Neural Mechanisms and Recovery of Language Production Deficits in Aphasia

失语症是脑损伤后的常见结果，通常会导致长期残疾和 生活质量下降。尤其是语言产生障碍，比如很难找到合适的词 或在句子中说话有问题，是失语症最常见的症状，并显著阻碍 沟通和社会参与。而一些有语言产出缺陷的人恢复得很好 在受伤后的第一年，其他人不会，这种结果的差异在很大程度上是不可预测的。许多 影响个体康复模式的因素之一是涉及不同的神经解剖学。 结构在由此产生的损伤和随后的恢复程度。令人惊讶的是，人们对此知之甚少 失语症患者语言产生缺陷的恢复过程中大脑结构的变化 初步证据表明，它们可能比传统使用的功能函数更好地预测复苏 改变措施。 拟议的纵向、多模式神经成像研究将探索患者的康复模式。 中风后患失语症的一大群人。通过结合一些新技术，我们将 调查大量的灰质和白质结构对语言恢复的贡献 生产赤字。50名失语症患者将在中风后1个月、3个月和12个月接受各种不同的测试 在单词、句子和语篇层面上的语言产生的衡量标准，以建立 性能和监控恢复不同阶段的变化。在相同的三个时间点， 参与者将接受结构磁共振和高角分辨率扩散成像(HARDI)以确定 病变部位、白质完整性以及灰质和白质随时间的变化。 这项研究的第一个主要目标是确定哪些受损的皮质区域和白质 在第一年中，语言产出的恢复会受到阻碍。第二个主要目标是 测量伴随观察的灰质形态计量学和白质完整性的神经元变化 行为改善。评估中风后第一年的不同时间段将使我们能够 梳理出在不同阶段预测、阻碍和支持语言恢复的神经指标。 拟议的项目将是第一次使用最先进的技术进行全面的纵向研究 探讨灰质区和白质束的可塑性及其对脑功能恢复的贡献。 在一整年的课程中学习不同的语言水平。最后，这项研究的结果将提供 对有助于语言能力成功恢复的因素的重要见解，并使临床医生能够 利用神经影像信息进行预后和最佳治疗的选择。

Aphasia is a common outcome following brain injury and often leads to long-term disability and diminished quality of life. Language production disorders in particular, such as difficulty finding the right word or problems speaking in sentences, are the most common symptoms of aphasia, and significantly hinder communication and social participation. While some people with language production deficits recover well during the first year after injury, others will not, and this discrepancy in outcomes is largely unpredictable. Many factors affect recovery patterns across individuals, one of which is the involvement of different neuroanatomical structures in the resulting impairment and subsequent degree of recovery. Surprisingly, little is known about structural changes in the brain accompanying recovery from language production deficits in aphasia, though preliminary evidence suggests they may be better predictors of recovery than traditionally-used functional change measures. The proposed longitudinal, multimodal neuroimaging study will explore the patterns of recovery in a large group of individuals with aphasia following stroke. By combining a number of novel techniques, we will investigate the contributions of numerous gray and white matter structures to the recovery of language production deficits. Fifty individuals with aphasia will be tested at 1-, 3- and 12-months post stroke on various measures of language production at the word, sentence and discourse level to establish baseline measures of performance and monitor changes across the different stages of recovery. At the same three time points, participants will undergo structural MRI and high angular resolution diffusion imaging (HARDI) to determine lesion site, white matter integrity, and changes in grey and white matter over time. The first main objective of the study is to determine which damaged cortical regions and white matter pathways impede recovery of language production throughout the first year. The second main objective is to measure neuronal changes in gray matter morphometry and white matter integrity that accompany observed behavioral improvement. Evaluating different time periods during the first year post-stroke will enable us to tease out neural indices predicting, impeding, and supporting language recovery at different stages. The proposed project will be the first comprehensive longitudinal study using state-of-the art techniques to examine plasticity within gray matter regions and white matter tracts and their contribution to recovery of different language levels over the course of one full year. In the end, the results of this study will provide important insights into factors contributing to successful recovery of language abilities and enable clinicians to utilize neuroimaging information in prognosis and selection of the most optimal treatments.