ORGANIZATION AND BREAKDOWN OF ROUTINE ACTION SKILLS

本申请的主题是获得性行为障碍(失用症)。 这会影响日常活动的表现。我们寻求开发新的 描述和理解神经认知的分析工具 神经系统疾病，如概念性失用， 额叶失用和创伤性脑损伤的执行障碍。 这些情况给神经病学带来了重大的临床问题。 并可能给家庭和家庭带来沉重的经济负担 社会。我们主张用认知神经心理学的方法来研究 问题，它利用了语言和行动之间的许多相似之处。 第一步包括分析动作的“句法”组织， 以及在自然动作背景下的动作错误的性质。《行动》 本课题组开发的编码系统(ACS)体现了一种描述性的 动作句法理论和编码错误及其他措施的方法 杂乱无章。从认知的角度解读 支持操作的系统，患者的ACS错误配置文件显示 关于认知系统的哪些组成部分的假设 受损的，幸免于难的。然后，可以通过以下方式检验这些假设 标准认知案例研究法。这项提案旨在适用于 并将这种普遍的方法推广到行动障碍的研究中 三条特定的线路。 第1部分开发了多级别动作测试(MLAT)，它要求 在上下文和组合中执行熟悉的日常任务 随着任务需求的连续体而变化。这项测试将被用作 概念行为障碍和额叶行为障碍筛查量表 类型，在脑外伤和中风患者中。第2部分使ACS适应 MLAT的任务环境，以努力。研究变化如何在 任务要求和语境约束会影响行动的表达 各种类型的疾病。第三部分详细介绍了纵向 案例研究，其中一组特别设计的神经心理学 定期对选定的子集进行测试 患者，努力进一步明确潜在的 对概念或执行系统的损害，以及 随着时间的推移而改变。 这项建议的三个部分合计旨在推进诊断 获得性行为障碍及其理论分析。《长河》 长期目标是建立对长期结果和新的 治疗这些通常使人丧失能力的疾病的方法。

The topic of this application is acquired disorders of action (apraxia) that impact performance of everyday activities. We seek to develop new analytic tools for describing and understanding the neuro-cognitive systems implicated in neurological conditions like ideational apraxia, frontal apraxia, and the executive disorder of traumatic brain injury. These conditions pose a significant clinical problem for neurological rehabilitationists and may place a heavy financial burden on families and society. We advocate a cognitive neuropsychological approach to the problem, which exploits the many parallels between speech and action. The first step involves analyzing the "syntactic" organization of action, and the nature of action errors, in natural action contexts. The Action Coding System (ACS), developed by our group, embodies a descriptive theory of action syntax and methods for coding errors and other measures of disorganization. Interpreted from the perspective of the cognitive systems supporting action, a patient's ACS error profile suggests hypotheses regarding which components of the cognitive system are impaired, and which are spared. These hypotheses may then be examined by the standard cognitive case-study method. This proposal seeks to apply and advance this general approach to the study of action disorders along three specific lines. Part 1 develops a Multi-level Action Test (MLAT) which requires the subject to perform familiar everyday tasks in contexts and combinations that vary along a continuum of task demands. This test will be used as a screening instrument for action disorders of the ideational and frontal types, in patients with TBI and stroke. Part 2 adapts the ACs to the task environment of the MLAT, in an effort to. examine how variations in task demands and contextual constraints effect the expression of action disorders of various types. Part 3 details a program of longitudinal case studies, in which a specially designed battery of neuropsychological tests is administered at regular intervals to a selected subset of patients, in an effort to further specify the nature of the underlying impairment to conceptual or executive systems, and the nature of the change over time. Together, the three parts of this proposal aim to advance the diagnosis of acquired action disorders and their theoretical analysis. The long term goal is to establish predictors of long-term outcome and new approaches to treatment for these often disabling conditions.