Data-Driven, Visual Framework for the Characterization of Aphasias Across Stroke, Post-resective, and Neurodegenerative Disorders Over Time.
Data-Driven, Visual Framework for the Characterization of Aphasias Across Stroke, Post-resective, and Neurodegenerative Disorders Over Time.
复制标题
DOI：
10.3389/fneur.2020.616764
复制
发表时间：
2020
影响因子：
3.4
通讯作者：
Chang EF
中科院分区：
文献类型：
--
作者：
Fan JM;Gorno-Tempini ML;Dronkers NF;Miller BL;Berger MS;Chang EF
失语症分类和专门的语言电池在神经退行性疾病和损伤性脑损伤领域不同，导致难以比较不同病因的语言缺陷。在这项研究中，我们提出了一个简化的框架，其中广泛使用的失语症电池捕获疾病病因的临床集群，并提供了一个定量和可视化的方法来表征和跟踪患者随时间的推移。该框架用于评估代表三种疾病病因的人群：卒中、原发性进行性失语（PPA）和术后失语。研究了三个人群共330例脑损伤导致失语的患者，包括76例卒中患者，107例符合PPA标准的患者和147例左半球切除术后患者。西方失语症成套测验（WAB）测量（信息内容，流畅性，回答是/否问题，听觉单词识别，顺序命令和重复）收集了三个人群，并进行分析，以开发一个多维失语症模型，使用降维技术。发现两个正交维度可以解释失语症表型和三种疾病病因之间87%的方差。第一个维度反映了失语症分项评分的共同权重，并与失语症严重程度相关。第二个维度包括流利性和理解，从而将韦尼克失语症与布罗卡失语症分开，并将非流利/语法性失语症与语义PPA变体分开。代表临床分类的聚类，包括晚期PPA表现，被保留在二维空间内。早期的PPA表现无法分类，因为需要专门的电池进行表型分析。纵向数据进一步用于可视化失语症在恢复或疾病进展期间的轨迹，包括术后失语症患者的快速恢复。这种方法对将失语症概念化为不同疾病病因的谱系障碍具有影响，并且可以作为跟踪失语症进展和恢复轨迹的框架。
Aphasia classifications and specialized language batteries differ across the fields of neurodegenerative disorders and lesional brain injuries, resulting in difficult comparisons of language deficits across etiologies. In this study, we present a simplified framework, in which a widely-used aphasia battery captures clinical clusters across disease etiologies and provides a quantitative and visual method to characterize and track patients over time. The framework is used to evaluate populations representing three disease etiologies: stroke, primary progressive aphasia (PPA), and post-operative aphasia. A total of 330 patients across three populations with cerebral injury leading to aphasia were investigated, including 76 patients with stroke, 107 patients meeting criteria for PPA, and 147 patients following left hemispheric resective surgery. Western Aphasia Battery (WAB) measures (Information Content, Fluency, answering Yes/No questions, Auditory Word Recognition, Sequential Commands, and Repetition) were collected across the three populations and analyzed to develop a multi-dimensional aphasia model using dimensionality reduction techniques. Two orthogonal dimensions were found to explain 87% of the variance across aphasia phenotypes and three disease etiologies. The first dimension reflects shared weighting across aphasia subscores and correlated with aphasia severity. The second dimension incorporates fluency and comprehension, thereby separating Wernicke's from Broca's aphasia, and the non-fluent/agrammatic from semantic PPA variants. Clusters representing clinical classifications, including late PPA presentations, were preserved within the two-dimensional space. Early PPA presentations were not classifiable, as specialized batteries are needed for phenotyping. Longitudinal data was further used to visualize the trajectory of aphasias during recovery or disease progression, including the rapid recovery of post-operative aphasic patients. This method has implications for the conceptualization of aphasia as a spectrum disorder across different disease etiology and may serve as a framework to track the trajectories of aphasia progression and recovery.
登录
查看更多内容
DOI：
10.1016/j.cortex.2018.08.002
发表时间：
2018-11
期刊：
Cortex; a journal devoted to the study of the nervous system and behavior
影响因子：
--
作者：
Mandelli ML;Welch AE;Vilaplana E;Watson C;Battistella G;Brown JA;Possin KL;Hubbard HI;Miller ZA;Henry ML;Marx GA;Santos-Santos MA;Bajorek LP;Fortea J;Boxer A;Rabinovici G;Lee S;Deleon J;Rosen HJ;Miller BL;Seeley WW;Gorno-Tempini ML
通讯作者：
Gorno-Tempini ML
影响因子：
4.8
作者：
Henry, Maya L.;Gorno-Tempini, Maria Luisa
通讯作者：
Gorno-Tempini, Maria Luisa
影响因子：
2.6
作者：
Jefferies, Elizabeth;Rogers, Timothy T.;Ralph, Matthew A. Lambon
通讯作者：
Ralph, Matthew A. Lambon
DOI：
10.1093/brain/awu286
发表时间：
2014-12
期刊：
Brain : a journal of neurology
影响因子：
--
作者：
Butler RA;Lambon Ralph MA;Woollams AM
通讯作者：
Woollams AM
影响因子：
14.5
作者：
Fridriksson, Julius;den Ouden, Dirk-Bart;Bonilha, Leonardo
通讯作者：
Bonilha, Leonardo