Meyer Aaron M, Faria Andreia V, Tippett Donna C, Hillis Argye E, Friedman Rhonda B
Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC.
Department of Neurology, Johns Hopkins University, Baltimore, MD.
Aphasiology. 2017;31(9):1059-1077. doi: 10.1080/02687038.2017.1296557. Epub 2017 Mar 2.
Structural imaging has not been used previously to predict the effect of treatment in primary progressive aphasia (PPA).
This study examined relationships between baseline brain volume and the effects of phonological and orthographic treatments for anomia in PPA. It was predicted that lower baseline volume would be associated with lower post-treatment naming accuracy for treated items and smaller generalization effects.
METHODS & PROCEDURES: Twenty-one individuals with PPA participated. The treatment stimuli consisted of nouns that were consistently named correctly at baseline (Prophylaxis items) and/or nouns that were consistently named incorrectly at baseline (Remediation items). All 21 participants had Prophylaxis items, while 10 participants had Remediation items. Naming accuracy for untrained and trained items (Exemplar set 1) was measured. In addition, stimulus generalization was examined by having participants name an alternative exemplar of each untrained and trained item (Exemplar set 2). Correlational analyses focused on the relationships between naming accuracy and volume of regions previously identified as having a role in naming and semantic processing.
OUTCOMES & RESULTS: Unexpectedly, there were no significant correlations between baseline volume and post-treatment accuracy for treated items. However, baseline volume within the left temporal pole was positively correlated with post-treatment accuracy for Untrained Exemplar set 2 Prophylaxis items, while baseline volume in the left inferior temporal gyrus was positively correlated with post-treatment accuracy for Untrained Exemplar set 1 Remediation items.
These findings suggest that lower volume in the left temporal pole is associated with decline for Untrained items, while lower volume in the left inferior temporal gyrus is associated with a lack of improvement for Untrained items. Possible explanations for the different patterns observed across Exemplar sets are discussed.
以往尚未使用结构成像来预测原发性进行性失语(PPA)的治疗效果。
本研究考察了原发性进行性失语患者的基线脑容量与针对命名障碍的语音和正字法治疗效果之间的关系。研究预测,较低的基线脑容量将与治疗项目的治疗后命名准确性较低以及较小的泛化效应相关。
21名原发性进行性失语患者参与研究。治疗刺激包括在基线时始终能正确命名的名词(预防项目)和/或在基线时始终命名错误的名词(补救项目)。所有21名参与者都有预防项目,而10名参与者有补救项目。测量未训练项目和训练项目(示例集1)的命名准确性。此外,通过让参与者对每个未训练和训练项目的替代示例进行命名来检验刺激泛化(示例集2)。相关性分析聚焦于命名准确性与先前确定在命名和语义处理中起作用的脑区体积之间的关系。
出乎意料的是,基线脑容量与治疗项目的治疗后准确性之间没有显著相关性。然而,左侧颞极内的基线脑容量与未训练示例集2预防项目的治疗后准确性呈正相关,而左侧颞下回的基线脑容量与未训练示例集1补救项目的治疗后准确性呈正相关。
这些发现表明,左侧颞极脑容量较低与未训练项目的衰退有关,而左侧颞下回脑容量较低与未训练项目缺乏改善有关。讨论了在不同示例集中观察到的不同模式的可能解释。