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

描述(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。虽然有许多失语症康复的治疗范例，并取得了行为上的成功结果，但作为成功治疗的结果，仍不清楚具体发生了哪些积极的神经生理学变化。这项拟议的项目将检测失语症患者对基于理论的生成性命名治疗的神经可塑性反应，该治疗已被证明产生了积极的行为结果。这项研究将集中在抽象和具体单词的加工上，因为在神经学健康的成年人中，它们被证明在行为上(参见Paivio，1991)和神经上(例如，Binder等人，2009)都得到了不同的加工。这种行为模式在失语症患者中被夸大了(例如，牛顿和巴里，1997)，并且可以在治疗中进行操纵，不仅在治疗的(抽象)项目中产生收益，而且还对未训练的(具体)项目进行泛化(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扫描一起使用，将激活模式的变化和语言网络内的有效连接与治疗的积极行为反应联系起来。六名失语症参与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以及相同上下文中的具体单词的改善，但训练具体单词只会提高训练的项目(Kiran，Sandberg&Abbott，2009)。因此，在拟议的研究中，只对抽象单词进行训练，以检查抽象单词和具体单词的神经激活模式的变化，这是治疗后改善词汇提取的功能。传统的fMRI分析将被用来检查抽象和具体字处理的激活模式从处理前到处理后的变化。将使用结构方程模型来检查抽象和具体字处理网络中区域之间从处理前到处理后的连通性变化。拟议工作的创新之处在于结合了a)使用传统的功能磁共振成像和有效的连接性分析来测量不同语言网络中的治疗收益，b)对可以参与的特定类型的刺激的关注 不同的大脑，以及c)基于理论的生成性命名疗法的使用，该疗法已被证明在治疗慢性失语症的单词提取缺陷方面是成功的。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，并将指导如何开发针对失语症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.