Patterns of decline and recovery in bilingual speakers with primary progressive aphasia

项目摘要 原发性进行性失语(PPA)是一种神经退行性疾病，其特征是言语和语言能力下降 语言能力，而其他认知能力相对较少。近年来，取得了重大进展。 然而，关于单语说话者的PPA的性质和治疗；性质和 这种诊断对双语说话者的治疗相对来说还没有被探索过。通过使用 历史数据集，这项建议将调查行为和神经衰退轨迹的差异 未经处理的双语演讲者相对于有PPA的单语演讲者(在每个变体中)，因此长- 在未来的病例中可以看出治疗的长期好处。此外，这项提案将比较 单语者和双语者之间PPA下降的轨迹(在每个变量内)，观察是否 在这种局灶性痴呆症中，双语能力提供了行为或神经优势。所选项目的性能 言语-语言和认知评估也将在不同组之间进行比较。结构神经成像 将用于检查灰质体积的纵向变化。 在本研究中，我们还将前瞻性地实施两种行为言语-语言干预(词汇 检索训练和脚本训练方法)，并将系统地操纵治疗目标 促进跨语言的泛化。我们使用认知-神经解剖学框架来预测差异 对同源负荷和基于每个PPA变体的每种治疗方法的反应性 独特的认知-语言和神经特征。十名拥有PPA的西班牙语-英语双语者将获得 言语语言干预。在卒中失语的康复研究中，跨语言同源词 已经观察到，这既促进了泛化，也阻碍了泛化，而不会损害语言收益。 因此，本研究将操纵刺激集中同源包含的密度，以确定 最大限度地扩大跨语言概括和最大限度地减少竞争的同源词比例。 这一项目与公共卫生的相关性在于它试图了解 双语说话者PPA的行为和神经改变。健康人2020计划的一个目标 是为了减少发病率和与之相关的成本，并保持或提高人们的生活质量 患有痴呆症。PPA是痴呆症的一种形式，但研究不足，患有PPA的双语者 从历史上看，服务不足。这项建议的发现将为临床提供关于 患有PPA的双语者的下降率和潜在的治疗益处。 该项目将为申请者提供独特的培训体验，其中包括学习新知识 方法论和数据分析技术。申请人的赞助商和顾问将提供专业知识 在干预、神经成像、双语、实验设计和统计等领域提供指导； 因此，她为成为双语失语症和痴呆症领域的独立研究员做好了准备。

Project Summary Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by a decline in speech and language abilities, with relative sparing of other cognitive abilities. In recent years, significant advances have been made regarding the nature and treatment of PPA in monolingual speakers, however; the nature and treatment of bilingual speakers with this diagnosis has been relatively unexplored. Through the use of a historical dataset, this proposal will investigate differences in the trajectory of behavioral and neural decline in untreated bilingual speakers relative to monolingual speakers with PPA (within each variant), so that the long- term benefits of treatment can be discerned in future cases. In addition, this proposal will compare the trajectory of decline between monolinguals and bilinguals with PPA (within each variant), to observe whether bilingualism provides a behavioral or neural advantage in this focal dementia. Performance on selected speech-language and cognitive assessments will also be compared between groups. Structural neuroimaging will be used to examine longitudinal change in gray matter volumes. In this study, we will also prospectively implement two behavioral speech-language interventions (lexical retrieval training and a script training approach), and will systematically manipulate treatment targets in order to facilitate cross-linguistic generalization. We use a cognitive-neuroanatomical framework to predict differential responsiveness to cognate loading and to each treatment approach on the basis of each PPA variant’s distinctive cognitive-linguistic and neural profile. Ten Spanish-English bilingual individuals with PPA will receive speech language intervention. In rehabilitative studies of stroke-induced aphasia, cross-linguistic cognates have been observed to both facilitate and impede generalization, with no cost to within language gains. Therefore, this study will manipulate the density of cognate inclusion in stimulus sets, to determine the proportion of cognates that maximizes cross-linguistic generalization and minimizes competition. The relevance of this project to public health lies in its attempts to understand the nature and treatment of behavioral and neural changes in bilingual speakers with PPA. One goal of the Healthy People 2020 program is to reduce the morbidity and costs associated with, and maintain or enhance the quality of life for persons with dementia. PPA is a form of dementia that has been understudied, and bilinguals with PPA have been historically underserved. The findings from this proposal will provide clinically relevant evidence regarding the rate of decline and potential benefit of treatment in bilinguals with PPA. This project will provide the applicant with a unique training experience, which will include learning new methodologies and data analysis techniques. The applicant’s sponsors and consultants will provide expertise and mentorship in the areas of intervention, neuroimaging, bilingualism, experimental design and statistics; thus, preparing her to become an independent researcher in the fields of bilingual aphasia and dementia.