Resting Brain Offers Clues About Disease

Northwestern neurologists pursue new early interventions for aphasia

By Roger AndersonAugust 10, 2017

New research at Northwestern’s Cognitive Neurology and Alzheimer's Disease Center (CNADC) is illustrating the benefit of an experimental imaging technique that measures brain activity through blood flow.

Preliminary results have shown that when functional magnetic resonance imaging (fMRI) is combined with traditional structural MRI, it has the potential to help with the diagnosis, treatment planning, and measurement of therapeutic interventions for primary progressive aphasia (PPA), a neurodegenerative disease associated with language decline.

Currently, the most common way to confirm the diagnosis of PPA is to use structural MRI to identify atrophy, or shrinkage, within the brain. However, in early stages of the disease, some patients do not display this atrophy, making diagnosis and treatment planning difficult.

“We identified 10 patients in our center and found that they had abnormality in their resting state fMRI although the structure of the brain looked normal,” says Borna Bonakdarpour, neurology, and principal investigator of the study. “This is a very important discovery to enhance early diagnosis and treatment of the disease.”

Each of the 10 patients suffered from the agrammatic form of PPA, meaning they had a deficit in language production and could not produce grammatical sentences. Their sentences were often very short and words were put together in the wrong order. A patient might say  “boy fall” instead of “the boy is falling off the stool,” or “I down fall … and hospital,” instead of “I fell down and they took me to the hospital.”

The research team — which includes CNADC members Marsel Mesulum, Robert Hurley, Emily Rogalski,  Hernando Fereira, and  Allan Wang — is in the process of submitting its fMRI findings from an additional group of about 70 PPA patients who have more severe language impairment.

The original work was published March 10 in Alzheimer Disease and Associated Disorders.