Neural Bases of Vocal Sensorimotor Impairment in Aphasia

项目概要/摘要 失语症是左半球中风的常见和破坏性的影响，是最衰弱的一个 以言语/语言产生和理解缺陷为特征的交流障碍。根据 到国家神经疾病和中风研究所（NINDS），大约有一百万人在 美国人患有失语症随着预期寿命的增加和对生命的挽救， 急性中风的治疗可以降低死亡率。虽然语言治疗可以改善沟通， 失语症，大多数慢性脑卒中患者永远不会完全康复，留下终身残疾，有些只是 只有极少的交流功能。因此，一个主要的公共卫生需求是确定 生物标志物，以告知有针对性的治疗，并改善其在失语症的长期结果。一个重大缺陷 目前现有的治疗方法的一个重要特点是，它们主要侧重于增强结果测量 相关的发声运动产生，而不考虑到，针对缺陷的感觉反馈， 和/或感觉运动整合机制可以显著提高治疗效率和效果。 因此，完善治疗策略的关键一步是开发客观的生物标志物， 声音感觉运动机制的完整性，并确定其功能受损的中风失语症患者。 这项拟议的项目意义重大，因为它朝着检查受损的生物标志物迈出了关键一步。 卒中后失语症患者的发声感觉运动功能，特别关注理解 听觉反馈机制在声音交流中的作用。核心假设是， 脑损伤和听觉-声音网络内的连接性减弱导致患者特异性损害 前馈运动、感觉反馈和/或感觉运动整合机制。主要目标是 结合多模态测量，包括改变的听觉反馈（AAF）的行为生物标志物， 病变解剖、白色纤维束成像、功能性神经成像（MRI）和神经生理学（EEG/ERP） 数据建立综合计算模型，用于检查中风患者受损的发声感觉运动功能 失语症患者我们还旨在使用一种创新的视觉反馈训练范式， 通过视觉形式的感觉信息的第二来源，以改善听觉-声音整合功能， 失语症患者视觉反馈训练范式的验证将为 开发个性化定制的靶向治疗，专注于患者特定的发声功能缺陷， 通信这项研究的长期目标是确定来源和形式（运动，感觉， 和/或感觉运动）的声音沟通缺陷，为临床医生提供如何微调 他们的策略，以最大限度地提高长期治疗结果和改善沟通功能， 失语症患者的生活质量。这项拟议中的研究与NIH的使命有关 与发展有助于减轻人类残疾负担的基本知识有关。

Project Summary/Abstract Aphasia is a common and devastating effect of left hemisphere stroke and is one of the most debilitating communication disorders characterized by speech/language production and comprehension deficits. According to the National Institute of Neurological Disorders and Stroke (NINDS), approximately one million individuals in the U.S. suffer from aphasia. This number is anticipated to rise as life expectancy increases and life-saving procedures in acute stroke decrease mortality rates. Although speech therapy can improve communication in aphasia, most patients with chronic stroke never fully recover and are left with life-long disability and some only experience very minimal return of communicative function. Therefore, a major public health need is to identify biomarkers to inform targeted treatment and improve its long-term outcomes in aphasia. A major shortcoming of currently existing treatment approaches is that they primarily focus on enhancing the outcome measures associated vocal motor production, without taking into account that targeting deficits in sensory feedback and/or sensorimotor integration mechanisms may significantly increase treatment efficiency and effectiveness. Therefore, a key step toward refining treatment strategies is to develop objective biomarkers that can probe the integrity of vocal sensorimotor mechanisms and identify their impaired function in stroke patients with aphasia. This proposed project is significant in that it takes a key step toward examining the biomarkers of impaired vocal sensorimotor function in patients with post-stroke aphasia, with particular focus on understanding the role of auditory feedback mechanisms in vocal communication. The central hypothesis is that distinct patterns of brain damage and diminished connectivity within the audio-vocal networks leads to patient-specific impairment of feedforward motor, sensory feedback, and/or sensorimotor integration mechanisms. The main objective is to incorporate multi-modality measures including the behavioral biomarkers of altered auditory feedback (AAF), lesion anatomy, white matter tractography, functional neuroimaging (MRI), and neurophysiological (EEG/ERP) data to build integrative computational models for examining impaired vocal sensorimotor function in stroke patients with aphasia. We also aim to use an innovative visual feedback training paradigm to provide a secondary source of sensory information via the visual modality to improve audio-vocal integration function in patients with aphasia. The validation of the visual feedback training paradigm will pave the way toward developing individually tailored targeted therapies that focus on patient-specific functional deficits for vocal communication. The long-term goal of this research is to identify the source and modality (motor, sensory, and/or sensorimotor) of vocal communication deficits to provide information for clinicians on how to fine-tune their strategies to maximize the long-term treatment outcomes and improve the communicative function and quality of life in patients suffering from aphasia. This proposed research is relevant to the NIH’s mission pertaining to developing fundamental knowledge that will help to reduce the burdens of human disability.