Model-oriented naming therapy in semantic dementia: A single-case fMRI study
Model-oriented naming therapy in semantic dementia: A single-case fMRI study
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DOI：
10.1080/02687038.2010.500567
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发表时间：
2010-01-01
期刊：
影响因子：
2
通讯作者：
Abel, Stefanie
中科院分区：
文献类型：
--
作者：
Dressel, Katharina;Huber, Walter;Abel, Stefanie
背景：语义性痴呆的失范治疗研究表明，重新学习是可能的，但改善的维持和推广是有限的。在脑卒中后失语症患者中已经证实了与失语症治疗相关的皮质激活变化。语义性痴呆患者在缺陷特异性治疗的影响下脑功能的恢复尚未得到探讨。然而，最近在神经退行性疾病患者中使用语言任务进行的激活研究报告了激活模式的改变，涉及主要受影响的左半球的不同脑区或对侧。目的：本研究的目的是探讨为失语症命名治疗建立的语音和语义线索层次是否对语意性痴呆患者也有效。此外，我们的目的是检查与治疗失范相关的大脑活动的变化。方法：1例语义性痴呆患者参与本研究。在为期4周的时间里，参与者接受了语音和语义线索层次的强化模型导向治疗。进行了两次前测和两次后测（一次在训练后立即进行，一次在2个月后进行）。第二次预测试和两次随访在扫描仪内登记。结果：行为上，两种治疗都产生了特定的训练效果，随后随着时间的推移而下降。关于功能性磁共振成像数据，治疗后的命名改善反映在皮层活动的变化上，主要位于右侧上颞回和下颞回。结论：提示层次是成功的，产生了特异性和立竿见影的治疗效果，证实了先前对语义性痴呆的治疗研究。治疗引起的皮层活动变化主要集中在右侧颞叶皮层。由于右侧皮质活动的调节与训练引起的任务表现的改善有关，它可能反映了该参与者的右半球代偿机制。
Background: Studies on anomia treatment in semantic dementia demonstrate that re-learning is possible, but maintenance and generalisation of improvements are limited. Changes in cortical activation associated with anomia treatment have already been demonstrated in aphasic patients after stroke. Recovery of brain functions under the impact of deficit-specific treatment in semantic dementia has not been explored yet. Nevertheless, recent activation studies using language tasks in patients with neurodegenerative diseases report altered activation patterns, involving diverse brain regions ipsi- or contralateral to the primarily affected left hemisphere. Aims: The purpose of the present study was to investigate if phonological and semantic cueing hierarchies established for naming therapy in aphasia were also effective in a patient with semantic dementia. Moreover, we aimed to examine changes of brain activity associated with anomia treatment. Methods Procedures: One individual with semantic dementia participated in the present study. Over a period of 4 weeks the participant received an intensive model-oriented treatment with phonological and semantic cueing hierarchies. Two pre-tests and two post-tests (one immediately after training and one 2 months later) were administered. The second pre-test and both follow-ups were registered inside the scanner. Outcomes Results: Behaviourally, both treatments resulted in specific training effects, which subsequently decreased over time. Concerning functional magnetic resonance imaging data, improved naming following therapy was mirrored by changes in cortical activity, predominantly located in right superior and inferior temporal gyrus. Conclusions: Cueing hierarchies were successful, resulting in specific and immediate treatment effects, corroborating previous treatment studies in semantic dementia. Treatment-induced changes in cortical activity were mainly concentrated in right temporal cortex. Since right-sided modulation of cortical activity was associated with training-induced improvements in task performance, it may reflect right hemispheric compensatory mechanisms in this participant.