Neural correlates and recovery of naturalistic language production in aphasia

失语症自然语言产生的神经关联和恢复

• 批准号: 10679666
• 负责人: Marianne E Casilio
• 金额: $ 3.55万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10679666
• 关键词: Acute; Address; Agrammatism; Aphasia; Area; Auditory; Behavioral; Behavioral Model; Benchmarking; Biological Markers; Brain Injuries; Brain region; Brain scan; Caregivers; Characteristics; Clinical; Clinical Management; Communication impairment; Complex; Data; Deceleration; Dimensions; Dissociation; Education; Generations; Goals; Growth; Health; Human; Impairment; Individual; Knowledge; Language; Left; Lesion; Linear Models; Linear Regressions; Literature; Location; Longitudinal Studies; Maps; Measures; Mentorship; Methods; Modeling; Neuronal Plasticity; Non-linear Models; Outcome Measure; Patients; Pattern; Performance; Practice Management; Production; Prognosis; Provider; Psychometrics; Recovery; Rehabilitation therapy; Research; Research Personnel; Sampling; Semantics; Series; Severities; Speech; Stroke; Techniques; Time; advanced analytics; aphasia recovery; brain behavior; care coordination; clinically relevant; cognitive neuroscience; disability; improved; insight; language impairment; lexical; neural; neural correlate; neuroimaging; novel; outcome prediction; phonology; post stroke; prognostication; skills; sound; stroke recovery; tool; translational research program; vector

PROJECT SUMMARY/ABSTRACT Aphasia is a common and debilitating communication disorder caused by damage to the language regions of the brain, most often from stroke. Impairments in the production of naturalistic language (also referred to as discourse or connected speech) are ubiquitous in aphasia and cause significant health-related disability. Given how integral naturalistic language production is to all human interaction, advancing our understanding of impaired naturalistic language production in aphasia is of high priority for all key stakeholders: individuals with aphasia, clinicians, and researchers. Despite its importance, our understanding of naturalistic language production in aphasia is limited. Specifically, two key questions remain unanswered: (1) How do salient features (e.g., abandoned utterances, grammatical omissions, phonemic paraphasias) of impaired naturalistic language production map onto neural characteristics, such as lesion location or extent? (2) How do features change over time? Although emerging evidence has yielded promising insights, challenges related to both the measures used and the individuals studied are barriers to advancing our knowledge on these topics. The goal of the proposed project is to address the limitations in the current literature by leveraging a novel measure of naturalistic language production in aphasia and applying it to a large and ongoing longitudinal study (R01 DC013270) using advanced analytic techniques. Specifically, we will score naturalistic language samples from ~225 individuals with aphasia across four time points over the first year of stroke recovery using a psychometrically robust measure I developed called the Auditory-Perceptual Rating of Connected Speech in Aphasia (APROCSA). Scores on three core dimensions of impaired naturalistic language production will serve as outcome measures. In Aim 1, we will characterize the neural correlates of naturalistic language production in acute aphasia by building a series of complementary multiple linear and support vector regression models to evaluate relations between naturalistic language impairment and structural brain damage, where lesion-delineated brain scans will be used to predict performance on the three APROCSA dimensions. In Aim 2, we will quantify patterns and predictors of naturalistic language production recovery in aphasia by measuring (1) the trajectory of behavioral change on the three APROCSA dimensions and (2) the influence of lesion location and extent on change, using a powerful approach called latent growth curve modeling. The impact of the proposed project will be an explanatory brain-behavior model of naturalistic language production in aphasia that improves clinicians’ ability to develop prognoses, provide informed education, and benchmark performance on an everyday language skill. This proposal will also provide essential mentorship for developing a translational research program that applies tools from cognitive neuroscience and quantitative methods to the study of naturalistic language production and other clinically relevant areas in aphasia.

项目总结/摘要 失语症是一种常见的和衰弱的沟通障碍所造成的损害语言区域 最常见的是中风自然语言的产生障碍（也称为 话语或连接言语）在失语症中普遍存在，并导致严重的健康相关残疾。给定 自然主义的语言生产是如何整合到所有人类互动中的，推进了我们对 失语症中自然语言产生受损是所有关键利益相关者的高度优先事项： 失语症，临床医生和研究人员。 尽管它的重要性，我们对失语症的自然语言生产的理解是有限的。 具体来说，两个关键问题仍然没有答案：（1）显著特征（例如，废弃的言论， 语法遗漏，音素失语症）受损的自然语言生产映射到神经 特征，如病变位置或范围？(2)特征如何随时间变化？尽管新兴 证据已经产生了有希望的见解，与所使用的措施和个人有关的挑战 研究是我们在这些主题上推进知识的障碍。拟议项目的目标是 通过利用自然主义语言的新措施来解决当前文学的局限性 失语症的产生，并将其应用于一项大型和正在进行的纵向研究（R 01 DC 013270）， 先进的分析技术。具体来说，我们将对来自约225个个体的自然语言样本进行评分 在中风恢复的第一年，失语症患者在四个时间点上使用心理测量学上可靠的 我开发了一个名为失语症连接语音听觉感知评级（APROCSA）的方法。 受损的自然语言生产的三个核心维度的分数将作为结果的措施。 在目标1中，我们将描述急性失语症中自然语言产生的神经相关性， 建立一系列互补的多元线性和支持向量回归模型来评估关系 自然语言障碍和结构性脑损伤之间的联系， 将用于预测APROCSA三个维度的绩效。 在目标2中，我们将通过以下方式量化失语症中自然语言产生恢复的模式和预测因素： 衡量（1）行为变化在APROCSA三个方面的轨迹，以及（2） 病变的位置和程度的变化，使用一个强大的方法称为潜在的增长曲线建模。 该项目的影响将是一个自然语言的解释性大脑行为模型 失语症的生产，提高临床医生的能力，发展失语症，提供知情的教育， 日常语言技能的基准表现。该提案还将为以下人员提供必要的指导： 开发一个转化研究计划，应用认知神经科学和定量 自然语言产生的研究方法和失语症的其他临床相关领域。