Bridging the gap between brain network science and high-definition non-invasive brain stimulation to develop a scalable adult literacy intervention

项目摘要 在美国，大约有4300万成年人难以理解基本文本。这是一个重大的公共卫生 考虑到阅读理解（RC）能力和广泛的健康之间的密切联系， 经济后果，包括美国与低识字率有关的每年3000多亿美元的经济负担。 尽管低RC普遍存在，但美国行为干预和国家统计数据的荟萃分析表明， 在过去的30年里，没有显示出显著的RC增益。这部分是由于行为的局限性。 的方法来描述复杂的过程中涉及的RC。大脑研究已经发现了更多的颗粒 RC/RC能力的机制。这包括我自己的研究，已经确定了大脑的通路， RC障碍中的行为弹性，即减轻RC障碍中严重症状的脑通路。 然而，迄今为止，大脑研究还无法将大脑网络科学应用于直接的临床益处。 当前提案的目标是通过整合最近的研究， 在两个独立领域取得突破：RC弹性脑网络科学和非侵入性脑网络 刺激.我已经建立了一个使用功能性核磁共振成像和脑电图来描述大脑特征的研究路线 RC能力和弹性的标志。我发现，跨网络沟通的阅读- 语言脑网络（RLN）和负责目标导向思维（认知控制）的脑网络 与网络内通信（例如，单独的RLN）相比，网络内通信（例如，CCN）更能预测RC结果。 这些结果反映了一系列疾病的发现，这些疾病将CCN与弹性联系起来，并提供了一个 大脑干预的有力目标。在一个单独的领域，脑刺激也看到了最近的 突破：使用EEG引导的，单独调整的完整网络刺激可恢复记忆 老年人的能力比刺激持续时间长，但这还没有应用到其他领域。拟议 该项目将利用RC脑网络科学和非侵入性脑刺激的最新进展 开发一种安全的基于大脑的遥控干预方案我假设推广跨网络 连接性将导致RC能力增加，特别是在低RC组中。在这个项目中，我将确定： 交叉与网络内刺激对读者的RC能力和大脑指标的因果影响（目标1）;如何 刺激结果与基线RC能力/大脑指标的个体差异相互作用（目标2）; 超越行为训练效果的刺激功效（目标3）。N = 225名RC能力良好和较差的成人 将在3次访视中进行测试：基线行为和fMRI/EEG指标的干预前访视;刺激 访视（随机化/受试者，用于交叉与网络内目标），包括行为和fMRI/EEG指标，以及 干预后访视，以测量延长的行为和fMRI/EEG效应。在刺激之前，受试者将 进行简短的RC干预。这种方法将使我们能够建立尖端刺激的功效 成人识字的方法，在一系列其他疾病的潜在应用。

PROJECT SUMMARY Approximately 43 million adults in the U.S. struggle to comprehend basic texts. This is a major public health crisis given the strong association between reading comprehension (RC) ability and broad health and economic outcomes, including more than 300 billion annual economic burden related to low literacy in the US. Despite the prevalence of low RC, meta-analyses of behavioral interventions and national statistics in the US reveal no significant RC gains over the past 30 years. This is due in part to limitations of behavioral approaches to characterize the complex processes involved in RC. Brain research has identified more granular mechanisms of RC/RC ability. This includes my own research that has identified brain pathways that promote behavioral resilience in RC disorders, i.e. brain pathways that mitigate severe symptoms in RC disorders. However, brain research has thus far been unable to apply brain network science for a direct, clinical benefit. The goal of the current proposal is to address the need for brain-based RC interventions by integrating recent breakthroughs in two separate fields: brain network science of RC resilience and non-invasive brain network stimulation. I have established a line of research that uses functional MRI and EEG to characterize brain signatures of RC ability and resilience. I have found that cross-network communication between the reading- language brain network (RLN) and a brain network responsible for goal-oriented thought (the cognitive control network; CCN) is more predictive of RC outcomes than within-network communication (e.g. RLN alone). These results mirror findings in a range of disorders that connect the CCN to resilience and provide a compelling target for brain intervention. In a separate field, brain stimulation has also seen a recent breakthrough: using EEG-guided, individually-tuned stimulation of full networks results in recovered memory capacity in older adults that outlasts stimulation, but this has not been applied to other domains. The proposed project will take advantage of recent advances in RC brain network science and non-invasive brain stimulation to develop a safe, brain-based RC intervention protocol. I hypothesize that promotion of cross-network connectivity will result in increased RC ability particularly in low RC groups. In this project, I will determine: the causal effects of cross- vs within-network stimulation on readers' RC ability and brain metrics (Aim 1); how stimulation outcomes interact with individual differences in baseline RC ability/brain metrics (Aim 2); and the efficacy of stimulation beyond behavioral training effects (Aim 3). N = 225 adults with good and poor RC ability will be tested across 3 visits: a pre-intervention visit for baseline behavior and fMRI/EEG metrics; a stimulation visits (randomized/subject for cross- vs. within-network targets) with behavior and fMRI/EEG metrics, and a post-intervention visit to measure prolonged behavior and fMRI/EEG effects. Before stimulation, subjects will receive a short RC intervention. This approach will allow us to establish the efficacy of cutting-edge stimulation approaches in adult literacy, with potential applications in a range of other disorders.