Neurolinguistic Intervention and Cortical Stimulation in Agrammatic Aphasia

语法性失语症的神经语言干预和皮质刺激

• 批准号: 7642778
• 负责人: ROBERT M LEVY
• 金额: $ 22.88万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-05 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7642778
• 关键词: Aftercare; Agrammatism; Algorithms; Aphasia; Area; Behavior Therapy; Behavioral; Brain; Broca Aphasia; Complex; Comprehension; Data; Devices; Electrodes; Functional Imaging; Goals; Impairment; Implant; Implanted Electrodes; Individual; Intervention; Ischemic Stroke; Language; Language Tests; Language Therapy; Lead; Learning; Linguistics; Maintenance; Methods; Motor; Neuronal Plasticity; Neurons; Participant; Phase; Process; Production; Protocols documentation; Recovery; Research; Research Design; Research Personnel; Research Project Grants; Speech; Stroke; Time; Training; Work; base; improved; innovation; insight; language processing; language training; lexical retrieval; multidisciplinary; neurophysiology; neurosurgery; novel; novel strategies; phonology; post stroke; programs; public health relevance; syntax; treatment effect

DESCRIPTION (provided by applicant): The goal of this project is to investigate how linguistically grounded intensive language treatment for individuals with aphasia after stroke can be enhanced by cortical stimulation, performed with implanted electrodes. We hypothesize that cortical stimulation, administered during intensive behavioral language treatment, will strengthen and sustain learning effects. Many speakers with Broca's aphasia present with agrammatism, i.e. difficulty with comprehending and producing sentences, particularly sentences with complex syntax. Research into behavioral treatment for aphasia is progressively leading to more refined methods of intervention. However, although language improvement in speakers with aphasia can still be shown many years after their stroke, there does seem to be a natural, neurophysiological boundary as to what is possible to achieve with behavioral therapy alone. In the current research project, therefore, we will assess the potential to enhance and sustain the beneficial effects of language treatment, by stimulating core brain areas that are known to potentially support language processing of the kind that is trained, simultaneous to behavioral intervention. We expect a program of intensive and focal language treatment, in combination with cortical stimulation of crucial language areas, to lead to significant and long-lasting improvement of language functions in agrammatic aphasia, in excess of the improvement seen after treatment without cortical stimulation. This novel research brings together a multidisciplinary team of established researchers in the areas of neurosurgery and cortical stimulation, neurophysiology, neurolinguistics and treatment for aphasia and holds promise to enhance language recovery in aphasia, raising the existing cap on language improvement in aphasia. Ten participants with agrammatic aphasia will receive 64 sessions of intense language treatment, focused on sentence building processes and grammatical markers. Prior to the treatment phase, five of these participants will be implanted with a cortical stimulation device, which will be switched on during language behavioral treatment. Functional imaging studies are used to determine optimal implant localization, as well as to investigate effects of treatment and stimulation on neural plasticity. An extensive battery of language tests will be used to assess treatment effects and their maintenance in the two subject groups. PUBLIC HEALTH RELEVANCE: If the project is successful, it will lay the groundwork for a truly new approach to aphasia treatment. This approach targets the physical cause of the language impairment, namely, damage to neuronal networks involved in language processing and production, through direct cortical stimulation in combination with language therapy.

描述(申请人提供)：这个项目的目标是调查如何通过植入电极的皮质刺激来加强中风后失语症患者的语言强化治疗。我们假设，在强化行为语言治疗期间给予皮质刺激，将加强和维持学习效果。许多患有Broca‘s失语症的人表现出语法错误，即理解和产生句子的困难，特别是复杂句法的句子。对失语症的行为治疗的研究正在逐步导致更精细的干预方法。然而，尽管失语症患者的语言能力在中风多年后仍有改善，但单靠行为疗法的效果似乎确实存在一个自然的、神经生理学的边界。因此，在目前的研究项目中，我们将评估通过刺激大脑核心区域来增强和维持语言治疗的有益效果的潜力，这些区域被认为可能支持接受过训练的那种语言处理，同时进行行为干预。我们预计，强化和集中语言治疗的计划，结合关键语言区域的皮质刺激，将导致失语症患者语言功能的显著和长期改善，超过在没有皮质刺激的治疗后的改善。这项新颖的研究汇集了一支由神经外科和皮质刺激、神经生理学、神经语言学和失语症治疗领域的知名研究人员组成的多学科团队，有望促进失语症的语言恢复，提高失语症语言改善的现有上限。10名患有失语症的参与者将接受的强化语言治疗，重点是造句过程和语法标记。在治疗阶段之前，这些参与者中的五人将被植入皮质刺激设备，该设备将在语言行为治疗期间开启。功能成像研究用于确定最佳植入部位，以及研究治疗和刺激对神经可塑性的影响。将使用一系列广泛的语言测试来评估治疗效果及其在两个受试组中的维持情况。与公共卫生相关：如果该项目成功，它将为一种真正新的失语症治疗方法奠定基础。这种方法针对语言障碍的物理原因，即通过直接的皮质刺激和语言治疗相结合，对参与语言处理和产生的神经元网络造成的损害。