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

描述（由申请人提供）：随着人口老龄化的增加，中风的发病率和随之而来的沟通障碍也在增加。虽然存在许多治疗模式的失语症康复与行为成功的结果，它仍然不清楚什么具体的积极的神经生理学变化发生的结果，成功的治疗。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。这项研究将集中在处理抽象和具体的话，因为他们已经被证明是差异处理行为（见Paivio，1991年的评论）和神经（例如，Binder等人，2009）在神经健康的成年人中。这种行为模式在失语症患者中被夸大了（例如，Newton &巴里，1997年），并可以在治疗中进行操纵，不仅在治疗（抽象）项目中产生收益，而且还推广到未经训练的（具体）项目（Kiran，Sandberg，Abbott，2009年）。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内的有效连接与对治疗的积极行为反应联系起来。六名失语症患者将在治疗前后使用fMRI进行扫描。将要使用的单词生成处理之前已经表明，在特定上下文中训练抽象单词会导致这些单词以及相同上下文中的具体单词的改进，但训练具体单词只会改进训练过的项目（Kiran，Sandberg，& Abbott，2009）。因此，在拟议的研究中，将只训练抽象词，以检查抽象词和具体词的神经激活模式的变化，作为治疗后改善词汇检索的函数。传统的功能磁共振成像分析将用于检查从治疗前到治疗后抽象和具体文字处理的激活模式的变化。结构方程模型将被用来研究从治疗前到治疗后，抽象和具体的文字处理网络中区域之间的连接变化。 这项工作的创新之处在于结合了以下几个方面：a）使用传统的功能磁共振成像和有效的连接分析来测量不同语言网络中的治疗收益，B）对特定类型刺激的注意力， 大脑不同，和c）使用基于理论的生成命名治疗，已被证明是成功的治疗慢性失语症的单词检索缺陷。这个项目的成功完成将增加我们对治疗如何影响神经可塑性的理解，并将指导如何开发失语症中单词查找缺陷的新治疗方法。

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.