Concurrent Validity, Test-Retest Reliability, and Sensitivity to Change of Functional Near-Infrared Spectroscopy for Measuring Language-Related Brain Activity in Post-Stroke Aphasia

功能性近红外光谱测量中风后失语症语言相关大脑活动的同时有效性、重测可靠性和敏感性

• 批准号: 10709585
• 负责人: Jeffrey P Johnson
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-10-01 至 2027-09-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10709585
• 关键词: Acceleration; Achievement; Address; Adjuvant; Affect; Aftercare; American; Anatomy; Aphasia; Auditory; Award; Behavioral; Behavioral Research; Brain; Brain imaging; Chronic; Claustrophobias; Clinic; Clinical; Clinical Treatment; Clinical Trials; Clinical Trials Design; Cognitive; Communication; Cross-Sectional Studies; Data; Development; Education; Elderly; Electroencephalography; Environment; Exclusion; Foundations; Functional Magnetic Resonance Imaging; Future; General Population; Generations; Geriatrics; Goals; Healthcare Systems; Hemoglobin concentration result; Home; Impairment; Individual; Injury; Intervention; Language; Language Disorders; Language Therapy; Linear Regressions; Linguistics; Literature; Maps; Measures; Medical Device; Mentorship; Metals; Methods; Modality; Modeling; Modernization; Names; National Institute on Deafness and Other Communication Disorders; Neurophysiology - biologic function; Participant; Penetration; Persons; Physiological; Population; Prevalence; Protocols documentation; Quality of life; Recording of previous events; Recovery; Rehabilitation therapy; Research; Research Activity; Resolution; Retrieval; Scanning; Science; Scientist; Semantics; Signal Transduction; Sorting; Speech; Speech Pathologist; Stroke; Structure; System; Task Performances; Technology; Testing; Therapeutic; Time; Training; Training Activity; Treatment outcome; United States National Institutes of Health; Universities; Veterans; aphasia recovery; aphasia rehabilitation; broadening participation research; career; clinical care; clinical center; clinically relevant; cost; efficacious treatment; experience; functional MRI scan; functional independence; functional magnetic resonance imaging/electroencephalography; functional near infrared spectroscopy; health related quality of life; improved; interest; language processing; medical implant; neurofeedback; neuroimaging; neurophysiology; neurotransmission; novel; phonology; portability; post stroke; prognostic; programs; response; service delivery; statistics; stroke-induced aphasia; theories; therapy development; tool

More than 2.5 million people in the U.S. have aphasia, a language disorder most often caused by stroke that dramatically affects an individual’s functional independence and quality of life. For several decades, fMRI has critically advanced aphasia research, but it has notable limitations. For example, individuals with conditions that affect many Veterans (e.g., implanted medical devices or a history of injury involving metal) cannot safely be scanned. These individuals have therefore been systematically excluded from fMRI studies of aphasia. Additionally, fMRI is conducted in a noisy, restrictive environment, necessitating the use of artificial experimental paradigms that may not engage the full range of anatomical and physiological mechanisms supporting real-world language and communicative function. In contrast to fMRI, functional near-infrared spectroscopy (fNIRS) has few contraindications, is silent, inexpensive, and can be administered in a standard clinic room with naturalistic language paradigms. Despite these advantages, fNIRS has rarely been used to study aphasia, likely due to a lack of data validating it as compared to fMRI in this specific population. This study will address critical gaps in the evidence that would support fNIRS’ use by investigating its correlation with fMRI for language mapping (Aim 1), its test-retest reliability (Aim 2), and its sensitivity to changes in brain function due to behavioral language treatment (Aim 3) in people with chronic post-stroke aphasia. In part A of this study, 24 people with chronic aphasia (PWA) will be scanned twice over a 3-week interval with both fNIRS and fMRI while performing three language tasks: picture naming and semantic and phonological matching. Concurrent validity will be established by correlating language activation measured by fNIRS with that of fMRI. fNIRS’ test-retest reliability will be assessed by computing intraclass correlation coefficients across the first and second fNIRS scans, with comparable comparisons of the fMRI scans. Twenty- four healthy older adults will complete the same protocols to inform interpretations of the results in PWA. In part B, 12 PWA will complete fNIRS and fMRI scans during language tasks before and after three weeks of intensive language therapy, administered as part of a separate clinical trial of treatment for word-retrieval impairments. Comparisons between pre- and post-treatment fNIRS and fMRI scans will be used to assess fNIRS’ sensitivity to change after intervention, relative to that of fMRI. Behavioral research activities (including intensive language therapy) will be conducted at the VA Pittsburgh Healthcare System (VAPHS). fMRI and fNIRS will be performed at the CMU-Pitt Brain Imaging Data Generation & Education Center and the Brain and Auditory Sciences Research Initiative at the University of Pittsburgh, respectively. The results of this study will help determine the viability of fNIRS for measuring language functions in post-stroke aphasia and may provide a foundation for increased use of fNIRS in aphasia research, broadening participation in neuroimaging studies and increasing the generalizability of their findings. The results may also support the development of novel uses for fNIRS, such as measuring brain responses during everyday language use or aphasia treatment, and using real-time neurofeedback as an adjuvant to behavioral aphasia therapy. The applicant is a VA CDA-1 awardee, research and clinical speech pathologist, and former Advanced Geriatrics Fellow in the Geriatric Research, Education, and Clinical Center at VAPHS, with experience in aphasia rehabilitation and fMRI. During the CDA-2, mentorship and structured training activities in advanced neuroimaging/fNIRS methods, advanced statistics, Bayesian adaptive clinical trials design, and validity theory will facilitate execution and completion of the project and achievement of the applicant’s career goals. These goals include completing a CDA-2 and becoming an independent VA clinician-scientist supported by VA Merit Review and NIH/NIDCD award mechanisms, with a research program focused on improving service delivery and maximizing treatment outcomes for Veterans and others with aphasia.

在美国，超过250万人患有失语症，这是一种最常见的由中风引起的语言障碍， 严重影响个人的功能独立性和生活质量。几十年来，功能磁共振成像已经 失语症的研究取得了很大进展，但也有明显的局限性。例如，有条件的个人 影响许多退伍军人（例如，植入的医疗器械或涉及金属的损伤史）不能安全地 被扫描。因此，这些人被系统地排除在失语症的fMRI研究之外。 此外，功能磁共振成像是在嘈杂，限制性的环境中进行的，需要使用人工 实验范式可能不涉及解剖和生理机制的全部范围 支持真实世界的语言和交际功能。与功能性磁共振成像相比，功能性近红外成像 光谱法（fNIRS）禁忌症少，无噪音，便宜，可以在标准的管理 自然主义语言范例的诊所房间。尽管有这些优点，fNIRS很少用于 研究失语症，可能是由于缺乏数据验证它相比，功能磁共振成像在这个特定的人群。这 这项研究将通过调查fNIRS的相关性来解决支持fNIRS使用的证据中的关键差距 功能磁共振成像语言映射（目标1），其重测信度（目标2），其敏感性的变化， 脑功能由于行为语言治疗（目标3）的人与慢性中风后失语症。 在这项研究的A部分，24名慢性失语症（PWA）患者将在3周内接受两次扫描 同时进行三种语言任务：图片命名和语义， 语音匹配同时有效性将建立相关的语言激活测量， fNIRS和fMRI的结果。fNIRS的重测信度将通过计算组内相关来评估 第一次和第二次fNIRS扫描的系数，与fMRI扫描的可比比较。二十- 四名健康的老年人将完成相同的协议，以告知PWA结果的解释。在 部分B，12 PWA将在三周之前和之后的语言任务中完成fNIRS和fMRI扫描， 强化语言治疗，作为单词检索治疗的单独临床试验的一部分 损伤治疗前和治疗后fNIRS和fMRI扫描之间的比较将用于评估 fNIRS对干预后变化的敏感性，相对于fMRI。行为研究活动（包括 强化语言治疗）将在VA匹兹堡医疗保健系统（VAPHS）进行。fMRI和 fNIRS将在CMU-Pitt脑成像数据生成与教育中心和脑 和匹兹堡大学的听觉科学研究计划。 这项研究的结果将有助于确定fNIRS测量语言功能的可行性， 中风后失语症，并可能提供一个基础，增加使用fNIRS在失语症的研究，扩大 参与神经影像学研究，并增加其发现的普遍性。结果还可能 支持开发fNIRS的新用途，例如测量日常语言中的大脑反应 使用或失语症治疗，并使用实时神经反馈作为行为失语症治疗的辅助手段。 申请人是VA CDA-1获奖者，研究和临床语言病理学家，前高级 VAPHS老年医学研究、教育和临床中心的老年医学研究员， 失语症康复和功能磁共振成像。在CDA-2期间， 神经影像学/fNIRS方法，高级统计学，贝叶斯适应性临床试验设计和有效性理论 将促进项目的执行和完成，并实现申请人的职业目标。这些 目标包括完成CDA-2并成为VA Merit支持的独立VA临床医生-科学家 审查和NIH/NIDCD奖励机制，研究计划侧重于改善服务提供 最大化退伍军人和其他失语症患者的治疗效果。