Investigating insight into inner speech in aphasia

调查失语症患者内心言语的洞察力

• 批准号: 9317283
• 负责人: Peter Ethan Turkeltaub
• 金额: $ 15.42万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9317283
• 关键词: Address; Affect; American; Anomia; Aphasia; Area; Associative aphasia; Brain; Brain imaging; Broca Aphasia; Case Series; Clinical; Cognitive deficits; Communication; Communication impairment; Data; Diagnosis; Failure; Family; Feasibility Studies; Frequencies; Functional Magnetic Resonance Imaging; Future; Goals; Grant; Head; Impairment; Individual; Individual Differences; Judgment; Language; Language Disorders; Language Tests; Measures; Mental Processes; Mind; Modeling; Modernization; Monitor; Motor; Names; Participant; Patient Self-Report; Pattern; Performance; Persons; Process; Publishing; Reporting; Research; Research Personnel; Retrieval; Sample Size; Self Perception; Self-Correction; Semantics; Source; Speech; Stroke; Techniques; Testing; Text; Translating; Treatment outcome; Work; base; design; disability; experience; improved; insight; language impairment; lexical retrieval; phonology; psychologic; public health relevance; relating to nervous system; response; sound; success; tool

 DESCRIPTION (provided by applicant): Aphasia, an acquired impairment of language and communication, affects about one million Americans, and causes significant long-term disability. People with aphasia often feel that they can say certain words in their heads, even though they can't say them aloud. Because this sense of "successful inner speech" is hard to verify, clinicians cannot be sure whether these reports are meaningful, and if so, what they can tell us about the internal mental processes of word-finding. Remarkably, although the sense of successful inner speech is an everyday experience for many people with aphasia, only one prior study, published in 1976, directly asked people with aphasia about their inner speech and tested whether these self-reports are meaningful. Building on this prior work using modern techniques, this project examines how subjective reports of inner speech relate to objective measures of the psychological and neural processes of word-finding. The main hypothesis is that the sense of successful inner speech emerges from access to a phonological word form. A corollary of the hypothesis is that brain activity related to phonological access corresponds with the subjective report of whether inner speech is correct or not. We will test these hypotheses using an inner/aloud naming task, phonological judgments, and functional MRI of inner naming. These tests examine whether reports of inner speech predict (1) subsequent aloud speech, (2) access to phonological information about the same words, and (3) brain activity when calling these words to mind. The study is designed to test hypotheses at the single-subject level because individual differences in language and cognitive deficits are expected to influence insight into inner speech. Pilot data collected to date demonstrate that self-reports of inner speech in aphasia are meaningful and likely reflect phonological access as hypothesized. We have also found that self-reports of inner speech predict word-by-word success in subsequent anomia treatment, demonstrating the clinical importance of this work. This research will provide a new source of information to study language and aphasia, and potentially a new way to guide individualized aphasia therapy. Further, this research will improve our understanding of the personal experience of having aphasia, an important goal for clinicians, people with aphasia, and their families.

 描述(申请人提供)：失语症是一种后天的语言和沟通障碍，影响着大约100万美国人，并导致严重的长期残疾。失语症患者经常觉得他们可以在脑海中说出某些单词，即使他们不能大声说出来。因为这种“成功的内心语言”的感觉很难验证，临床医生不能确定这些报告是否有意义，如果有，它们能告诉我们什么关于找词的内部心理过程。值得注意的是，尽管成功的内心语言是许多失语症患者的日常体验，但在1976年发表的一项先前的研究中，只有一项直接询问了失语症患者他们的内心语言，并测试了这些自我报告是否有意义。在这项使用现代技术的先前工作的基础上，这个项目考察了内心言语的主观报告与寻找单词的心理和神经过程的客观测量之间的关系。主要的假设是，成功的内在言语的感觉来自于对音系词形式的接触。这一假设的一个推论是，与语音通达相关的大脑活动与内心言语是否正确的主观报告相对应。我们将使用内部/大声命名任务、语音判断和内部命名的功能磁共振成像来检验这些假设。这些测试考察了内心言语的报告是否预示着(1)随后的有声言语，(2)获得关于相同单词的语音信息，以及(3)回忆这些单词时的大脑活动。这项研究旨在测试单个受试者的假设，因为语言和认知缺陷的个体差异预计会影响对内心话语的洞察。到目前为止收集的试点数据表明，失语症患者的内心言语自我报告是有意义的，可能反映了假说中的语音通达。我们还发现，内在言语的自我报告预测了随后的失调症治疗的逐字成功，证明了这项工作的临床重要性。本研究将为语言和失语症的研究提供新的信息源，并有可能为指导个体化失语症的治疗提供新的途径。此外，这项研究将提高我们对失语症个人经历的理解，这是临床医生、失语症患者及其家人的重要目标。