Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, Arizona.
Hum Brain Mapp. 2018 Aug;39(8):3285-3307. doi: 10.1002/hbm.24077. Epub 2018 Apr 17.
Research on neuroplasticity in recovery from aphasia depends on the ability to identify language areas of the brain in individuals with aphasia. However, tasks commonly used to engage language processing in people with aphasia, such as narrative comprehension and picture naming, are limited in terms of reliability (test-retest reproducibility) and validity (identification of language regions, and not other regions). On the other hand, paradigms such as semantic decision that are effective in identifying language regions in people without aphasia can be prohibitively challenging for people with aphasia. This paper describes a new semantic matching paradigm that uses an adaptive staircase procedure to present individuals with stimuli that are challenging yet within their competence, so that language processing can be fully engaged in people with and without language impairments. The feasibility, reliability and validity of the adaptive semantic matching paradigm were investigated in sixteen individuals with chronic post-stroke aphasia and fourteen neurologically normal participants, in comparison to narrative comprehension and picture naming paradigms. All participants succeeded in learning and performing the semantic paradigm. Test-retest reproducibility of the semantic paradigm in people with aphasia was good (Dice coefficient = 0.66), and was superior to the other two paradigms. The semantic paradigm revealed known features of typical language organization (lateralization; frontal and temporal regions) more consistently in neurologically normal individuals than the other two paradigms, constituting evidence for validity. In sum, the adaptive semantic matching paradigm is a feasible, reliable and valid method for mapping language regions in people with aphasia.
针对失语症康复的神经可塑性研究依赖于识别失语症个体大脑语言区域的能力。然而，常用于激发失语症患者语言处理的任务，如叙事理解和图片命名，在可靠性（测试-重测再现性）和有效性（语言区域的识别，而不是其他区域）方面存在局限性。另一方面，在识别无失语症人群中的语言区域方面非常有效的语义决策范式，对于失语症患者来说可能极具挑战性。本文描述了一种新的语义匹配范式，该范式使用自适应阶梯程序向个体呈现具有挑战性但在其能力范围内的刺激，从而使语言处理能够在有语言和无语言障碍的个体中充分参与。与叙事理解和图片命名范式相比，十六名慢性中风后失语症患者和十四名神经正常参与者对自适应语义匹配范式的可行性、可靠性和有效性进行了研究。所有参与者都成功地学习和执行了语义范式。在失语症患者中，语义范式的测试-重测再现性良好（Dice 系数=0.66），优于其他两个范式。该语义范式在神经正常个体中更一致地揭示了典型语言组织的已知特征（偏侧化；额颞区域），比其他两个范式更具有有效性。总之，自适应语义匹配范式是一种在失语症患者中映射语言区域的可行、可靠和有效的方法。
