Neural Bases of Vocal Sensorimotor Impairment

项目摘要/摘要 失语症是左半球中风的常见和破坏性影响，是最使人虚弱的疾病之一。 以言语/语言产生和理解缺陷为特征的交流障碍。根据 到国家神经疾病和中风研究所(NINDS)，大约有100万人在 美国人患有失语症。随着预期寿命的延长和生命的挽救，这一数字预计还会上升 急性卒中的治疗程序可降低死亡率。虽然言语疗法可以改善患者的沟通能力 失语症，大多数慢性中风患者永远不会完全康复，留下终身残疾，有些人只 体验到极小的交际功能回报。因此，一个主要的公共卫生需求是确定 生物标志物，为失语症的靶向治疗和改善其长期结果提供信息。一个主要缺点 目前现有的治疗方法的主要特点是它们主要侧重于增强结果衡量标准。 相关的发声运动产生，而不考虑感觉反馈中的靶向缺陷 和/或感觉运动整合机制可显著提高治疗效率和效果。 因此，完善治疗策略的关键一步是开发能够探测 卒中失语症患者发声感觉运动机制的完整性并确定其功能受损。 这项拟议的项目意义重大，因为它向检查受损的生物标志物迈出了关键的一步。 卒中后失语患者的发声感觉运动功能，尤其注重了解其作用 声音交流中的听觉反馈机制。中心假设是不同的模式 脑损伤和音频-发声网络内的连接减弱导致患者特有的损伤 前馈运动、感觉反馈和/或感觉运动整合机制。主要目标是 结合包括改变的听觉反馈(AAF)的行为生物标记物的多模式测量， 病变解剖、白质纤维束成像、功能神经成像(MRI)和神经生理学(EEG/ERP) 建立检测中风患者发声感觉运动功能受损的综合计算模型的数据 失语症患者。我们还致力于使用创新的视觉反馈培训模式来提供 通过视觉通道的第二感觉信息来源，以改善听觉-声音整合功能 失语症患者。视觉反馈训练范例的验证将为 开发针对患者特定发声功能缺陷的个体化靶向治疗 沟通。这项研究的长期目标是确定来源和方式(运动、感觉、 和/或感觉运动)来为临床医生提供关于如何微调的信息 他们的策略是最大限度地提高长期治疗结果，改善沟通功能和 失语症患者的生活质量。这项拟议的研究与美国国立卫生研究院的任务相关 与发展有助于减轻人类残疾负担的基础知识有关的。

Project Summary/Abstract Aphasia is a common and devastating effect of left hemisphere stroke and is one of the most debilitating communication disorders characterized by speech/language production and comprehension deficits. According to the National Institute of Neurological Disorders and Stroke (NINDS), approximately one million individuals in the U.S. suffer from aphasia. This number is anticipated to rise as life expectancy increases and life-saving procedures in acute stroke decrease mortality rates. Although speech therapy can improve communication in aphasia, most patients with chronic stroke never fully recover and are left with life-long disability and some only experience very minimal return of communicative function. Therefore, a major public health need is to identify biomarkers to inform targeted treatment and improve its long-term outcomes in aphasia. A major shortcoming of currently existing treatment approaches is that they primarily focus on enhancing the outcome measures associated vocal motor production, without taking into account that targeting deficits in sensory feedback and/or sensorimotor integration mechanisms may significantly increase treatment efficiency and effectiveness. Therefore, a key step toward refining treatment strategies is to develop objective biomarkers that can probe the integrity of vocal sensorimotor mechanisms and identify their impaired function in stroke patients with aphasia. This proposed project is significant in that it takes a key step toward examining the biomarkers of impaired vocal sensorimotor function in patients with post-stroke aphasia, with particular focus on understanding the role of auditory feedback mechanisms in vocal communication. The central hypothesis is that distinct patterns of brain damage and diminished connectivity within the audio-vocal networks leads to patient-specific impairment of feedforward motor, sensory feedback, and/or sensorimotor integration mechanisms. The main objective is to incorporate multi-modality measures including the behavioral biomarkers of altered auditory feedback (AAF), lesion anatomy, white matter tractography, functional neuroimaging (MRI), and neurophysiological (EEG/ERP) data to build integrative computational models for examining impaired vocal sensorimotor function in stroke patients with aphasia. We also aim to use an innovative visual feedback training paradigm to provide a secondary source of sensory information via the visual modality to improve audio-vocal integration function in patients with aphasia. The validation of the visual feedback training paradigm will pave the way toward developing individually tailored targeted therapies that focus on patient-specific functional deficits for vocal communication. The long-term goal of this research is to identify the source and modality (motor, sensory, and/or sensorimotor) of vocal communication deficits to provide information for clinicians on how to fine-tune their strategies to maximize the long-term treatment outcomes and improve the communicative function and quality of life in patients suffering from aphasia. This proposed research is relevant to the NIH’s mission pertaining to developing fundamental knowledge that will help to reduce the burdens of human disability.