Assessment and Characterization of Naming in Older Adults with Epilepsy

描述（由申请人提供）：说话时使用正确词汇的能力对于正常的社交、学术和职业功能至关重要。由于词语发现或“命名”是由颞叶区域调节的，命名困难是显性颞叶癫痫（TLE）患者的常见主诉和频繁发现。命名在TLE患者的临床护理中起着核心作用，因为命名行为有助于确定癫痫发作的偏侧和局部，识别对命名至关重要的皮层区域是识别语言皮层的主要技术

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.