Rehabilitation and Prophylaxis of Anomia in Primary Progressive Aphasia

原发性进行性失语症失语症的康复和预防

基本信息

批准号：
10194444
负责人：
RHONDA B FRIEDMAN
金额：
$ 74.36万
依托单位：
GEORGETOWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-08-01 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10194444
关键词：
Aftercare Alzheimer&apos s Disease Alzheimer&apos s disease diagnosis Anomia Area Atrophic Attention Biometry Brain region Caregivers Categories Cognitive Communication Data Degenerative Disorder Diagnostic Disease Enrollment Evaluation Family Family Caregiver Funding Goals Grant Home Impairment International Laboratories Language Language Disorders Left MRI Scans Maintenance Measurement Measures Names Neurodegenerative Disorders Neurology Outcome Participant Patients Persons Predictive Value Primary Progressive Aphasia Prophylactic treatment Quality of life Rehabilitation therapy Reporting Research Semantic Aphasias Semantics Source Speech-Language Pathology Stroke Structure Structure of inferior temporal gyrus Subgroup Techniques Test Result Testing Theoretical model Time Travel Validation Videoconferencing Waiting Lists Work base cerebral atrophy cognitive neuroscience design improved language impairment lexical optimal treatments preservation remediation success therapy development treatment effect treatment strategy

项目摘要

The long-range goal of this project is to provide the clinician with a scientifically-based means of determining optimal treatment(s) for anomia in patients with neurodegenerative disorders, including primary progressive aphasia (PPA) and Alzheimer's disease (AD). The desired outcomes are a longer period of preservation of function (Prophylaxis) for words that can be retrieved successfully, and improvement (Remediation) for words that cannot be retrieved successfully at baseline. Semantically-based treatment will be compared with lexically-based treatment, and maintenance of treatment gains will be measured at one-month, eight months, and 15 months post-treatment. Participants will be persons with all three types of PPA -- semantic (svPPA), nonfluent/agrammatic (nfvPPA), and logopenic (lvPPA) -- and persons with AD who have significant word- finding problems (anomia). Through the use of a within-subjects design, each participant will receive both treatments, with different items in the two treatment sets. Participants who are unable to travel to the laboratory for the required number of treatment and evaluation sessions will participate remotely via videoconferencing. At baseline, structural MRI scans will be obtained, and two semantic batteries will be administered: one consisting of conceptually-based tests (without words), and one consisting of lexically-based tests. The results of these test batteries will be used to compute a Relative Lexical-Semantic/Conceptual-Semantic impairment measure for each participant. Based on theoretical considerations discussed in the proposal, it is predicted that persons whose lexical impairments are greater than their conceptual impairments will show greater treatment effects for lexically- based treatment than for semantically-based treatment, while those with a greater conceptual impairment will show greater treatment effects with a semantically-based treatment than a lexically-based treatment. Further, it is predicted that the Relative Lexical-Semantic/Conceptual-Semantic impairment measure will provide additional information about the treatment effects, above and beyond what can be obtained from the Diagnostic Subgroups and demographic variables. The use of baseline atrophy in predicting treatment effects will also be tested; Specifically, it is predicted that participants with baseline atrophy in the left temporal pole and/or the left inferior temporal gyrus will be more likely to demonstrate generalization to untrained items when semantic treatment is utilized, compared to the lexical treatment condition. The validation of techniques for improving word-finding, and hence communication, in persons with PPA and AD is of great significance for these patients and their families and caregivers. And being able to determine, on the basis of scientific data, which treatment is most likely to succeed for a given patient, is the aspiration of every clinician.

该项目的远程目标是为临床医生提供基于科学的确定手段神经退行性疾病患者的最佳治疗方法，包括原发性进行性疾病失语（PPA）和阿尔茨海默氏病（AD）。期望的结果是更长的保存期可以成功检索的单词的功能（预防），并改进（补救）单词在基线时无法成功检索。将基于语义的治疗与基于词汇的治疗和维持治疗收益将在一个月，八个月的时间内测量治疗后15个月。参与者将是所有三种类型的PPA的人 - 语义（SVPPA），非频率/农业（NFVPPA）和徽标（LVPPA）以及具有重要词的AD的人发现问题（异常）。通过使用主题内设计，每个参与者都将获得两者治疗，在两个治疗组中具有不同的项目。无法前往实验室的参与者对于所需数量的治疗和评估会议，将通过视频会议远程参与。在基线时，将获得结构性MRI扫描，将管理两个语义电池：一个由基于概念的测试（无单词）组成，由基于词汇的测试组成。结果这些测试电池将用于计算相对的词语语义/概念语义障碍为每个参与者进行衡量。基于提案中讨论的理论考虑因素，可以预测其词汇的人损害大于其概念障碍，将对词汇表现出更大的治疗效果 - 基于基于语义的治疗的治疗与基于词汇的治疗相比，通过基于语义的治疗显示出更大的治疗效果。此外，它预测，相对词汇语义/概念语义障碍措施将提供有关治疗效果的其他信息，超越了从诊断子组和人口统计学变量。使用基线萎缩来预测治疗效果也将进行测试；具体而言，可以预测左颞极中基线萎缩的参与者和/或左下的颞回，更可能在未经训练的项目中证明与词汇治疗条件相比，使用语义处理。验证技术在患有PPA和AD的人身上改善单词调查，因此可以进行沟通，对这些患者及其家人和照料者。并能够根据科学数据确定每位临床医生的吸引力是给定患者最有可能成功的治疗方法。