TMS to explore interhemispheric interactions and to treat aphasia and neglect

该建议的中心目的是表征额叶的结构-功能关系， 语义，语音和形态语言处理，并应用这种理解的领域- 专门组织对失语症的治疗。第一个具体目标是检验假设， 左额下回在语言处理的不同领域存在解剖学差异。 将对正常受试者进行经颅磁刺激（TMS）， 表现，揭示语言域之间的分离。第二个目的是检验假设 左额叶语言区和相应的对侧大脑半球之间的相互作用 区域是特定于域的。正常受试者的TMS将阐明是否操纵右侧 半球影响形态、语音和语义加工。的解剖学假说 这项研究将在失语症受试者中进行进一步的测试，在他们的语言领域将在治疗前后进行评估。 每天10次右侧TMS。我们还将使用功能性磁共振成像（fMRI）， 进一步验证这些功能解剖学假设。该项目符合候选人的直接目标， 发展他对研究设计、心理测量、TMS和fMRI的熟练程度，并通过进一步提高他的 长期以来对大脑皮层可塑性的行为影响的兴趣。它推进了他的长期目标， 作为认知神经科学和神经学的独立研究者， 学术机构。宾夕法尼亚大学是追求这些目标的丰富环境， 功能神经影像中心（CfN）和认知神经科学中心（Center for Cognitive Neuroscience） （CCN）.候选人还将通过课程和方法来增加他的职业发展 通过大学提供的培训机会。最后，这项工作对健康的影响是深远的- 到达。失语症是一种常见的，往往是毁灭性的后果中风，影响约1 美国每年有100万患者，这个国家每年有8万新患者。TMS诱导特征- 对失语症恢复的特定作用可能为未来的治疗方法指明方向，包括 脑刺激，可能比目前的失语症治疗更有效， 患者的特殊语言缺陷。

The central aim of this proposal is characterize structure-function relationships in the frontal lobes related to semantic, phonologic, and morphologic language processing, and to apply this understanding of domain- specific organization to the treatment of aphasia. The first specific aim is to test the hypothesis that anatomical distinctions exist in the left inferior frontal gyrus for different domains of language processing. Transcranial magnetic stimulation (TMS) will be administered to normal subjects to disrupt subject performance, revealing dissociations between language domains. The second aim is to test the hypothesis that interhemispheric interactions between the left frontal language areas and homologous contralateral regions are domain-specific. TMS in normal subjects will elucidate whether manipulation of the right hemisphere influences morphologic, phonologic, and semantic processing. The anatomic hypotheses of the study will be tested further in aphasic subjects, in whom language domains will be assessed before and after 10 daily sessions of right-sided TMS. We will also use functional magnetic resonance imaging (fMRI) to further test these functional-anatomic hypotheses. This project meets the candidate's immediate goals by developing his proficiency with, study design, psychological measures, TMS, and fMRI, and by furthering his longstanding interest in the behavioral effects of cortical plasticity. It advances his long term goal of establishing a career as an independent investigator in cognitive neuroscience and neurology in an academic institution. The University of Pennsylvania is a rich environment for pursuing these goals, featuring resources such as the Center for Functional Neuroimaging (CfN) and the Center for Cognitive Neuroscience (CCN). The candidate will also augment his career development through coursework and methodologic training opportunities offered through the university. Finally, the health implications of this work are far- reaching. Aphasia is a common and often devastating consequence of strokes, affecting approximately 1 million patients in the United States and 80,000 new patients in this country annually. TMS-induced feature- specific effects on aphasia recovery could point the way toward future therapeutic approaches, including brain stimulation, that may be both more efficacious than current therapies for aphasia and which focus on patients' specific language deficits.