This project will investigate the relation between neurophysiology and anomia recovery in aphasia following stroke. Stroke is the leading cause of disability in the United States, with an increasing number of patients surviving stroke, typically to a life of greatly reduced quality. Aphasia is one of the most frequent and tragic impairments that result from stroke. It is crucial to be able to understand how to determine an accurate prognosis, and also to maximize the effects of therapy on recovery. This project is focused on anomia recovery in aphasia, but also has more general applicability to recovery of motor and cognitive function following stroke. Previous research suggests the size and location of brain damage may be important factors in determining the extent of treatment-assisted aphasia recovery. While basic lesion parameters of size and location can be derived from the MRI scans of routine clinical investigation, many more sophisticated modalities of MRI are now available. This proposal will determine the degree to which standard structural scans can be used to predict treatment outcome, and what extra value can be derived from other MRI techniques such as perfusion and diffusion weighted MRI. The present project uses a prospective design to investigate the relation among 'brain fitness' (the structural lesion, cerebral perfusion, fiber density, and peri-lesional gliosis) and treatment assisted anomia recovery in aphasia. A group of persons with aphasia will undergo detailed assessment of neurophysiology using standard and advanced MRI techniques before and after two types of anomia treatment either focusing on phonological or semantic processing. The value of different indices will be assessed using logistic regression techniques that we have recently developed and validated. In addition, this research will investigate the neural basis of treated language recovery using fMRI. The long term goals of this research are to design more accurate and appropriate approaches to determine prognosis of patients with aphasia, maximizing the effects of treatment by ensuring optimal selection of treatment according to lesion parameters, and identifying targets for novel therapeutic interventions by assessing the neural substrates of successful recovery. ? ? ?
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