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，是中风后常见的一种疾病，会破坏患者的能力 参与社交场合，参加自己喜欢的活动，并经常在一段时间后重新获得高质量的生活 卒中。失语症的恢复通常在亚急性卒中后阶段(~2周至6个月后)最大 中风)是由于神经可塑性(即大脑功能和行为关系的重组)所致。然而，在多大程度上 亚急性失语症的康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康复过程中个体间的差异。卒中后早期 随着大脑网络功能信息的加入，康复预测可能会有所改善，但非常 目前对语言变化的功能连通性相关性知之甚少 失语症患者的亚急性期。这项研究旨在解决这一差距。美国职业棒球大联盟25人 亚急性期(研究开始时卒中后3个月)和25名神经典型对照将参加 拟开展的研究。在研究进入时，所有参与者将完成语言测试，静息状态下的功能接近- 红外光谱(RS-fNIRS)和结构核磁共振。PWA将完成测试，并在开始时再次进行RS-fNIR 慢性期早期(卒中后6~8个月)。这项研究将使用fNIRS来索引大脑网络 功能，因为它是一种灵活、便携的替代功能磁共振成像，更容易为中风后早期患者 各阶段。语言障碍将通过语义、语音、语言领域的测量来捕捉 这是PWA接受性和表现性语言缺陷的基础，并提供了比 有关损害部位的全球语言衡量标准。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)与亚急性语言障碍相关；(2) 随着时间的推移而变化，并与语言的纵向变化有关；以及(3)通过早期预测语言习得 慢性卒中阶段。在AIMS上，我们预测更强/增加的左半球内和半球间 连通性将与PWA患者更好/更好的语言技能相关，与既往亚急性中风的情况一致 功能磁共振起作用了。我们还假设，功能连接性和语言之间的关系将是 空间定位到腹流区域用于语义，背流区域用于语音，一致 语言神经生物学的现代模型。通过实现这些目标，该项目将推进我们的 在关键的亚急性到早期的语言有益神经重组的本质的理解 慢性卒中后康复窗口。这项工作将为建立计算机化 在PWA中结合了多模式脑功能和脑结构数据的恢复模型。这些功能的整合 数据类型还将指导有关语言和非侵入性大脑的时间和类型的决策 在亚急性卒中阶段，患者应接受刺激治疗，以最大限度地恢复。

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.