Functional Connectivity Correlates of Subacute to Early Chronic Post-Stroke Aphasia Recovery

项目摘要 失语症是一种获得性语言障碍，是一种常见的中风后疾病， 参与社交活动，参加首选活动，并经常在一段时间后重新获得高质量的生活 中风失语症的恢复通常在亚急性卒中后阶段（卒中后约2周至6个月）最大。 中风）由于神经可塑性（即，大脑功能和行为关系的重组）。然而， 亚急性失语症的恢复在个体之间差异很大，目前的预测模型基于 人口统计学和病变数据不能完全解释恢复的个体间变异性。卒中后早期 恢复预测可能会随着包含有关大脑网络功能的信息而改善， 目前对语言变化的功能连接相关性知之甚少， 失语症患者的亚急性期（PWA）。这项研究旨在解决这一差距。25个PWA在 亚急性期（进入研究时卒中发作后3个月）和25名神经典型对照将参加 提议的研究。在研究入组时，所有受试者将完成语言测试、静息状态功能测试、 红外光谱（rs-fNIRS）和结构MRI。PWA将在发病时再次完成检测和rs-fNIRS 早期慢性期（卒中后约6-8个月）。本研究将采用fNIRS技术对脑网络进行索引 功能，因为它是一种灵活的，便携式的功能磁共振成像的替代品，更容易为患者在早期中风后 阶段语言障碍将通过语义学和语音学，语言领域的措施来捕获 这是PWA中接受性和表达性语言缺陷的基础， 关于语言障碍的全球语言测量。通过三个研究目标，我们将确定 亚急性rs-fNIRS功能连接模式，（1）与亚急性语言缺陷相关，（2） 随着时间的推移而变化，并与纵向语言变化有关，（3）预测语言增益的早期 慢性中风期在所有目标中，我们预测，更强/增加的左半球内和半球间 连通性将与PWA中更好/改善的语言技能相关，与既往亚急性卒中一致 功能磁共振成像的工作。我们还假设，功能连接和语言之间的关系将是 空间定位于腹侧流区域的语义和背侧流区域的语音，一致 与现代语言神经生物学模型相结合。通过实现这些目标，该项目将推动我们的 了解在关键的亚急性到早期的语言过程中， 慢性中风后恢复期这项工作将为构建计算 在PWA中整合多模态脑功能和脑结构数据的恢复模型。整合这些 数据类型还将指导关于语言和非侵入性大脑的时间和类型的决定 刺激治疗患者应接受，以最大限度地提高他们的恢复在亚急性中风阶段。

Project Summary Aphasia, an acquired language disorder, is a common post-stroke condition that devastates patients’ ability to engage in social situations, participate in preferred activities, and often regain a high quality of life after a stroke. Aphasia recovery is often greatest during the subacute post-stroke phase (~ 2 weeks to 6 months post- stroke) due to neuroplasticity (i.e., reorganization of brain function and behavior relationships). Yet, the extent of subacute aphasia recovery varies widely between individuals, and current predictive models based on demographic and lesion data do not fully account for inter-individual variability in recovery. Early post-stroke recovery predictions are likely to improve with the inclusion of information about brain network function, yet very little is currently known about the functional connectivity correlates of language changes that occur over the subacute phase in people with aphasia (PWA). This research aims to address this gap. Twenty-five PWA in the subacute phase (£ 3 months post-stroke onset at study entry) and 25 neurotypical controls will participate in the proposed research. At study entry, all participants will complete language testing, resting-state functional Near- Infrared Spectroscopy (rs-fNIRS), and structural MRI. PWA will complete testing and rs-fNIRS again at the onset of the early chronic phase (~ 6-8 months post-stroke). fNIRS will be used in this research to index brain network function as it is a flexible, portable alternative to fMRI that is more accessible to patients in early post-stroke stages. Language impairments will be captured by measures of semantics and phonology, linguistic domains that underlie receptive and expressive language deficits in PWA and provide more specific information than global language measures regarding impairment locus. Through three study aims, we will determine the subacute rs-fNIRS functional connectivity patterns that (1) are associated with subacute language deficits, (2) change over time and are related to longitudinal language changes, and (3) predict language gains by the early chronic stroke stage. Across aims, we predict that stronger/increased left intra- and inter-hemispheric connectivity will be associated with better/improved language skills in PWA, consistent with prior subacute stroke fMRI work. We additionally hypothesize that relationships between functional connectivity and language will be spatially localized to ventral stream regions for semantics and dorsal stream regions for phonology, consistent with modern models of the neurobiology of language. By achieving these aims, this project will advance our understanding of the nature of beneficial neural reorganization of language during the crucial subacute to early chronic post-stroke recovery window. This line of work will provide a foundation for building computational recovery models that incorporate multimodal brain function and brain structure data in PWA. Integration of these types of data will also guide decisions regarding the timing and type of language and non-invasive brain stimulation therapies patients should receive to maximize their recovery during the subacute stroke phase.