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.

项目摘要/摘要 痴呆症是工业化国家面临的最艰巨的公共卫生危机之一。许多国家， 包括美国在内的1个最近采用了全面的国家痴呆策略。2美国 国家痴呆策略（第2B节）已确定早期诊断并与社区治疗的联系 服务作为其管理计划的支柱。提供基于证据的门诊治疗 进步的语言障碍仍然非常稀疏。 2014年，我们开始通过 纵向干预针对维持核心词汇的纵向干预，该核心词汇由100个单词组成两年。 这种对护理人员友好的治疗在促进关键词汇保留的巨大希望 额颞变性和阿尔茨海默氏病。次要目的涉及评估以后的预测 语言忘记。在这个初始项目期间，我们学到了很多东西，其更新具有潜力 告诉我们更多。我们当前的建议包括三个目标，所有目标都直接与美国保持一致 国家痴呆症战略和我们资助研究所的使命（即国家聋哑研究所 和其他沟通障碍）.3在特定目标1（SA1）中，我们将评估长期有效性 在前部的非侵入性脑刺激方案（经颅直流电流刺激） 颞叶是我们正在进行的语义行为处理的辅助。我们将使用跨界 设计中，两组具有语义变异的主要进行性渐进性失语的患者完整的假和 主动刺激条件与行为治疗配对（顺序平衡）。我们将随后 在两年内遵循该患者队列以评估治疗增长的耐用性。在SA2中，我们将评估 在服务不足的人群中，新兴的认知语言障碍的预测因素（即，年长的非洲人 美国成年人）。我们将确定老年人有增加转化为轻度认知风险的老年人 全球认知和语言措施所索引的障碍。然后，我们将跟随并描述这个 使用敏感行为的前瞻性队列（视觉对抗命名期间的凝视模式）和 神经心理学标记。最后，在SA3中，我们将抽象评估表示，处理和转移 单词含义是年龄，病理和个体差异的功能（例如词汇大小，年份 教育）使用机器学习。这种更新反映了一条富有成效和严格的线的延续 将产生有关人类语义记忆的互补数据，促进的最佳实践 语言维护和与年龄相关语言变化的变异性。