SimulScan: Simultaneous functional and dynamic MRI for evaluating swallowing across age and in neurogenic dysphagia

项目总结 吞咽困难，或吞咽困难，在美国每年影响900多万成年人，患有神经性疾病 中风和帕金森氏症(PD)等疾病是导致这种疾病的头号原因。 神经系统疾病中的吞咽困难与显著的负面结果有关，例如延长 住院、呼吸损害、抑郁、营养不良和死亡率。更好地理解 神经源性吞咽困难的中枢(神经)和生理/生物力学缺陷将使 通过改进对患者的识别和制定有针对性的 和个性化的治疗干预。目前尚不存在支持并发3D可视化的工具 吞噬生理/生物力学事件以及与之相关的功能性大脑活动 推动了这些活动。该项目将优化和验证一种新的多模式成像方法和 可视化和量化吞咽生理事件和脑功能的分析平台 用核磁共振成像吞咽。使用最新开发的FAST Dynamic框架 成像，将演示和验证一种技术，该技术将实现功能的全3D成像 同时吞咽解剖和脑功能成像。由此产生的方法将提供 前所未有的高空间和高时间分辨率的动态吞咽运动和 大脑活动与这一关键的生命维持功能相关，并有可能提供一种新的 最先进的神经源性吞咽困难的诊断和治疗结果工具。利用新的 多模式成像方法，我们将演示吞咽功能和吞咽功能变化的敏感性 通过检测一组年轻人(18-25岁)和老年人(60-85岁)的神经活动 健康的成年燕子和其他口咽部任务。然后，我们将建立 这一新方法鉴定神经源性吞咽困难表型的初步敏感性 中风和帕金森氏病(每种情况各60例)。这项技术将使确定 不同的动态运动和条件/疾病内和跨条件/疾病的功能障碍的MRI征象。 这一研究路线将产生重要的积极影响，因为它有改进的潜力 神经源性吞咽困难的特征，并为开始改善诊断提供基础 这种衰弱的疾病的准确性、预后和未来的治疗。

PROJECT SUMMARY Dysphagia, or difficulty swallowing, affects over 9 million adults in the US annually, with neurologic conditions, such as stroke and Parkinson’s disease (PD), being the number one cause of the disorder. Dysphagia in neurologic disease is associated with significant negative outcomes, such as prolonged hospitalization, respiratory compromise, depression, malnutrition, and mortality. A better understanding of both the central (neural) and physiological/biomechanical deficits seen in neurogenic dysphagia will enable better clinical management through improved identification of patients and the development of targeted and personalized therapeutic interventions. No current tools exist to enable the concurrent 3D visualization of swallowing physiological/biomechanical events along with the associated functional brain activity that drives those events. This project will optimize and validate a novel multimodal imaging method and analysis platform to visualize and quantify both swallowing physiology events and brain function during swallowing using magnetic resonance imaging. Using a recently-developed framework for fast dynamic imaging, a technique will be demonstrated and validated that will achieve full 3D imaging of the functional swallowing anatomy along with imaging of brain function, simultaneously. The resulting method will provide unprecedented high-spatial and high-temporal resolution images of the dynamic swallowing motions and the brain activity associated with this critical life-sustaining function and has the potential to offer a new state-of-the-art diagnostic and treatment outcome tool for neurogenic dysphagia. Utilizing the new multimodal imaging method, we will demonstrate the sensitivity to changes in swallowing function and neural activity by examining a group of young (aged 18-25 years old) and older (aged 60-85 years old) healthy adults performing incidental swallows and other oropharyngeal tasks. We will then establish the preliminary sensitivity of this new approach in identifying phenotypes of neurogenic dysphagia in patients with stroke and Parkinson’s disease (n=60 for each condition). The technique will enable the determination of differential dynamic motion and fMRI signatures of dysfunction within and across conditions/diseases. This line of research will have an important positive impact because it has the potential to improve neurogenic dysphagia characterization and to provide the foundation to start improving diagnostic accuracy, prognosis, and treatment of this debilitating condition in the future.