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.

项目概要/摘要 失语症是一种常见的、令人衰弱的沟通障碍，由语言区域受损引起 大脑的损伤，最常见的是中风。自然主义语言产生的障碍（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 自然主义语言的产生如何成为所有人类互动的一部分，促进我们对 失语症的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：患有失语症的个人 失语症、临床医生和研究人员。 尽管它很重要，但我们对失语症自然语言产生的理解仍然有限。 具体来说，有两个关键问题仍未得到解答：（1）显着特征（例如，废弃的话语、 自然语言产生受损的语法遗漏、音位性失语）映射到神经元上 特征，例如病变位置或范围？ (2) 特征如何随时间变化？虽然新兴 证据产生了有希望的见解，挑战与所使用的措施和个人有关 研究了提高我们在这些主题上的知识的障碍。拟议项目的目标是 通过利用自然主义语言的新方法来解决当前文献的局限性 失语症的生产并将其应用于一项大型且正在进行的纵向研究（R01 DC013270） 先进的分析技术。具体来说，我们将对来自约 225 个人的自然语言样本进行评分 使用心理测量稳健的方法，在中风恢复第一年的四个时间点出现失语症 我开发的测量方法称为失语症关联言语的听觉感知评级（APROCSA）。 自然语言产生受损的三个核心维度的分数将作为结果衡量标准。 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： 构建一系列互补的多重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，其中病变描绘的脑部扫描 将用于预测三个 APROCSA 维度的性能。 在目标 2 中，我们将通过以下方式量化失语症自然语言产生恢复的模式和预测因素： 测量 (1) 行为变化轨迹对 APROCSA 三个维度的影响，以及 (2) 使用称为潜在生长曲线建模的强大方法来确定病变位置和变化范围。 拟议项目的影响将是自然语言的解释性大脑行为模型 失语症的产生可提高临床医生制定预后、提供知情教育的能力，以及 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： 开发应用认知神经科学和定量工具的转化研究计划 研究失语症自然语言产生和其他临床相关领域的方法。