Neural correlates of recovery from aphasia after acute stroke

急性中风后失语恢复的神经相关性

• 批准号: 8758212
• 负责人: Stephen M Wilson
• 金额: $ 44.52万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8758212
• 关键词: Acquired Communication Disorders; Acute; Address; Affect; American; Aphasia; Area; Arteriogram; Behavior Therapy; Behavioral; Brain; Brain Injuries; Brain imaging; Brain region; Cell Death; Clinical; Communities; Consent; Contralateral; Data; Data Set; Diffusion Magnetic Resonance Imaging; Evaluation; Functional Imaging; Functional Magnetic Resonance Imaging; Goals; Hour; Image; Impairment; Individual; Infarction; Knowledge; Language; Left; Life; Longitudinal Studies; Machine Learning; Magnetic Resonance Imaging; Maps; Measures; Medical; Modality; Pathologist; Patients; Pattern; Perfusion; Physicians; Process; Protocols documentation; Recovery; Rehabilitation therapy; Reperfusion Therapy; Research; Resolution; Secure; Speech; Spin Labels; Staging; Stroke; Testing; Time; Tissues; acute stroke; aphasic; experience; hemodynamics; hypoperfusion; imaging modality; improved; language onset; language processing; neuroimaging; neuromechanism; outcome forecast; post stroke; prognostic; public health relevance; relating to nervous system; relational database; response; treatment planning; web based interface; white matter; white matter damage

DESCRIPTION (provided by applicant): The overall goal of this project is to identify the neural correlates of recovery from aphasia during the first three months after acute stroke. Aphasia is one of the most common and debilitating consequences of strokes affecting the dominant hemisphere. In the acute and subacute stages, most patients experience some degree of recovery of language function. These first few months after brain damage occurs are critically important because the greatest behavioral gains take place during this time, even when patients do not receive treatment. However the extent of recovery is highly variable: some patients recover most or nearly all language function, while others make few gains and remain chronically aphasic. It is not well understood what neural mechanisms underlie recovery during this period, nor why some patients recover so much better than others. To address these questions, we propose to study individuals with aphasia due to acute left hemisphere stroke. Patients will be examined at four time points after stroke: 24-48 hours, 2 weeks, 1 month, and 3 months. At each time point, a comprehensive yet time-efficient language evaluation will be administered to quantify expressive and receptive language function, and a multimodal brain imaging protocol will be implemented that includes structural imaging (MRI), functional imaging (fMRI), perfusion imaging (arterial spin labeling, ASL) and diffusion tensor imaging (DTI). The proposed research has two specific aims. The first is to identify the neural changes that are associated with successful recovery from aphasia in the acute and subacute periods after a stroke. The second aim is to determine the initial imaging and behavioral variables that are most predictive of the extent of eventual recovery of language function. We hypothesize that the inclusion of fMRI, ASL and DTI in combination with comprehensive language assessments will provide a more complete characterization of the brain's changing state than standard clinical imaging and language measures, and will explain a greater proportion of the variance in recovery patterns. A better understanding of the neural correlates of successful recovery will improve the accuracy of prognoses so as to better plan medical treatments and behavioral interventions.

描述（由申请人提供）：该项目的总体目标是在急性中风后的头三个月内确定从失语症中恢复的神经相关性。失语症是影响主要半球的中风的最常见和令人衰弱的后果之一。在急性和亚急性阶段，大多数患者的语言功能恢复了一定程度。脑损伤发生后的头几个月至关重要，因为即使患者未接受治疗，在这段时间内的行为收益最大。但是，恢复的程度是高度可变的：有些患者恢复了大多数或几乎所有语言的功能，而另一些患者的收益很少，并且长期失语。在此期间，尚不清楚哪些神经机制是康复的基础，也不是为什么有些患者康复得比其他患者康复得那么好。为了解决这些问题，我们建议研究因急性左半球中风而失语症的人。中风后四个时间点检查患者：24-48小时，2周，1个月和3个月。在每个时间点，将进行全面但耗时的语言评估，以量化表达和接受语言功能，并将实施包括结构成像（MRI），功能成像（FMRI），灌注成像，灌注成像（动脉旋转标记，ASL，ASL）和扩散Tensor Tensor Imaging（DTITI）的多模式脑成像协议。拟议的研究有两个具体的目标。首先是确定与中风后急性和亚急性期间成功恢复有关的神经变化。第二个目的是确定最终可以预测语言功能恢复程度的初始成像和行为变量。我们假设将fMRI，ASL和DTI与全面的语言评估结合在一起将提供比标准临床成像和语言度量的更完整的表征，并将解释恢复模式的差异比例更大。更好地了解成功恢复的神经相关性将提高预后的准确性，从而更好地计划医疗治疗和行为干预措施。