One goal of the Healthy People 2010 program is to reduce health disparities across different segments of the population. Diagnosis and treatment of language deficits in patients with chronic aphasia is one area where disparities continue to exist even though this topic is of great theoretical and clinical significance. The current research on this topic, however, lacks specific recommendations on what language therapies have the potential to facilitate maximal language recovery in individuals with stroke and more importantly, the neural mechanisms that underlie such plasticity changes. This grant proposal extends the PI's previous work in monolingual aphasia rehabilitation to utilizing advanced functional neuroimaging techniques to better understand the mechanisms involved in language recovery in patients who receive theoretically motivated language therapy.
The aim of this K18 mentored grant proposal is for the candidate to learn (a) detailed structural lesion analysis techniques, (b) state of the art fMRI data analysis techniques specific to stroke populations, and (c) MEG/EEG experimentation and analysis methods to examine effective connectivity changes subsequent to rehabilitation. These techniques will be implemented in a small scale project involving ten patients with aphasia who will participate in a ten week structured naming therapy program and will undergo pre and post therapy structural T1, functional MRI, and MEG/EEG experiments. At the end of this project, the candidate will be successful at utilizing an integrated set of tools that will ultimately allow a detailed, anatomically grounded characterization of the psycholinguistic, structural and functional basis of language recovery in chronic stroke survivors. The proposed work is also clinically important because it has the potential to define future health care practice in chronic stroke management.
This training plan will integrate three complementary advanced neuroimaging techniques to examine the effect of language therapy on language recovery in individuals with post stroke aphasia who have naming deficits. The proposed work is important because it has the potential to define future health care practice in chronic stroke management. Better therapies will be developed if we understand how the brain is capable of recovering subsequent to a stroke and conversely, we will be able to characterize brain plasticity mechanism more reliably if we are confident about the effectiveness of therapies that can improve language recovery in individuals with chronic aphasia.
