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

项目摘要 吞咽困难或吞咽困难，每年影响美国超过900万成年人，其中神经系统疾病 疾病，如中风和帕金森病（PD），是疾病的头号原因。 神经系统疾病中的吞咽困难与显著的负面结果相关，例如长期的 住院、呼吸系统损害、抑郁、营养不良和死亡率。更好地了解 在神经性吞咽困难中看到的中枢（神经）和生理/生物力学缺陷将使得 通过改进患者识别和制定有针对性的 和个性化的治疗干预。当前没有工具可用于启用并发3D可视化 吞咽生理/生物力学事件沿着相关的功能性大脑活动， 驱动这些事件。该项目将优化和验证一种新的多模态成像方法， 分析平台，以可视化和量化吞咽生理事件和脑功能， 吞咽使用磁共振成像。使用最近开发的快速动态框架 成像，将证明和验证一种技术，该技术将实现功能的全3D成像。 吞咽解剖沿着脑功能成像。所得到的方法将提供 前所未有的高空间和高时间分辨率的动态吞咽运动图像， 大脑活动与这一关键的生命维持功能有关，并有可能提供一个新的 神经性吞咽困难最先进的诊断和治疗结果工具。利用所述新的 多模态成像方法，我们将证明吞咽功能变化的敏感性， 通过检查一组年轻人（18-25岁）和老年人（60-85岁）的神经活动， 进行偶然吞咽和其他口咽任务的健康成年人。然后我们将建立 这种新方法在识别神经源性吞咽困难患者表型方面的初步敏感性 中风和帕金森病患者（每种情况n=60）。这项技术将使确定 差异动态运动和功能磁共振成像特征的功能障碍内和跨条件/疾病。 这一系列的研究将产生重要的积极影响，因为它有潜力改善 神经源性吞咽困难的表征，并提供基础，开始改善诊断 准确性、预后和未来对这种衰弱性疾病的治疗。

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.