Neural Mechanisms Underlying Learning following Semantic Mediation Treatment in a case of Phonologic Alexia.
Neural Mechanisms Underlying Learning following Semantic Mediation Treatment in a case of Phonologic Alexia.
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DOI：
10.1007/s11682-008-9027-2
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发表时间：
2008-09
影响因子：
3.2
通讯作者：
Friedman, Rhonda B.
中科院分区：
文献类型：
--
作者：
Kurland, Jacquie;Cortes, Carlos R.;Wilke, Marko;Sperling, Anne J.;Lott, Susan N.;Tagamets, Malle A.;VanMeter, John;Friedman, Rhonda B.
关键词：
语音失读症患者可以通过将语义贫乏的单词(例如，函数器)与与语音相关的语义丰富的单词(例如，名词)配对来训练它们阅读。这种认知再培训方法的成功基础是什么机制？如果技能被“过度学习”，即超出标准地练习，机制会发生变化吗？在过度学习后，我们在治疗前和治疗后使用功能磁共振成像来评估一名语音失读症患者在左侧颞顶卒中两年后与治疗相关的功能重组。在治疗前，在不同的词组中，激活曲线没有统计学上的显著差异。处理后，两个训练集上的准确率都有所提高。与未训练的单词相比，阅读训练的单词在右半球，包括右下额叶和下顶叶皮质，招募了更大和更显著的激活簇。过度学习后，当阅读过度学习的单词时，与未训练的单词相比，在过度学习的单词上表现出接近正常的表现，主要激活转移到左半球区域，包括顶叶周围的激活。
Patients with phonologic alexia can be trained to read semantically impoverished words (e.g., functors) by pairing them with phonologically-related semantically rich words (e.g, nouns). What mechanisms underlie success in this cognitive re-training approach? Does the mechanism change if the skill is “overlearned”, i.e., practiced beyond criterion? We utilized fMRI pre- and post-treatment, and after overlearning, to assess treatment-related functional reorganization in a patient with phonologic alexia, two years post left temporoparietal stroke. Pre-treatment, there were no statistically significant differences in activation profiles across the sets of words. Post-treatment, accuracy on the two trained sets improved. Compared with untrained words, reading trained words recruited larger and more significant clusters of activation in the right hemisphere, including right inferior frontal and inferior parietal cortex. Post-overlearning, with near normal performance on overlearned words, predominant activation shifted to left hemisphere regions, including perilesional activation in superior parietal lobe, when reading overlearned vs. untrained words.
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