Early Detection and Treatment of Emerging Cognitive-Linguistic Impairment in Minority Cognitive Aging and Primary Progressive Aphasia

早期发现和治疗少数认知衰老和原发性进行性失语症中出现的认知语言障碍

• 批准号: 10330021
• 负责人: James Joseph Reilly
• 金额: $ 46.74万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-02-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10330021
• 关键词: Address; Adjuvant; Adopted; Adult; African American; Age; Aging; Alzheimer' s Disease; Ambulatory Care; Anatomy; Anterior; Atrophic; Behavior Therapy; Behavioral; Bilateral; Brain region; Caregivers; Cathodes; Clinical; Cognition; Cognitive; Cognitive aging; Color; Communities; Complement; Comprehension; Country; Crossover Design; Data; Dementia; Developed Countries; Development; Dimensions; Disease; Early Diagnosis; Early treatment; Education; Effectiveness; Elderly; Electrodes; Emotions; Episodic memory; Eye; Functional disorder; Funding; Future; Human; Impaired cognition; Impairment; Incidence; Individual Differences; Industrialization; Inferior; Institutes; Intervention; Knowledge; Language; Language Disorders; Linguistics; Link; Love; Low income; Machine Learning; Maintenance; Measures; Memory; Methods; Minority; Mission; Molecular Target; Names; National Institute on Deafness and Other Communication Disorders; Nature; Neuropsychology; Neurosciences Research; Pathology; Patients; Pattern; Perception; Physiological; Primary Progressive Aphasia; Process; Progressive Aphasias; Property; Prospective cohort; Public Health; Regimen; Research; Risk; Screening procedure; Semantic memory; Semantics; Severity of illness; Site; Standardization; System; Temporal Lobe; Testing; Time; Training; Underserved Population; United States; Variant; Visual; Vocabulary; Word Processing; age related; base; cognitive change; cognitive neuroscience; cohort; diagnostic biomarker; diagnostic criteria; drug discovery; effectiveness evaluation; evidence base; executive function; follow-up; forgetting; frontal lobe; frontotemporal degeneration; gaze; high dimensionality; improved; indexing; language impairment; machine learning algorithm; mild cognitive impairment; neurological rehabilitation; noninvasive brain stimulation; novel; prevent; screening; sound; stroke-induced aphasia; supervised learning; treatment services; voltage

PROJECT SUMMARY/ABSTRACT Dementia is among the most daunting public health crises facing industrialized nations. Many countries, including the United States,1 have recently adopted comprehensive national dementia strategies.2 The US National Dementia Strategy (section 2B) has identified early diagnosis and links to community treatment services as pillars of its management plan. The availability of evidence-based outpatient treatment for progressive language impairments remains exceedingly sparse. In 2014, we began to address this void via a longitudinal intervention targeting maintenance of a core vocabulary consisting of 100 words over two years. This caregiver-friendly treatment is showing great promise for promoting the retention of key vocabulary in frontotemporal degeneration and Alzheimer's Disease. A secondary aim involved evaluating prediction of later language forgetting. We have learned much during this initial project period, and its renewal has the potential to tell us much more. Our current proposal consists of three aims, all of which directly align both with the US National Dementia Strategy and the mission of our funding institute (i.e., the National Institute on Deafness and Other Communication Disorders).3 In Specific Aim 1 (SA1), we will evaluate the long-term effectiveness of a regimen of noninvasive brain stimulation (transcranial direct current stimulation) delivered over the anterior temporal lobes as an adjuvant to our ongoing semantic behavioral treatment. We will do so using a crossover design where two groups of patients with semantic variant Primary Progressive Aphasia complete sham and active stimulation conditions paired with behavioral treatment (order counterbalanced). We will subsequently follow this patient cohort over two years to evaluate the durability of treatment gains. In SA2, we will evaluate predictors of emerging cognitive-linguistic impairment in a vastly underserved population (i.e., older African American adults). We will identify older adults who are at increased risk for conversion to mild cognitive impairment as indexed by global cognitive and language measures. We will then follow and characterize this prospective cohort using sensitive behavioral (gaze patterns during visual confrontation naming) and neuropsychological markers. Finally, in SA3 we will evaluate representation, processing, and shifts in abstract word meaning as functions of age, pathology, and individual differences (e.g., vocabulary size, years of education) using machine learning. This renewal reflects the continuation of a productive and rigorous line of research that will yield complementary data about human semantic memory, best practices in promoting language maintenance, and variability of age-associated language change.

项目摘要/摘要 痴呆症是工业化国家面临的最令人生畏的公共卫生危机之一。许多国家， 包括美国在内，1最近采取了全面的国家痴呆症策略。2美国 《国家痴呆症战略》(第2B节)确定了早期诊断和与社区治疗的联系 将服务作为其管理计划的支柱。循证门诊治疗的可获得性 进行性语言障碍仍然极其稀少。2014年，我们开始通过一个 纵向干预的目标是在两年内保持一个由100个单词组成的核心词汇。 这种对照顾者友好的治疗显示出促进关键词汇保留的巨大希望 额颞部退行性变与阿尔茨海默病。次要目标包括评估对未来的预测 语言失忆。在这个最初的项目期间，我们学到了很多，它的更新有潜力 告诉我们更多的信息。我们目前的提议包括三个目标，所有这些目标都直接与美国保持一致 国家痴呆症战略和我们的资助研究所(即国家聋人研究所)的使命 3在具体目标1(SA1)中，我们将评估 经前路无创脑刺激(经颅直流电刺激)方案 颞叶作为我们正在进行的语义行为治疗的佐剂。我们将使用交叉来实现这一点 两组语义变异的原发性进行性失语患者完全假失语和 积极的刺激条件与行为治疗相结合(顺序平衡)。我们随后将 对这一患者队列进行两年以上的跟踪调查，以评估治疗成果的持久性。在SA2中，我们将评估 在严重缺乏服务的人群(即老年非洲人)中出现认知-语言障碍的预测因素 美国成年人)。我们将确定哪些老年人转换为轻度认知障碍的风险更高 以全球认知和语言测量为索引的损害。然后我们将跟踪并描述这一点 使用敏感行为的预期队列(视觉对抗命名时的凝视模式)和 神经心理标志物。最后，在SA3中，我们将评估抽象的表示、处理和转换 词义受年龄、病理和个体差异的影响(例如，词汇量、年龄 教育)使用机器学习。这次更新反映了一条富有成效和严谨的路线的延续 将产生关于人类语义记忆的补充数据的研究，促进 语言维持，以及与年龄相关的语言变化的可变性。