For 35 years I have worked on language acquisition, conducting behavioral studies of children learning their first languages and the mechanisms of learning that make children so skilled in language acquisition. I've recently become interested in the related question of developmental plasticity in recovery from brain injury. I spent 2011-12 as a visitor to Georgetown University Medical Center (GUMC) and the National Rehabilitation Hospital (NRH), where I observed adult and child stroke patients and fMRI studies of language reorganization in epilepsy. I found this work completely gripping and am now refocusing my research on stroke recovery in children. In July 2012 I accepted a faculty position at Georgetown University as Director of a Center for Brain Plasticity and Recovery and have been starting to do research on pediatric stroke recovery. I am applying for a K18 award to provide myself with time over the next 2 years to enhance my research skills in studying the organization of language after childhood stroke, through a comprehensive and well- structured training and research plan under the direction of the outstanding mentors and consultants available to me at GUMC, NRH, and CNMC. I have already done extensive clinical observation. My training plan includes coursework, individual meetings, directed readings, and research training on using neuropsychological, fMRI, and DTI techniques to understand neural mechanisms of reorganization of language in children after perinatal stroke. My mentors will be Dr. Alexander Dromerick (adult stroke recovery, patient recruiting and research) and Dr. William Gaillard (fMRI research on child language reorganization after brain injury), with a team that will train me on adult aphasia and recovery (Dr. Peter Turkeltaub), pediatric stroke (Dr. Jessica Carpenter), functional imaging (Dr. John VanMeter), neuropsychological assessment (Dr. Madison Berl), and advanced techniques in analysis of patient and stroke imaging (Dr. Peter Turkeltaub) and in connectivity analyses (Dr. Chandan Vaidya). I will attend a course on fMRI and an advanced fMRI workshop and attend a semester-long course at GUMC providing advanced training in responsible conduct in research. I will also conduct a research study on language in children who have had a left hemisphere perinatal stroke. This project will focus on older children, many years after stroke, using fMRI, DTI, and behavioral techniques to examine the patterns and principles of how language is organized in the brain after stroke. The ultimate aim of this work is to improve stroke recovery in children and adults by understanding successful language organization in children. While this long-term goal is beyond the scope of the present proposal, the proposed training will be crucial in allowing me to proceed on to independent research in this new field.
Both children and adults can experience strokes that damage crucial portions of the brain, producing impairments of motor abilities, language, and cognition. After a career of studying the normal processes of language acquisition, I am now beginning research on recovery and development of language after stroke in children. The aim of my research is to understand the principles constraining the organization of language in the brain by examining variation in language organization that occurs in children after perinatal stroke, a rare brain injury that can help to reveal the limits of early developmental plasticity. Understanding these principles can allow us to develop new treatments to stimulate stroke recovery in adults as well as children. In order to do this work I need two years of training in brain imaging techniques, particularly in patient populations, which will then enable me to continue my research as an independent investigator in this new field.
