Early Detection and Treatment of Emerging Cognitive-Linguistic Impairment in Minority Cognitive Aging and Primary Progressive Aphasia

早期发现和治疗少数认知衰老和原发性进行性失语症中出现的认知语言障碍

• 批准号: 10548191
• 负责人: James Joseph Reilly
• 金额: $ 29.74万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-02-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10548191
• 关键词: Address; Adjuvant; Adopted; Adult; African American; Age; Aging; Alzheimer' s Disease; Ambulatory Care; Anatomy; Anterior; Atrophic; Behavior Therapy; Behavioral; Bilateral; Brain region; Caregivers; Cognition; Cognitive; Cognitive aging; Color; Communities; Complement; Comprehension; Country; Crossover Design; Data; Dementia; Developed Countries; Development; Dimensions; Disease; Early Diagnosis; Early identification; Early treatment; Education; Effectiveness; Elderly; Electrodes; Emotions; Episodic memory; Eye; Friends; Functional disorder; Funding; Future; Human; Impaired cognition; Impairment; Incidence; Individual Differences; Industrialization; Inferior; Intervention; Knowledge; Language; Language Development; Language Disorders; Learning; Linguistics; Link; Love; Low income; Machine Learning; Maintenance; Measures; Memory; Methods; Minority; Mission; Molecular Target; Names; National Institute on Deafness and Other Communication Disorders; Nature; Neuropsychology; Neurosciences Research; Pathology; Patients; Pattern; Perception; Physiological; Primary Progressive Aphasia; Process; Productivity; Progressive Aphasias; Property; Prospective cohort; Public Health; Regimen; Research; Risk; Screening procedure; Semantic memory; Semantics; Severity of illness; Site; Standardization; System; Temporal Lobe; Testing; Time; Training; Underserved Population; United States; Variant; Visual; Vocabulary; Word Processing; age related; clinical translation; cognitive change; cognitive neuroscience; cohort; diagnostic biomarker; diagnostic criteria; drug discovery; effectiveness evaluation; evidence base; executive function; follow-up; forgetting; frontal lobe; frontotemporal degeneration; gaze; high dimensionality; improved; indexing; language impairment; machine learning algorithm; mild cognitive impairment; neurological rehabilitation; noninvasive brain stimulation; novel; overtreatment; prevent; screening; sound; stroke-induced aphasia; supervised learning; transcranial direct current stimulation; treatment services; voltage

PROJECT SUMMARY/ABSTRACT Dementia is among the most daunting public health crises facing industrialized nations. Many countries, including the United States,1 have recently adopted comprehensive national dementia strategies.2 The US National Dementia Strategy (section 2B) has identified early diagnosis and links to community treatment services as pillars of its management plan. The availability of evidence-based outpatient treatment for progressive language impairments remains exceedingly sparse. In 2014, we began to address this void via a longitudinal intervention targeting maintenance of a core vocabulary consisting of 100 words over two years. This caregiver-friendly treatment is showing great promise for promoting the retention of key vocabulary in frontotemporal degeneration and Alzheimer's Disease. A secondary aim involved evaluating prediction of later language forgetting. We have learned much during this initial project period, and its renewal has the potential to tell us much more. Our current proposal consists of three aims, all of which directly align both with the US National Dementia Strategy and the mission of our funding institute (i.e., the National Institute on Deafness and Other Communication Disorders).3 In Specific Aim 1 (SA1), we will evaluate the long-term effectiveness of a regimen of noninvasive brain stimulation (transcranial direct current stimulation) delivered over the anterior temporal lobes as an adjuvant to our ongoing semantic behavioral treatment. We will do so using a crossover design where two groups of patients with semantic variant Primary Progressive Aphasia complete sham and active stimulation conditions paired with behavioral treatment (order counterbalanced). We will subsequently follow this patient cohort over two years to evaluate the durability of treatment gains. In SA2, we will evaluate predictors of emerging cognitive-linguistic impairment in a vastly underserved population (i.e., older African American adults). We will identify older adults who are at increased risk for conversion to mild cognitive impairment as indexed by global cognitive and language measures. We will then follow and characterize this prospective cohort using sensitive behavioral (gaze patterns during visual confrontation naming) and neuropsychological markers. Finally, in SA3 we will evaluate representation, processing, and shifts in abstract word meaning as functions of age, pathology, and individual differences (e.g., vocabulary size, years of education) using machine learning. This renewal reflects the continuation of a productive and rigorous line of research that will yield complementary data about human semantic memory, best practices in promoting language maintenance, and variability of age-associated language change.

项目概要/摘要 痴呆症是工业化国家面临的最严峻的公共卫生危机之一。许多国家， 包括美国在内1最近通过了全面的国家痴呆症战略。2美国 国家痴呆症战略（第 2B 节）确定了早期诊断以及与社区治疗的联系 服务作为其管理计划的支柱。循证门诊治疗的可用性 进行性语言障碍仍然极其罕见。 2014 年，我们开始通过 纵向干预的目标是在两年内维持由 100 个单词组成的核心词汇。 这种照顾者友好的治疗方法在促进关键词汇的保留方面显示出巨大的希望。 额颞叶退化和阿尔茨海默病。第二个目标涉及评估以后的预测 语言遗忘。我们在这个初始项目期间学到了很多东西，并且它的更新具有潜力 告诉我们更多。我们当前的提案包括三个目标，所有这些目标都与美国直接一致 国家痴呆症战略和我们资助机构（即国家耳聋研究所）的使命 和其他沟通障碍）。3 在具体目标 1 (SA1) 中，我们将评估以下内容的长期有效性： 通过前部进行无创脑刺激（经颅直流电刺激）的方案 颞叶作为我们正在进行的语义行为治疗的辅助手段。我们将使用交叉来做到这一点 两组患有语义变异原发性进行性失语症的患者完成假手术和 主动刺激条件与行为治疗相结合（顺序平衡）。我们随后将 对这个患者队列进行两年多的跟踪，以评估治疗效果的持久性。在SA2中，我们将评估 在服务严重不足的人群（即非洲老年人）中出现的认知语言障碍的预测因素 美国成年人）。我们将确定哪些老年人转变为轻度认知的风险较高 以全球认知和语言测量为指标的损害。然后我们将跟踪并描述这一点 使用敏感行为（视觉对抗命名期间的注视模式）的前瞻性队列 神经心理学标记。最后，在 SA3 中，我们将评估抽象的表示、处理和转换 词义是年龄、病理和个体差异（例如词汇量、工作年数）的函数 教育）使用机器学习。这次更新反映了富有成效和严谨的路线的延续 研究将产生有关人类语义记忆的补充数据、促进 语言维持以及与年龄相关的语言变化的可变性。