Both functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) can be helpful in characterizing the neurophysiological status of patients with aphasia. Such measurements can be used to develop treatment approaches, select patient-specific treatments, and gauge the effectiveness of treatment. However, brain imaging in aphasia must be improved. Both fMRI and DTI are highly sensitive to both head motion and oropharyngeal motion, and these artifacts are exacerbated in patients with non-fluent aphasia, who have a more difficult time producing speech. Stroke is often precipitated by and/or accompanied by alterations in vasculature, which can affect the MRI signal. Hemodynamic redistribution leads to ambiguity about the source of MRI signals presumed to indicate neural reorganization and/or remodeling. Artifacts from reperfusion hemorrhage leads to susceptibility artifact in the vicinity of lesions. The proposed work will specifically address each of these technical issues to facilitate the use of neurophysiological (functional imaging) measures in patients with aphasia. For fMRI and DTI to guide therapeutic decision-making, there must be formal ways to characterize the physiological state of individual patients and to correlate biological and behavioral parameters. In this proposal, we develop two classes of measures, scalar indices and network activation maps, and investigate their relationship to measures of speech and language. Scalar indices reduce an entire pattern of activation into a single number, such as degree of brain lateralization or integrity of callosal white matter. Network maps include structural equation models and Euclidean distance maps, and we develop methods to compare such large-scale models between individuals or groups (e.g., patients who do and do not benefit from therapy). This component of the research aims to develop rational neurophysiological measures for aphasia research. Finally, these methodological improvements will be applied to a treatment study for patients with chronic non-fluent aphasia and left frontal lesions. The therapeutic intervention is based on (a) neurobiological observations that the brain has circuits particularly active in motor imitation through observation-execution matching, including oral motor imitation; (b) behavioral observations that imitation is a cornerstone of many treatments for non-fluent aphasia; and (c) treatment data that favor intensive approaches and graded incremental learning. Outcomes are assessed by both physiological and behavioral measures, which are collected every three weeks starting six weeks before treatment and ending six weeks after completion of treatment.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
5R01DC007488-02
Application #
7047797
Study Section
Language and Communication Study Section (LCOM)
Program Officer
Cooper, Judith
Project Start
2005-04-01
Project End
2010-03-31
Budget Start
2006-04-01
Budget End
2007-03-31
Support Year
2
Fiscal Year
2006
Total Cost
$405,181
Indirect Cost
Name
University of Chicago
Department
Neurology
Type
Schools of Medicine
DUNS #
005421136
City
Chicago
State
IL
Country
United States
Zip Code
60637
Duncan, E Susan; Small, Steven L (2017) Imitation-based aphasia therapy increases narrative content: a case series. Clin Rehabil 31:1500-1507
Duncan, E Susan; Small, Steven L (2016) Increased Modularity of Resting State Networks Supports Improved Narrative Production in Aphasia Recovery. Brain Connect 6:524-9
Duncan, E Susan; Schmah, Tanya; Small, Steven L (2016) Performance Variability as a Predictor of Response to Aphasia Treatment. Neurorehabil Neural Repair 30:876-82
Sarasso, Simone; Määttä, Sara; Ferrarelli, Fabio et al. (2014) Plastic changes following imitation-based speech and language therapy for aphasia: a high-density sleep EEG study. Neurorehabil Neural Repair 28:129-38
Mikami, Katsunaka; Jorge, Ricardo E; Moser, David J et al. (2013) Prevention of poststroke apathy using escitalopram or problem-solving therapy. Am J Geriatr Psychiatry 21:855-62
Small, Steven L; Buccino, Giovanni; Solodkin, Ana (2013) Brain repair after stroke--a novel neurological model. Nat Rev Neurol 9:698-707
Small, Steven L; Buccino, Giovanni; Solodkin, Ana (2012) The mirror neuron system and treatment of stroke. Dev Psychobiol 54:293-310
Tremblay, Pascale; Small, Steven L (2011) On the context-dependent nature of the contribution of the ventral premotor cortex to speech perception. Neuroimage 57:1561-71
Sarasso, S; Santhanam, P; Maatta, S et al. (2010) Non-fluent aphasia and neural reorganization after speech therapy: insights from human sleep electrophysiology and functional magnetic resonance imaging. Arch Ital Biol 148:271-8
Lee, Jaime; Fowler, Robert; Rodney, Daniel et al. (2010) IMITATE: An intensive computer-based treatment for aphasia based on action observation and imitation. Aphasiology 24:449-465

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