Assessment and Characterization of Naming in Older Adults with Epilepsy

老年癫痫患者命名的评估和特征

• 批准号: 9248434
• 负责人: MARLA J HAMBERGER
• 金额: $ 37.03万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9248434
• 关键词: Address; Adult; Affect; Age; Aging; Alzheimer' s Disease; Anatomy; Aphasia; Area; Assessment tool; Attention; Auditory; Behavioral; Benchmarking; Benign; Brain; Characteristics; Classification; Clinical; Clinical Research; Cognitive; Comorbidity; Coupled; Diagnosis; Differential Diagnosis; Elderly; Epilepsy; Exhibits; Goals; Impairment; Incidence; Individual; Knowledge; Language; Lead; Left; Location; Measures; Mediating; Mediation; Modality; Names; National Institute of Neurological Disorders and Stroke; Occupational; Operative Surgical Procedures; Patients; Pattern; Performance; Play; Population; Prevalence; Process; Protocols documentation; Research; Retrieval; Risk; Role; Seizures; Severities; Standardization; Symptoms; Techniques; Temporal Lobe; Temporal Lobe Epilepsy; Testing; Visual; Vocabulary; Work; age related; aging brain; clinical care; clinically relevant; clinically significant; cortex mapping; early onset; follow-up; healthy aging; individual patient; insight; instrument; middle age; nervous system disorder; neural correlate; neuroimaging; normal aging; public health relevance; social; tool; young adult

DESCRIPTION (provided by applicant): The ability to produce the correct words while speaking is critical for normal social, academic and occupational functioning. As word finding or "naming" is mediated by the temporal lobe region, naming difficulty is a common complaint and frequent finding in people with dominant temporal lobe epilepsy (TLE). Naming plays a central role in the clinical care of TLE patients, in that naming performance assists in the determination of lateralization and localization of seizure onset, and identification of cortical areas that are essential for naming is the principle technique for identifying language cortex prior to respective surgery. Although naming in epilepsy has received considerable attention, these efforts have been restricted to younger adults. The incidence and prevalence of epilepsy is currently highest, and continues to rise, in the elderly. Thus, the absence of information on naming in older adults with epilepsy presents a growing clinical problem, particularly as aging introduces new concerns overlaid upon existent, epilepsy-related naming difficulty. Specifically, naming decline is also a feature of normal aging and a hallmark symptom of Alzheimer's disease. When an older adult with epilepsy presents with word finding decline, we currently lack both the knowledge and the proper tools to determine whether the decline represents a typical age-related trajectory in epilepsy, the beginning of a more severe degenerative process, or the relatively benign effects of normal aging. Importantly, the answer to this question would have a significant impact on diagnosis, follow up and treatment. Unfortunately currently available naming measures have serious limitations that compromise their utility, including assessment restricted to the visual modality, insensitive performance measures, vocabulary confounds and cultural biases. The proposed project will address these problems by: 1) Developing and standardizing age appropriate auditory naming and complementary, visual naming measures for older adults, and 2) Applying these measures to characterize and distinguish among naming patterns in healthy older adults, older adults with epilepsy, and older adults with mild Alzheimer's disease. We anticipate that results will: a) Provide new clinical and research instruments for thorough and effective assessment of naming in older adults, b) Delineate the trajectory of naming across the age span in epilepsy, c) Generate new insights into temporal lobe mediation of word retrieval in the aging brain, and d) Provide a noninvasive protocol to assist in the differential diagnosis of degenerative and non-degenerative disorders that affect higher cortical function in older adults.

描述（由申请人提供）：说话时产生正确单词的能力对于正常的社会，学术和职业功能至关重要。由于暂时叶区域介导了单词查找或“命名”，因此命名难度是颞叶癫痫（TLE）的人常见的抱怨和经常发现。命名在TLE患者的临床护理中起着核心作用，因为命名性能有助于确定癫痫发作的横向化和定位，并且识别命名必不可少的皮质区域是识别各自语言皮质的主要技术 外科手术。尽管癫痫的命名受到了很大的关注，但这些努力仅限于年轻人。癫痫的发病率和患病率目前最高，并且在老年人中持续上升。因此，缺乏有关癫痫病老年人命名的信息带来了越来越多的临床问题，尤其是在衰老引入有关存在的，与癫痫相关的命名困难覆盖的新问题时。具体而言，命名下降也是正常衰老和阿尔茨海默氏病的标志性症状的特征。当一个患有癫痫的老年人出现单词发现下降时，我们目前缺乏知识和适当的工具来确定下降是否代表了癫痫的典型轨迹，更严重的退化过程的开始还是相对良性正常衰老的影响。重要的是，这个问题的答案将对诊断，随访和治疗产生重大影响。不幸的是，目前可用的命名措施具有严重的局限性，损害了其效用，包括限于视觉方式的评估，不敏感的绩效指标，词汇混杂和文化偏见。拟议的项目将通过以下方式解决这些问题：1）制定和标准化年龄适当的听觉命名和互补的老年人的视觉命名措施，以及2）采用这些措施来表征和区分健康的老年人，老年人，患有癫痫病的老年人的命名模式以及患有轻度阿尔茨海默氏病的老年人。我们预计结果将：a）提供新的临床和研究工具，以彻底有效地评估老年人的命名，b）描述癫痫病年龄跨度的命名轨迹在衰老大脑中的检索，d）提供了一种非侵入性方案，以帮助对影响老年人较高皮质功能的退化性和非分类性疾病的差异诊断。