复的神经生物学，布伦达·拉普（约翰霍普金斯）;和子项目3。在语法缺失中恢复句子处理的神经生物学，辛西娅·汤普森（西北）。结合专业人员的专业知识和努力，这个项目将使我们能够全面研究失语症的恢复。该方法的核心是一组常见的认知和神经成像指标，包括功能性磁共振成像（fMRI），结构和灌注成像以及弥散张量成像（DTI），我们将使用这些指标作为工具，在几个时间点识别，监测和评估认知脑变化，与治疗应用一致，并跨越一年的时间。跨项目数据将保存在集中的神经影像学和数据分析核心（核心B）中，由托德帕恩什（PI;西北大学神经物理学家）领导的神经影像学专家和统计学家专家团队使用最先进的神经影像学采集和分析方法进行分析。这将使我们能够检查旨在改善特定失语症语言缺陷的治疗效果，并回答有关语言和大脑变量之间的关系以及慢性失语症治疗诱导与自然恢复的问题。这项工作将极大地影响失语症患者的临床干预实践，提供与治疗效果和恢复预后相关的重要信息，并有助于了解大脑可塑性和成人大脑语言功能的重组。

DESCRIPTION (provided by applicant): This Clinical Research Center (P50) proposal is focused on providing a neuroimaging-based examination of language recovery in individuals with chronic aphasia resulting from stroke. The goal of the Center is to bring together the expertise of clinical investigators with mutual scientific interest and complementary expertise in understanding the cognitive and neural correlates of stroke-induced language recovery, the effects of language treatment on these processes, and cognitive and neural factors (biomarkers) of language/brain recovery. The proposal includes three subprojects, which examine language recovery in three language domains, with experts in each serving as PI: Subproject 1. The neurobiology of recovery of spoken naming in aphasia, Swathi Kiran (Boston University) and David Caplan (Harvard, MGH); Subproject 2. The neurobiology of recovery of written naming in acquired dysgraphia, Brenda Rapp (Johns Hopkins); and Subproject 3. The neurobiology of recovery of sentence processing in agrammatism, Cynthia Thompson (Northwestern). Combining the expertise and efforts of the PIs on this project will allow us to study aphasia recovery in a comprehensive manner. At the heart of the approach is a common set of cognitive and neuroimaging measures, including functional magnetic resonance imaging (fMRI), structural and perfusion imaging, and diffusion tensor imaging (DTI), which we will use as tools for identifying, monitoring and evaluating cognitive-brain changes at several time points, coinciding with treatment application and spanning a one-year period. Cross-project data will be deposited into a centralized Neuroimaging and Data Analysis Core (Core B) where they will be analyzed by an expert team of neuroimaging specialists and statisticians, led by Todd Parnsh (PI; neurophysicist at Northwestern), using state-of-the art neuroimaging acquisition and analysis methods. This will allow us to examine the effects of treatment designed to improve specific aphasic language deficits and to answer questions relevant to the relation between language and brain variables and treatment-induced versus natural recovery in chronic aphasia. The work will highly impact clinical intervention practices for individuals with aphasia, providing importan information relevant to the effects of treatment and prognosis for recovery, and contribute to knowledge about brain plasticity and the reorganization of language functions in the adult brain.