The overall goal of this project is to identify the neural correlates of recovery from aphasia during the first three months after acute stroke. Aphasia is one of the most common and debilitating consequences of strokes affecting the dominant hemisphere. In the acute and subacute stages, most patients experience some degree of recovery of language function. These first few months after brain damage occurs are critically important because the greatest behavioral gains take place during this time, even when patients do not receive treatment. However the extent of recovery is highly variable: some patients recover most or nearly all language function, while others make few gains and remain chronically aphasic. It is not well understood what neural mechanisms underlie recovery during this period, nor why some patients recover so much better than others. To address these questions, we propose to study individuals with aphasia due to acute left hemisphere stroke. Patients will be examined at four time points after stroke: 24-48 hours, 2 weeks, 1 month, and 3 months. At each time point, a comprehensive yet time-efficient language evaluation will be administered to quantify expressive and receptive language function, and a multimodal brain imaging protocol will be implemented that includes structural imaging (MRI), functional imaging (fMRI), perfusion imaging (arterial spin labeling, ASL) and diffusion tensor imaging (DTI). The proposed research has two specific aims. The first is to identify the neural changes that are associated with successful recovery from aphasia in the acute and subacute periods after a stroke.
The second aim i s to determine the initial imaging and behavioral variables that are most predictive of the extent of eventual recovery of language function. We hypothesize that the inclusion of fMRI, ASL and DTI in combination with comprehensive language assessments will provide a more complete characterization of the brain's changing state than standard clinical imaging and language measures, and will explain a greater proportion of the variance in recovery patterns. A better understanding of the neural correlates of successful recovery will improve the accuracy of prognoses so as to better plan medical treatments and behavioral interventions.

Public Health Relevance

Approximately one million Americans are living with aphasia, an acquired communication disorder that is one of the most common and debilitating consequences of stroke. The proposed research will use multimodal neuroimaging and comprehensive language evaluations to better understand the process of recovery from aphasia in the crucial first few months after acute stroke. The knowledge gained will help to improve accuracy of prognoses, which will support better planning of treatment and rehabilitation.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
5R01DC013270-04
Application #
9326960
Study Section
Language and Communication Study Section (LCOM)
Program Officer
Cooper, Judith
Project Start
2014-06-01
Project End
2019-05-31
Budget Start
2017-06-01
Budget End
2018-05-31
Support Year
4
Fiscal Year
2017
Total Cost
$419,061
Indirect Cost
$147,031
Name
Vanderbilt University Medical Center
Department
Type
Independent Hospitals
DUNS #
079917897
City
Nashville
State
TN
Country
United States
Zip Code
37232
Wilson, Stephen M; Bautista, Alexa; McCarron, Angelica (2018) Convergence of spoken and written language processing in the superior temporal sulcus. Neuroimage 171:62-74
Wilson, Stephen M; Eriksson, Dana K; Schneck, Sarah M et al. (2018) A quick aphasia battery for efficient, reliable, and multidimensional assessment of language function. PLoS One 13:e0192773
Fisher, Julia M; Dick, Frederic K; Levy, Deborah F et al. (2018) Neural representation of vowel formants in tonotopic auditory cortex. Neuroimage 178:574-582
Henry, Maya L; Hubbard, H Isabel; Grasso, Stephanie M et al. (2018) Retraining speech production and fluency in non-fluent/agrammatic primary progressive aphasia. Brain 141:1799-1814
Wilson, Stephen M; Yen, Melodie; Eriksson, Dana K (2018) An adaptive semantic matching paradigm for reliable and valid language mapping in individuals with aphasia. Hum Brain Mapp 39:3285-3307
Chang, Edward F; Kurteff, Garret; Wilson, Stephen M (2018) Selective Interference with Syntactic Encoding during Sentence Production by Direct Electrocortical Stimulation of the Inferior Frontal Gyrus. J Cogn Neurosci 30:411-420
DeMarco, Andrew T; Wilson, Stephen M; Rising, Kindle et al. (2018) The neural substrates of improved phonological processing following successful treatment in a case of phonological alexia and agraphia. Neurocase 24:31-40
Multani, Namita; Galantucci, Sebastiano; Wilson, Stephen M et al. (2017) Emotion detection deficits and changes in personality traits linked to loss of white matter integrity in primary progressive aphasia. Neuroimage Clin 16:447-454
McCarron, Angelica; Chavez, Ashley; Babiak, Miranda et al. (2017) Connected speech in transient aphasias after left hemisphere resective surgery. Aphasiology 31:1266-1281
Wilson, Stephen M (2017) Lesion-symptom mapping in the study of spoken language understanding. Lang Cogn Neurosci 32:891-899

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