Changes in Neural Patterns in Persons with Aphasia Following Theory-based Generat

描述（由申请人提供）：随着老龄化人口的增加，这些人中风的发病率也在增加，随之而来的是沟通障碍。虽然有许多治疗模式存在于失语症康复和行为成功的结果，但目前尚不清楚哪些特定的积极的神经生理变化是成功治疗的结果。拟议的项目将检查失语症患者对基于理论的生成命名治疗的神经可塑性反应，该治疗已被证明能产生积极的行为结果。本研究将重点关注抽象词和具体词的处理，因为在神经健康的成年人中，它们在行为上（见Paivio， 1991年的回顾）和神经上（如Binder等人，2009年）都有不同的处理方式。这种行为模式在失语症患者中被夸大（例如，Newton & Barry, 1997），并且可以在治疗中被操纵，不仅在治疗（抽象）项目中产生收益，而且还可以推广到未训练（具体）项目（Kiran, Sandberg, & Abbott, 2009）。因此，这种治疗将与治疗前和治疗后的功能磁共振成像扫描相结合，将激活模式的变化和语言网络的有效连接与治疗后的积极行为反应联系起来。6名失语症患者将在治疗前后使用功能磁共振成像进行扫描。将使用的单词生成处理先前已经表明，在特定上下文中训练抽象单词会导致这些单词和相同上下文中具体单词的改善，但训练具体单词只会提高训练项目（Kiran, Sandberg, & Abbott, 2009）。因此，在本研究中，我们将只训练抽象词汇，以检验在治疗后，抽象词汇和具体词汇的神经激活模式的变化作为词汇检索改善的功能。传统的功能磁共振成像分析将用于检查从处理前到处理后抽象和具体文字处理的激活模式的变化。结构方程模型将用于检查从预处理到后处理的抽象和具体的文字处理网络区域之间连通性的变化。这项工作的创新之处在于：a)使用传统的功能磁共振成像和有效的连通性分析来衡量不同语言网络的治疗效果；b)关注可以参与的特定类型的刺激

DESCRIPTION (provided by applicant): the aging population increases, so does the incidence of stroke and consequent communication deficits in such individuals. Although many treatment paradigms exist for aphasia rehabilitation with behaviorally successful outcomes, it is still unclear what specific positive neurophysiological changes are occurring as the result of successful treatment. The proposed project will examine the neuroplastic response in persons with aphasia to a theoretically-based generative naming treatment that has been shown to produce positive behavioral results. This study will focus on the processing of abstract and concrete words because they have been shown to be differentially processed both behaviorally (see Paivio, 1991 for a review) and neurally (e.g., Binder et al., 2009) in neurologically healthy adults. This behavioral pattern is exaggerated in persons with aphasia (e.g., Newton & Barry, 1997) and can be manipulated in treatment to produce gains not only in treated (abstract) items, but also generalization to untrained (concrete) items (Kiran, Sandberg, & Abbott, 2009). This treatment will therefore be used in concert with pre- and post- treatment fMRI scans to link changes in activation patterns and effective connectivity within language networks to a positive behavioral response to treatment. Six participants with aphasia will be scanned using fMRI before and after treatment. The word generation treatment that will be used has previously shown that training abstract words in a particular context results in improvement for those words as well as concrete words in the same context, but training concrete words only improves the trained items (Kiran, Sandberg, & Abbott, 2009). Therefore, only abstract words will be trained in the proposed study to examine changes in neural activation patterns for both abstract and concrete words as a function of improved lexical retrieval subsequent to treatment. Traditional fMRI analysis will be used to examine changes in activation patterns for abstract and concrete word processing from pre- to post- treatment. Structural equation modeling will be used to examine changes in connectivity between regions in abstract and concrete word processing networks from pre- to post-treatment. The innovation of the proposed work lies in combination of a) the use of both traditional fMRI and effective connectivity analyses to measure treatment gains in different language networks, b) the attention to specific kinds of stimuli that can engage the brain differently, and c) the use of a theory-based generative naming treatment that has been shown to be successful for treating word retrieval deficits in chronic aphasia. The successful completion of this project will increase our understanding of how treatment influences neural plasticity and will guide how new treatments for word-finding deficits in aphasia will be developed.