Rehabilitation and Prophylaxis of Anomia in Primary Progressive Aphasia

原发性进行性失语症失语症的康复和预防

• 批准号: 9381305
• 负责人: RHONDA B FRIEDMAN
• 金额: $ 79.26万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9381305
• 关键词: Aftercare; Alzheimer' s Disease; Anomia; Area; Atrophic; Attention; Biological Preservation; Biometry; Brain region; Caregivers; Categories; Cognitive; Communication; Data; Degenerative Disorder; Diagnosis; Diagnostic; Disease; Enrollment; Evaluation; Family; Family Caregiver; Funding; Goals; Grant; Home environment; Impairment; International; Laboratories; Language; Language Development; Language Disorders; Left; MRI Scans; Maintenance; Measurement; Measures; Names; Neurodegenerative Disorders; Neurology; Outcome; Participant; Patients; Persons; Predictive Value; Primary Progressive Aphasia; Prophylactic treatment; Quality of life; Rehabilitation therapy; Reporting; Research; Semantic Aphasias; Semantics; Source; Speech-Language Pathology; Stroke; Structure of inferior temporal gyrus; Subgroup; Techniques; Test Result; Testing; Theoretical model; Time; Travel; Validation; Videoconferencing; Waiting Lists; Work; base; cerebral atrophy; cognitive neuroscience; design; improved; language impairment; lexical; remediation; success; therapy development; treatment effect; treatment strategy

The long-range goal of this project is to provide the clinician with a scientifically-based means of determining optimal treatment(s) for anomia in patients with neurodegenerative disorders, including primary progressive aphasia (PPA) and Alzheimer's disease (AD). The desired outcomes are a longer period of preservation of function (Prophylaxis) for words that can be retrieved successfully, and improvement (Remediation) for words that cannot be retrieved successfully at baseline. Semantically-based treatment will be compared with lexically-based treatment, and maintenance of treatment gains will be measured at one-month, eight months, and 15 months post-treatment. Participants will be persons with all three types of PPA -- semantic (svPPA), nonfluent/agrammatic (nfvPPA), and logopenic (lvPPA) -- and persons with AD who have significant word- finding problems (anomia). Through the use of a within-subjects design, each participant will receive both treatments, with different items in the two treatment sets. Participants who are unable to travel to the laboratory for the required number of treatment and evaluation sessions will participate remotely via videoconferencing. At baseline, structural MRI scans will be obtained, and two semantic batteries will be administered: one consisting of conceptually-based tests (without words), and one consisting of lexically-based tests. The results of these test batteries will be used to compute a Relative Lexical-Semantic/Conceptual-Semantic impairment measure for each participant. Based on theoretical considerations discussed in the proposal, it is predicted that persons whose lexical impairments are greater than their conceptual impairments will show greater treatment effects for lexically- based treatment than for semantically-based treatment, while those with a greater conceptual impairment will show greater treatment effects with a semantically-based treatment than a lexically-based treatment. Further, it is predicted that the Relative Lexical-Semantic/Conceptual-Semantic impairment measure will provide additional information about the treatment effects, above and beyond what can be obtained from the Diagnostic Subgroups and demographic variables. The use of baseline atrophy in predicting treatment effects will also be tested; Specifically, it is predicted that participants with baseline atrophy in the left temporal pole and/or the left inferior temporal gyrus will be more likely to demonstrate generalization to untrained items when semantic treatment is utilized, compared to the lexical treatment condition. The validation of techniques for improving word-finding, and hence communication, in persons with PPA and AD is of great significance for these patients and their families and caregivers. And being able to determine, on the basis of scientific data, which treatment is most likely to succeed for a given patient, is the aspiration of every clinician.

该项目的长期目标是为临床医生提供一种基于科学的方法来确定 神经退行性疾病（包括原发性进行性疾病）患者失名症的最佳治疗方法 失语症（PPA）和阿尔茨海默病（AD）。期望的结果是更长的保存期， 功能（预防）用于可以成功检索的单词，改善（补救）用于单词 在基线时无法成功检索。基于语义的治疗将与 基于词汇的治疗，治疗收益的维持将在一个月，八个月， 治疗后15个月。参与者将是具有所有三种类型PPA的人-语义（svPPA）， 不流利/语法错误（nfvPPA）和逻辑缺失（lvPPA）-以及AD患者有重要单词- 失范（Anomia）通过使用受试者内设计，每位参与者将获得 治疗，两个治疗集中有不同的项目。无法前往实验室的受试者 将通过视频会议远程参加所需次数的治疗和评价会议。 在基线时，将获得结构MRI扫描，并将管理两个语义电池：一个 一种是基于概念的测试（没有单词），另一种是基于词汇的测试。结果 这些测试组合中的一个将用于计算相对词汇语义/概念语义损伤 衡量每一位参与者。 根据建议中讨论的理论考虑，预计词汇 在词汇方面， 基于语义的治疗比基于语义的治疗，而那些有更大的概念障碍， 基于语义的处理比基于词汇的处理显示出更大的处理效果。此外，它 据预测，相对词汇语义/概念语义障碍措施将提供 关于治疗效果的额外信息，超出了从 诊断亚组和人口统计学变量。基线萎缩在预测治疗效果中的应用 也将进行测试;具体而言，预计左颞极基线萎缩的参与者 和/或左颞下回将更有可能表现出对未训练项目的泛化， 与词汇处理条件相比，使用语义处理。技术验证， 改善PPA和AD患者的词汇发现，从而改善沟通，对于 这些病人和他们的家人和照顾者。并且能够根据科学数据确定， 对于给定的患者，哪种治疗最有可能成功是每个临床医生的愿望。