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

项目摘要 原发性进行性失语症（PPA）是一种神经退行性疾病，其特征是言语能力下降， 语言能力，其他认知能力相对较少。近年来，取得了重大进展， 然而，关于PPA在单语者中的性质和治疗， 对患有这种诊断的双语者的治疗还相对未被探索。通过使用 历史数据集，该提案将调查行为和神经衰退轨迹的差异， 未治疗的双语说话者相对于PPA单语说话者（在每个变体内），因此长- 在未来的病例中可以看出治疗的长期益处。此外，本提案将比较 PPA单语者和双语者之间的下降轨迹（在每个变量内），以观察是否 双语在这种局灶性痴呆中提供了行为或神经优势。在选定的 还将比较各组之间的言语-语言和认知评估。结构神经影像学 将用于检查灰质体积的纵向变化。 在这项研究中，我们还将前瞻性地实施两种行为言语语言干预（词汇干预）， 检索训练和脚本训练方法），并将系统地操纵治疗目标， 促进跨语言概括。我们使用认知神经解剖学框架来预测 基于每种PPA变体的对同源负荷和对每种治疗方法的反应性 独特的认知语言学和神经学特征10名西班牙语-英语双语个人与PPA将获得 言语干预。在中风失语症的康复研究中， 人们注意到，这种做法既促进也阻碍了普遍化，而在语文收益范围内没有付出任何代价。 因此，本研究将操纵刺激集中同源包含物的密度，以确定 最大化跨语言概括和最小化竞争的同源词的比例。 该项目与公共卫生的相关性在于它试图了解 双语者PPA的行为和神经变化。2020年健康人计划的一个目标 降低发病率和相关费用，维持或提高人们的生活质量 患有痴呆症PPA是一种未被充分研究的痴呆症，患有PPA的双语者 历史上服务不足。本提案的结果将提供有关以下方面的临床相关证据： PPA双语患者的下降率和治疗的潜在获益。 该项目将为申请人提供独特的培训体验，其中包括学习新的 方法和数据分析技术。申请人的赞助商和顾问将提供专业知识 以及在干预、神经成像、双语、实验设计和统计等领域的指导; 因此，她准备成为双语失语症和痴呆症领域的独立研究人员。

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.