Healthy Clinical Trial
Official title:
Multimodal Studies of Language Production and Comprehension in Normal Volunteers and Patients With Neurologically-Based Language Impairments
Positron Emission Tomography (PET) is a technique used to investigate the functional activity
of the brain. The PET technique allows doctors to study the normal biochemical and metabolic
processes of the central nervous system of normal individuals and patients with neurologic
illnesses without physical / structural damage to the brain. Radioactive water H215O in PET
scans permits good visualization of areas of the brain related to speech.
Most of the PET scan studies conducted have concentrated on learning about how language is
formed and decoded. Few studies have been conducted on speech production. This study aims to
use radioactive water (H215O) and Positron Emission Tomography (PET scan) to measure blood
flow to different areas of the brain in order to better understand the mechanisms involved in
speech motor control.
When a region of the brain is active, it uses more fuel in the form of oxygen and sugar
(glucose). As the brain uses more fuel it produces more waste products, carbon dioxide and
water. Blood carries fuel to the brain and waste products away from the brain. As brain
activity increases blood flow to and from the area of activity increases also. Knowing these
facts, researchers can use radioactive chemicals (H215O) and PET scans to observe what areas
of the brain are receiving more blood flow.
Researchers will ask patients to perform tasks that will affect speech, voice, and language.
At the same time patients will undergo a PET scan. The tasks are designed to help researchers
observe the blood flow to brain areas associated with voicebox (laryngeal) functions,
movement of muscles in the jaw, tongue, and mouth, and other aspects of motor speech.
Special studies will be conducted to evaluate how certain therapies and tasks can draw out
symptoms in illnesses in which speech and language are affected. Results of these tests will
be used in other studies to evaluate the neurologic mechanisms of diseases like Tourette's
syndrome and parkinson's disease.<TAB>
Objective
The primary objective of this protocol is to use multimodal neuroimaging combining
complementary electrophysiological and hemodynamic methods to characterize brain-language
relationships in healthy subjects and those with neurological disorders that affect speech
and language. A secondary objective is to utilize these findings to develop evaluation
measures for future treatment studies.
Study Populations
We will focus on four neurological disorders that affect language processing post-stroke
aphasia, traumatic brain injury, epilepsy and developmental stuttering. Each constitutes a
significant clinical problem central to the NIDCD s mission. These disorders can impair
language at several levels - from its elementary perceptual and motor features, the
peripheral building blocks of language, to higher levels of language formulation, including
word, sentence and narrative processing.
Design
We will utilize a set of tasks designed to evaluate language at the levels at which clinical
pathology emerges. We will combine hemodynamic (functional MRI) and electrophysiological
(EEG, MEG) modalities to capitalize on the superior spatial resolution of the former and
temporal resolution of the latter methods. Whenever possible the same task paradigms are used
with both techniques. We will conduct crosssectional sub-studies, addressing specific
questions in each of the disorders of interest; we will also conduct longitudinal sub-studies
of recovery and neuroplastic reorganization in post-stroke aphasia.
Outcome Measures
Outcome measures include speech-language and psychological tests, measures of behavioral
performance during scanning and corresponding MRI, EEG and MEG data. Relationships between
these datasets will be evaluated using statistical analytic packages.
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