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

• 批准号: 9381305
• 负责人: RHONDA B FRIEDMAN
• 金额: $ 79.26万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9381305
• 关键词: Aftercare; Alzheimer' s Disease; Anomia; Area; Atrophic; Attention; Biological Preservation; Biometry; Brain region; Caregivers; Categories; Cognitive; Communication; Data; Degenerative Disorder; Diagnosis; Diagnostic; Disease; Enrollment; Evaluation; Family; Family Caregiver; Funding; Goals; Grant; Home environment; Impairment; International; Laboratories; Language; Language Development; 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 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; remediation; success; therapy development; treatment effect; treatment strategy

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.

该项目的长期目标是为临床医生提供一种基于科学的方法来确定 神经退行性疾病（包括原发性进展性疾病）患者贫血的最佳治疗方法 失语症（PPA）和阿尔茨海默病（AD）。期望的结果是更长的保存期限 对能够成功检索的单词进行功能（Prophylaxis），对单词进行改善（Remediation） 无法在基线成功检索。基于语义的治疗将与 基于词汇的治疗，以及治疗增益的维持将在一个月、八个月、 以及治疗后15个月。参与者将是具有所有三种 PPA 类型的人——语义 (svPPA)、 不流利/不语法 (nfvPPA) 和语词缺乏 (lvPPA)——以及患有 AD 的人有重要的单词—— 发现问题（贫血症）。通过使用受试者内设计，每个参与者都将获得 治疗，两个治疗组中使用不同的项目。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加。 在基线时，将获得结构 MRI 扫描，并将使用两套语义电池：一套 一组测试由基于概念的测试（无单词）组成，一组测试由基于词汇的测试组成。结果 这些测试组将用于计算相对词汇语义/概念语义损伤 对每个参与者进行测量。 根据提案中讨论的理论考虑，预计其词汇的人 损伤大于概念损伤将显示出更大的词汇治疗效果 基于语义的治疗优于基于语义的治疗，而那些概念障碍较大的人会 基于语义的处理比基于词汇的处理显示出更好的处理效果。此外，它 预计相对词汇语义/概念语义损伤测量将提供 关于治疗效果的附加信息，超出了可以从 诊断亚组和人口统计变量。使用基线萎缩来预测治疗效果 也将受到考验；具体来说，预测左颞极基线萎缩的参与者 和/或左颞下回更有可能表现出对未经训练的项目的泛化 与词汇处理条件相比，使用语义处理。技术验证 改善 PPA 和 AD 患者的找词能力以及沟通能力对于以下方面具有重要意义： 这些患者及其家人和护理人员。并能够根据科学数据确定， 对于特定患者来说，哪种治疗最有可能成功，是每个临床医生的愿望。