Rehabilitation and Prophylaxis of Anomia in Primary Progressive Aphasia

描述（由申请人提供）：本研究的目的是纠正原发性进行性失语症（PPA）患者的词语发现问题，并延缓词语发现障碍的进一步发展。目前的方法是新颖的，因为它包含一个预防成分，我们试图加强保持功能的神经连接，使它们在疾病进展时更能抵抗退化。虽然这项研究是专门针对找字问题的，但一个成功的结果将预示着其他旨在预防或逆转痴呆症患者认知功能下降的研究。PPA患者的图片命名能力刚刚开始出现下降的迹象，将在两种情况下进行图片命名练习：查看图片并重复名称；然后看画上的名字，再加上读和写名字。在这些条件下训练的图片命名将在训练后的三个时间间隔内与研究前测试但从未训练过的图片命名进行比较。一个包含训练项目的场景描述任务将用于评估泛化。据预测，把图片和它的名字配对，再加上写名字的运动任务，会比简单地练习看图片和重复名字产生更大的能力。还预测了对其他示例和其他任务情况的泛化。此外，我们将对患者的大脑进行成像，以确定脑萎缩的模式是否可以用来预测治疗反应。

DESCRIPTION (provided by applicant): The goal of this study is to remediate word-finding problems in patients with Primary Progressive Aphasia (PPA) and to delay the further progression of word-finding impairment. The current approach is novel in that it contains a prophylaxis component in which we attempt to strengthen neural connections that remain functional, making them more resistant to degradation as the disease progresses. While the study is specific in its targeting of word-finding problems, a successful outcome would bode well for other studies aimed at prevention or reversal of declining cognitive functions in dementia. Patients with PPA whose naming of pictures has just begun to show signs of decline will receive practice with picture naming in two conditions: viewing the picture and repeating the name; and viewing the picture with its written name, plus reading and writing the name. Naming of pictures trained in each of these conditions will be compared, at three time intervals post-training, with naming of pictures tested before the study but never trained. A scene-description task containing trained items will be used to assess generalization. It is predicted that the pairing of the picture with its written name, combined with the motor task of writing the name, will result in a greater ability to name the picture at a later date than simple practice viewing the picture and repeating the name. Generalization to other exemplars and to other task situations is also predicted. In addition, we will image the brains of the patients to determine whether patterns of brain atrophy can be used to predict treatment response. PUBLIC HEALTH RELEVANCE: Primary progressive aphasia is a progressive disorder of language processing. During the early stages of primary progressive aphasia, when patients are still living at home and functioning within the normal family setting, one of the greatest challenges to normal living is difficulty communicating caused in part by the inability to access the appropriate words. The successful delay or remediation of such word finding problems - the goal of the proposed study - would have significant consequences for the quality of life of patients with primary progressive aphasia, and for their families and caregivers.