Croot Karen
ARC Centre of Excellence in Cognition and Its Disorders, Department of Cognitive Science, Macquarie University, Sydney, Australia.
School of Psychology, University of Sydney, New South Wales, Australia.
Semin Speech Lang. 2018 Jul;39(3):242-256. doi: 10.1055/s-0038-1660783. Epub 2018 Jun 22.
Lexical retrieval impairments (also known as anomia or word-finding deficits) are an early and prominent symptom in primary progressive aphasia (PPA), causing distress and frustration to individuals with PPA and their communication partners, and prompting research on lexical retrieval treatment. This paper reviews the research on lexical retrieval treatment in PPA from the earliest reports in the 1990s to early 2018 and considers the implications of this research for clinical practice. The number of published studies has increased markedly over the past decade, consisting primarily of behavioral studies, with rapid recent growth in noninvasive brain stimulation studies. Five general treatment techniques were identified in the behavioral studies, described here as standard naming treatment, Look, Listen, Repeat treatment, cueing hierarchies, semantically focused treatments, and lexical retrieval in context. Across techniques, behavioral studies targeting difficult-to-retrieve items typically report immediate gains, and there is evidence these gains can be maintained over months to years by some participants who continue with long-term treatment. There is also evidence that prophylactic treatment supports retrieval of treated items compared with untreated items. There is limited evidence for generalization of treatment to untreated items, suggesting the primary aim of lexical retrieval treatment in this population is to maintain retrieval of a core vocabulary for as long as possible. Language and cognitive assessment and piloting of the intended treatment can inform decisions about treatment selection and participant suitability for long-term lexical retrieval treatment. The paper concludes with some questions to guide clinical decision making about whether to implement or continue with a behavioral lexical retrieval treatment.
词汇检索障碍（也称为命名障碍或找词困难）是原发性进行性失语症（PPA）早期出现的突出症状，给PPA患者及其交流伙伴带来痛苦和沮丧，并促使人们对词汇检索治疗展开研究。本文回顾了自20世纪90年代最早的报告至2018年初关于PPA词汇检索治疗的研究，并探讨了该研究对临床实践的启示。在过去十年中，已发表的研究数量显著增加，主要包括行为学研究，近年来非侵入性脑刺激研究也迅速增多。在行为学研究中确定了五种一般治疗技术，在此描述为标准命名治疗、看、听、重复治疗、提示层次、语义聚焦治疗和语境中的词汇检索。在各种技术中，针对难以检索项目的行为学研究通常报告有即时改善，并且有证据表明，一些继续接受长期治疗的参与者能够在数月至数年的时间内维持这些改善。也有证据表明，与未治疗的项目相比，预防性治疗有助于已治疗项目的检索。将治疗推广到未治疗项目的证据有限，这表明该人群中词汇检索治疗的主要目标是尽可能长时间地维持核心词汇的检索。语言和认知评估以及对预期治疗的试点可以为治疗选择和参与者是否适合长期词汇检索治疗的决策提供参考。本文最后提出了一些问题，以指导关于是否实施或继续进行行为性词汇检索治疗的临床决策。
