Contrasting treatment for word retrieval impairments

由于左脑半球疾病导致的失语症患者的一个突出症状是难以检索影响名词或动词的单词。认知神经心理学模型认为，单词检索涉及一系列复杂的词汇过程，包括语义和语音两个阶段。随后，研究纳入了语义学或音韵学的恢复处理，并在一些个体，特别是名词的词语检索能力方面有了明显的改善。对可能引起其他认知过程的替代词检索治疗的效果的研究较少，对动词的治疗没有效果，以及对同一失语症患者的不同治疗的比较。在我们的研究中，我们建议为一系列评估名词和动词的理解和产生的词汇任务开发规范性数据。我们稍后会对失语症患者进行实验来记录单词检索障碍的性质。然后，我们将完成一系列的研究，在这些研究中，我们对比了两种单词检索处理。恢复性治疗将鼓励使用典型的语义和语音单词检索过程，而替代言语+手势治疗将鼓励使用哑语来唤起相应的言语反应。我们将比较名词和动词的治疗效果。我们将评估在结构词检索任务中的表现，以及在会话和治疗结果的功能测量中的表现。在最后的实验中，我们将使用功能磁共振成像研究治疗效果的神经相关性。

A prominent symptom seen in individuals with aphasia due to left cerebral hemisphere disease is difficulty with word retrieval affecting either nouns or verbs. Recent investigation of treatments for word retrieval impairments have been influenced by cognitive neuropsychological models which recognize that word retrieval involves a complex set of lexical processes including semantic and phonologic stages. Subsequently, studies have incorporated restitutive semantic or phonologic treatments and have demonstrative improvements in word retrieval abilities in some individuals, particularly for nouns. Less attention has been given to examining the effects of substitutive word retrieval treatments that might invoke other cognitive processes, no treatment effects for verbs, and to comparing different treatments in the same individuals with aphasia. In our studies, we propose to develop normative data for a battery of lexical tasks assessing comprehension and production of nouns and verbs. We will later administer the battery the battery to patients with aphasia to document the nature of the word retrieval impairments. We then will complete a series of studies in which we contrast two word retrieval treatments. The restitutive treatment will encourage the use of typical semantic and phonologic word retrieval processes, whereas the substitutive verbal+ gestural treatment will encourage the use of pantomimes to evoke a corresponding verbal response. We will compare treatment effects for both nouns and verbs. We will assess performance in structural word retrieval tasks as well as in conversational and functional measures of treatment outcome. In a final experiment, we will study the neural correlates of treatment effects using fMRI.