Assessment and Characterization of Naming in Older Adults with Epilepsy

老年癫痫患者命名的评估和特征

• 批准号: 9248434
• 负责人: MARLA J HAMBERGER
• 金额: $ 37.03万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9248434
• 关键词: Address; Adult; Affect; Age; Aging; Alzheimer' s Disease; Anatomy; Aphasia; Area; Assessment tool; Attention; Auditory; Behavioral; Benchmarking; Benign; Brain; Characteristics; Classification; Clinical; Clinical Research; Cognitive; Comorbidity; Coupled; Diagnosis; Differential Diagnosis; Elderly; Epilepsy; Exhibits; Goals; Impairment; Incidence; Individual; Knowledge; Language; Lead; Left; Location; Measures; Mediating; Mediation; Modality; Names; National Institute of Neurological Disorders and Stroke; Occupational; Operative Surgical Procedures; Patients; Pattern; Performance; Play; Population; Prevalence; Process; Protocols documentation; Research; Retrieval; Risk; Role; Seizures; Severities; Standardization; Symptoms; Techniques; Temporal Lobe; Temporal Lobe Epilepsy; Testing; Visual; Vocabulary; Work; age related; aging brain; clinical care; clinically relevant; clinically significant; cortex mapping; early onset; follow-up; healthy aging; individual patient; insight; instrument; middle age; nervous system disorder; neural correlate; neuroimaging; normal aging; public health relevance; social; tool; young adult

DESCRIPTION (provided by applicant): The ability to produce the correct words while speaking is critical for normal social, academic and occupational functioning. As word finding or "naming" is mediated by the temporal lobe region, naming difficulty is a common complaint and frequent finding in people with dominant temporal lobe epilepsy (TLE). Naming plays a central role in the clinical care of TLE patients, in that naming performance assists in the determination of lateralization and localization of seizure onset, and identification of cortical areas that are essential for naming is the principle technique for identifying language cortex prior to respective surgery. Although naming in epilepsy has received considerable attention, these efforts have been restricted to younger adults. The incidence and prevalence of epilepsy is currently highest, and continues to rise, in the elderly. Thus, the absence of information on naming in older adults with epilepsy presents a growing clinical problem, particularly as aging introduces new concerns overlaid upon existent, epilepsy-related naming difficulty. Specifically, naming decline is also a feature of normal aging and a hallmark symptom of Alzheimer's disease. When an older adult with epilepsy presents with word finding decline, we currently lack both the knowledge and the proper tools to determine whether the decline represents a typical age-related trajectory in epilepsy, the beginning of a more severe degenerative process, or the relatively benign effects of normal aging. Importantly, the answer to this question would have a significant impact on diagnosis, follow up and treatment. Unfortunately currently available naming measures have serious limitations that compromise their utility, including assessment restricted to the visual modality, insensitive performance measures, vocabulary confounds and cultural biases. The proposed project will address these problems by: 1) Developing and standardizing age appropriate auditory naming and complementary, visual naming measures for older adults, and 2) Applying these measures to characterize and distinguish among naming patterns in healthy older adults, older adults with epilepsy, and older adults with mild Alzheimer's disease. We anticipate that results will: a) Provide new clinical and research instruments for thorough and effective assessment of naming in older adults, b) Delineate the trajectory of naming across the age span in epilepsy, c) Generate new insights into temporal lobe mediation of word retrieval in the aging brain, and d) Provide a noninvasive protocol to assist in the differential diagnosis of degenerative and non-degenerative disorders that affect higher cortical function in older adults.

描述(由申请人提供)：在说话时说出正确的单词的能力对正常的社交、学术和职业运作至关重要。由于寻词或命名是由颞叶区域调节的，命名困难是显性颞叶癫痫(TLE)患者常见的主诉和常见的发现。命名在TLE患者的临床护理中起着核心作用，因为命名操作有助于确定癫痫发作的偏侧化和局部化，而识别对命名至关重要的皮质区域是识别语言皮质的基本技术 做手术。虽然癫痫的命名受到了相当大的关注，但这些努力仅限于年轻人。癫痫的发病率和流行率目前在老年人中最高，而且还在继续上升。因此，缺乏有关癫痫老年人命名的信息是一个日益严重的临床问题，特别是随着年龄的增长带来了新的担忧，覆盖了现有的癫痫相关命名困难。具体地说，命名能力下降也是正常衰老的一个特征，也是阿尔茨海默病的一个显著症状。当患有癫痫的老年人出现单词查找能力下降时，我们目前缺乏知识和适当的工具来确定这种下降是否代表了癫痫中典型的年龄相关轨迹，更严重退化过程的开始，还是正常衰老的相对良性影响。重要的是，这个问题的答案将对诊断、随访和治疗产生重大影响。不幸的是，目前可用的命名方法有严重的局限性，损害了它们的实用性，包括仅限于视觉通道的评估、不敏感的操作措施、词汇混淆和文化偏见。拟议的项目将通过以下方式解决这些问题：1)为老年人开发和标准化适合年龄的听觉命名和补充的视觉命名措施，以及2)应用这些措施来表征和区分健康老年人、患有癫痫的老年人和患有轻度阿尔茨海默病的老年人的命名模式。我们期望这些结果将：a)为彻底和有效地评估老年人的命名提供新的临床和研究工具，b)描绘癫痫患者跨年龄命名的轨迹，c)对衰老大脑中颞叶调节单词提取产生新的见解，以及d)提供一种非侵入性的方案，以帮助鉴别诊断影响老年人较高皮质功能的退行性和非退行性疾病。