# Functional anomaly mapping of aphasia recovery

> **NIH NIH K99** · GEORGETOWN UNIVERSITY · 2021 · $121,473

## Abstract

Project Summary
Difficulty communicating (aphasia) is one of the most common and debilitating results of left-hemisphere
stroke. Although aphasia symptoms are highly variable and recovery is difficult to predict, much research has
shown that lesion size and location are major drivers of aphasia symptoms and recovery. However, this
previous research has only considered direct anatomical damage caused by the lesion. This is a critical
limitation because stroke lesions also cause indirect effects on the function of brain structures distant from the
lesion. Throughout this application, I refer to this as “remote dysfunction.” Although initially thought to resolve
quickly after the stroke, remote dysfunction is now known to persist throughout recovery and independently
contribute to outcomes. Studies of aphasia recovery have focused almost exclusively on the idea of recovery
through reorganization, whereby behavioral improvement occurs through plastic reorganization of brain
networks. These studies have eschewed the older idea that recovery occurs through partial resolution of
remote dysfunction (RRD) caused by lesions. Consequently, it is not clear how RRD contributes to aphasia
recovery. The applicant has developed a new machine learning approach called functional anomaly mapping
(FAM) that uses resting BOLD functional MRI signal to map remote dysfunction throughout the brain in
individual stroke survivors. FAM maps have much better test-retest reliability than current measures, like task-
related fMRI activity and resting state functional connectivity, as well as several other features that make it
promising as a clinically useful tool. The applicant has already demonstrated that remote dysfunction
measured with FAM relates to behavioral outcomes in people with chronic aphasia. During the mentored
phase of this award, the applicant will optimize the FAM approach and test competing hypotheses about the
biological mechanisms generating the remote dysfunction measured in chronic aphasia. During the
independent phase, the applicant proposes a longitudinal study to understand the contribution of RRD to
aphasia recovery. The applicant proposes a comprehensive training plan to expand his knowledge in the
following areas: the biological mechanisms of stroke recovery and neuroplasticity beyond aphasia, machine
learning, biomarker development, and advanced neuroimaging analysis. The research and training during this
award will enable the applicant to develop a long-term, independent research program focused on
understanding the neural correlates of aphasia and developing translational brain measures to inform clinical
decision-making in aphasia neurorehabilitation.

## Key facts

- **NIH application ID:** 10214766
- **Project number:** 1K99DC018828-01A1
- **Recipient organization:** GEORGETOWN UNIVERSITY
- **Principal Investigator:** Andrew T DeMarco
- **Activity code:** K99 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $121,473
- **Award type:** 1
- **Project period:** 2021-07-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10214766

## Citation

> US National Institutes of Health, RePORTER application 10214766, Functional anomaly mapping of aphasia recovery (1K99DC018828-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10214766. Licensed CC0.

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