Factors Affecting Maintenance of New Learning in Aphasia

描述（由申请人提供）：获得性语言障碍中最常见的症状之一是找词困难或失范。虽然已经开发了许多有希望的语言障碍治疗方法，但仍有一些基本问题尚未得到解答。记忆研究很久以前就证实，最近获得的记忆也是最脆弱的。那么，为什么一旦达到预定的表现标准，失语症治疗通常就会结束呢？也许继续治疗会更好，让这些来之不易的记忆有时间巩固？目前还不清楚是什么因素影响了患者长期维持这些治疗的能力。在不了解这一点的情况下，很难确定需要多少疗程的治疗才能达到最大的效果。本项目旨在增加这些主题的文献。我们将研究在达到预先设定的标准后继续治疗是否可以改善治疗的长期维持。该研究还试图利用功能性磁共振成像（fMRI）来了解大脑中与这些不同水平的训练相关的潜在变化。通过在受试者内部设计中使用多次扫描会话以及与对照组进行比较，我们将能够得出关于常用治疗效果的结论，以及关于在临床实践中继续这种治疗的效果。如果继续治疗被证明能使表现的改善更持久，我们的功能磁共振成像数据将能够向我们展示与更持久的行为改变相关的激活模式。如今，美国有近100万成年人患有失语症。由于失范症是其最普遍的症状，我们必须找到更好的治疗方法，这对公众健康至关重要。为了最大限度地利用神经成像技术，我们还需要了解与不同类型或强度的治疗相关的解剖学变化。

DESCRIPTION (provided by applicant): One of the most prevalent symptoms observed in acquired disorders of language is word-finding difficulty or anomia. Though many promising therapies for language disorders have been developed, there are still fundamental questions that remain unanswered. Memory research established long ago that the most recently acquired memories are also the most fragile. Why then, does aphasia therapy usually end as soon as a pre-determined performance criterion has been reached? Might it make better sense to continue therapy, allowing these hard-earned memories the time they need to consolidate? It is still unclear what factors affect a patient's ability to maintain the benefits of these therapies for the long-term. Without knowing this, it is difficult to determine how many sessions of therapy are needed to achieve the maximum benefit. This project seeks to add to a growing literature on these topics. We will examine whether or not the continuation of therapy after a pre-set criterion has been reached could improve the long-term maintenance of the therapy. The study also seeks to understand the underlying changes in the brain associated with these different levels of training using functional magnetic resonance imaging (fMRI). By using multiple scanning sessions in a within-subjects design as well as by comparison to a control group, we will be able to draw conclusions about the effects of a commonly-used therapy and about the effects of continuing this therapy beyond where it would normally stop in clinical practice. If continuation of therapy proves to make performance gains longer-lasting, our fMRI data will be able to show us the activation patterns associated with a more permanent change in behavior. Almost 1 million adults live with aphasia in America today. Because anomia is its most prevalent symptom, it is essential to public health that we discover better ways of remediating it. We have much to learn about the anatomical changes associated with different types or levels of intensity of therapy in order to use neuroimaging technology to our greatest advantage.