Neural Predictors of Recovery from Auditory Comprehension Deficits in Aphasia

 描述(由申请人提供)： 许多类型的脑损伤，特别是中风，都会导致严重的语言障碍。许多患有失语症的退伍军人在与他们交谈时会有一定程度的语言理解困难，这影响了他们的沟通能力。一些人随着时间的推移恢复了他们的听觉理解技能，而另一些人则没有。到目前为止，对于为什么会发生这种情况，还没有明确的解释，这使得临床医生很难向他们的患者和家人提供一个具体的预后，即可以预期的语言恢复程度。这项拟议的研究将研究与听觉理解障碍恢复相关的神经因素。新的神经成像技术将检查影响康复的大脑结构，特别是连接皮质区域的纤维路径。对这些纤维束的损害将用最新的扩散成像进行评估，以可视化和量化个别纤维束的损害。45名有听觉理解障碍的老式失语症患者将在中风后1个月和12个月进行评估，以跟踪理解障碍的程度和恢复过程。在发病后1个月和12个月还将进行结构磁共振成像(MRI)，以评估皮质区域的损害程度以及这种损害是否可以预测康复。同样在同一时间间隔获得的高角分辨率扩散成像(HARDI)将量化单个白质通路的损害程度，而纤维束成像将提供每个患者每个纤维束的视觉确认。最后，将在1个月和12个月测量白质完整性，以评估在恢复期纤维通路中发生的变化。拟议的项目将审查尚未充分探索的复苏的几个方面。凭借我们在失语症和神经成像方面的专业知识，以及我们成功地使用Hardi纤维束成像技术来全面描述白质通路的损伤程度，我们处于独特的地位来开展这项创新研究。该项目将产生的信息可以 直接影响患者护理；临床医生将拥有更准确的信息来指导 他们的治疗方法，并更好地告知退伍军人和照顾者如何规划他们的未来。

 DESCRIPTION (provided by applicant): Many types of brain injuries, particularly stroke, can result in serious language impairment. Many veterans with "aphasia" have some degree of difficulty understanding language when they are spoken to, which affects their ability to communicate. Some recover their auditory comprehension skills over time, while some do not. To date, there is no clear-cut explanation as to why this occurs, making it difficult for clinicians to offer a concrete prognosis to their patiets and family members as to the degree of language recovery that can be expected. The proposed study will examine the neural factors associated with recovery from auditory comprehension impairment. Novel neuroimaging techniques will examine the brain structures that affect recovery, particularly the fiber pathways that connect cortical regions to each other. Damage to these fiber tracts will be assessed with the latest in diffusion imaging to visualize and quantify the damage in individual tracts. 45 veteran aphasic patients with auditory comprehension deficits will be assessed at 1 and 12 months post- onset of their stroke to track the degree of comprehension impairment and the course of its recovery. Structural magnetic resonance imaging (MRI) will also be performed at 1 and 12 months post-onset to assess the extent of the damage to cortical areas and whether this damage can predict recovery. High angular resolution diffusion imaging (HARDI), also obtained at the same time intervals, will quantify the extent of the damage to individual white matter pathways, while tractography will provide visual confirmation of each fiber tract in each patient. Finally, white matter integrity will be measured t 1 and 12 months to assess the changes that occur in fiber pathways during the recovery period. The proposed project will examine several aspects of recovery that have not been fully explored. With our expertise in aphasia and neuroimaging and our success in using HARDI tractography to characterize the full extent of the damage in white matter pathways, we are in a unique position to carry out this innovative research. This project will yield information that can directly influence patient care; clinicians will have more accurate information with which to guide their treatment approach, and better inform veterans and caregivers as to how to plan their futures.