Neural Mechanisms and Recovery of Language Production Deficits in Aphasia

失语症语言产生缺陷的神经机制和恢复

• 批准号: 9368867
• 负责人: Nina F. Dronkers
• 金额: $ 42.99万
• 依托单位: EAST BAY INSTITUTE FOR RESEARCH AND EDUC
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-09 至 2018-06-01
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9368867
• 关键词: Affect; American; Aphasia; Area; Behavioral; Brain; Brain Injuries; Brain imaging; Brain region; Characteristics; Communication; Contralateral; Craniocerebral Trauma; Diffuse; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Evaluation; Exhibits; Fiber; Image; Imaging Device; Imaging Techniques; Impairment; Individual; Injury; Language; Language Disorders; Lesion; Longitudinal Studies; Magnetic Resonance Imaging; Measurable; Measurement; Measures; Modification; Monitor; Neurologic; Neurons; Outcome; Participant; Pathway interactions; Patients; Pattern; Performance; Play; Production; Quality of life; Recovery; Resolution; Site; Speech; Stroke; Structure; Symptoms; Techniques; Testing; Thick; Time; accurate diagnosis; aphasic; base; common symptom; density; disability; effective therapy; gray matter; indexing; insight; morphometry; multimodality; myelination; neuroimaging; neuromechanism; novel; outcome forecast; post stroke; prevent; reconstruction; relating to nervous system; skills; social engagement; time interval; tool; tractography; treatment strategy; white matter; white matter damage

Aphasia is a common outcome following brain injury and often leads to long-term disability and diminished quality of life. Language production disorders in particular, such as difficulty finding the right word or problems speaking in sentences, are the most common symptoms of aphasia, and significantly hinder communication and social participation. While some people with language production deficits recover well during the first year after injury, others will not, and this discrepancy in outcomes is largely unpredictable. Many factors affect recovery patterns across individuals, one of which is the involvement of different neuroanatomical structures in the resulting impairment and subsequent degree of recovery. Surprisingly, little is known about structural changes in the brain accompanying recovery from language production deficits in aphasia, though preliminary evidence suggests they may be better predictors of recovery than traditionally-used functional change measures. The proposed longitudinal, multimodal neuroimaging study will explore the patterns of recovery in a large group of individuals with aphasia following stroke. By combining a number of novel techniques, we will investigate the contributions of numerous gray and white matter structures to the recovery of language production deficits. Fifty individuals with aphasia will be tested at 1-, 3- and 12-months post stroke on various measures of language production at the word, sentence and discourse level to establish baseline measures of performance and monitor changes across the different stages of recovery. At the same three time points, participants will undergo structural MRI and high angular resolution diffusion imaging (HARDI) to determine lesion site, white matter integrity, and changes in grey and white matter over time. The first main objective of the study is to determine which damaged cortical regions and white matter pathways impede recovery of language production throughout the first year. The second main objective is to measure neuronal changes in gray matter morphometry and white matter integrity that accompany observed behavioral improvement. Evaluating different time periods during the first year post-stroke will enable us to tease out neural indices predicting, impeding, and supporting language recovery at different stages. The proposed project will be the first comprehensive longitudinal study using state-of-the art techniques to examine plasticity within gray matter regions and white matter tracts and their contribution to recovery of different language levels over the course of one full year. In the end, the results of this study will provide important insights into factors contributing to successful recovery of language abilities and enable clinicians to utilize neuroimaging information in prognosis and selection of the most optimal treatments.

失语症是脑损伤后的常见结果，通常会导致长期残疾， 生活质量下降。特别是语言产生障碍，例如难以找到正确的单词 或者说句子的问题，是失语症最常见的症状， 沟通和社会参与。虽然有些语言产生缺陷的人恢复得很好， 在受伤后的第一年，其他人不会，这种结果的差异在很大程度上是不可预测的。许多 影响个体恢复模式的因素之一是不同神经解剖结构的参与， 结构在所造成的损害和随后的恢复程度。令人惊讶的是， 然而，伴随失语症语言产生缺陷恢复的大脑结构变化， 初步证据表明，它们可能是比传统使用的功能更好的预测恢复 改变措施。 拟议的纵向，多模式神经影像学研究将探讨恢复的模式， 中风后出现失语症的一大群人。通过结合一些新的技术，我们将 研究大量的灰色和白色物质结构对语言恢复的贡献 生产赤字。50名失语症患者将在中风后1个月、3个月和12个月接受各种测试， 在单词、句子和语篇层面上衡量语言产出， 性能和监控不同恢复阶段的变化。在相同的三个时间点， 参与者将接受结构MRI和高角分辨率弥散成像（HARDI），以确定 病变部位、白色物质完整性以及灰质和白色物质随时间的变化。 这项研究的第一个主要目的是确定哪些受损的皮层区域和白色物质 在第一年中，通路阻碍语言产生的恢复。第二个主要目标是 测量观察到的灰质形态学和白色物质完整性的神经元变化 行为改善评估中风后第一年的不同时间段将使我们能够 梳理神经指标预测，阻碍和支持语言恢复在不同阶段。 拟议的项目将是第一个采用最先进技术的全面纵向研究 检查灰质区域和白色物质束的可塑性及其对恢复的贡献。 在一整年的时间里，不同的语言水平。最后，本研究的结果将提供 对成功恢复语言能力的因素的重要见解，并使临床医生能够 利用神经影像学信息进行预后和选择最佳治疗。