Assessment and Characterization of Naming in Older Adults with Epilepsy

描述（由申请人提供）：说话时产生正确单词的能力对于正常的社交，学术和职业功能至关重要。由于词的发现或“命名”是由颞叶区域介导的，命名困难是显性颞叶癫痫（TLE）患者的常见主诉和常见发现。命名在TLE患者的临床护理中起着核心作用，因为命名表现有助于确定癫痫发作的偏侧化和定位，并且对命名所必需的皮层区域的识别是在相应的命名之前识别语言皮层的主要技术。 手术虽然命名癫痫已经得到了相当大的关注，这些努力一直局限于年轻人。癫痫的发病率和患病率目前在老年人中最高，并继续上升。因此，老年癫痫患者命名信息的缺乏是一个日益严重的临床问题，特别是随着年龄的增长，在现有的癫痫相关命名困难的基础上引入了新的问题。具体来说，命名衰退也是正常衰老的一个特征，也是阿尔茨海默病的标志性症状。当一个老年癫痫患者出现单词发现能力下降时，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癫痫的典型年龄相关轨迹，更严重的退行性过程的开始，或者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，目前可用的命名措施有严重的局限性，损害其效用，包括评估限于视觉模态，不敏感的性能指标，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）开发和标准化适合年龄的听觉命名和补充，老年人的视觉命名措施，以及2）应用这些措施来描述和区分健康老年人，癫痫老年人和轻度阿尔茨海默病老年人的命名模式。我们预计，结果将：a）提供新的临床和研究工具，用于对老年人的命名进行全面有效的评估，B）描绘癫痫中跨年龄跨度的命名轨迹，c）对衰老大脑中颞叶介导的单词检索产生新的见解，以及d）提供非侵入性方案以帮助鉴别退行性和非退行性的影响老年人高级皮质功能的退行性疾病。

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.