Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson.
Am J Speech Lang Pathol. 2020 Feb 21;29(1S):425-436. doi: 10.1044/2019_AJSLP-CAC48-18-0224. Epub 2019 Aug 16.
Purpose Lexical retrieval impairment is a universal characteristic of aphasia and a common treatment focus. Although naming improvement is well documented, there is limited information to shape expectations regarding long-term recovery. This was the motivation for a retrospective study of longitudinal data on the Boston Naming Test (BNT; Kaplan, Goodglass, & Weintraub, 1983, 2000). Method BNT scores were analyzed from a heterogeneous cohort of 42 individuals with anomia associated with a range of aphasia types. The data were collected over the course of 20 years from individuals who had participated in treatment and received at least 2 BNT administrations. A linear mixed model was implemented to evaluate effects of initial BNT score, time postonset, and demographic variables. For those over 55 years of age, BNT change was evaluated relative to data from the Mayo Clinic's Older Americans Normative Studies. Results There was a significant average improvement of +7.67 points on the BNT in individuals followed for an average of 2 years. Overall, the average rate of improvement was +5.84 points per year, in contrast to a decline of 0.23 points per year in a healthy adult cohort from the Mayo Clinic's Older Americans Normative Studies. Naming recovery was approximately linear, with significant main effects of initial BNT score (i.e., initial severity) and time postonset; the greatest changes were noted in those whose initial severity was moderate. Conclusions These findings indicate a positive prognosis for naming improvement over time regardless of demographic factors and provide estimates for clinical predictions for those who seek rehabilitation during the chronic phase.
目的
词汇提取障碍是失语症的普遍特征,也是常见的治疗重点。尽管命名改善已有充分记录,但关于长期恢复的信息有限,难以预测。这就是对波士顿命名测试(BNT;Kaplan、Goodglass 和 Weintraub,1983、2000)的纵向数据进行回顾性研究的动机。
方法
从伴有各种类型失语症的命名障碍的异质队列中分析了 BNT 得分。这些数据是从 20 年来接受过治疗并至少接受过 2 次 BNT 评估的个体中收集的。实施线性混合模型来评估初始 BNT 得分、发病后时间和人口统计学变量的影响。对于 55 岁以上的个体,将 BNT 变化与 Mayo 诊所老年人正常研究的数据进行比较。
结果
在平均随访 2 年的个体中,BNT 平均提高了+7.67 分。总体而言,平均每年的改善率为+5.84 分,而 Mayo 诊所老年人正常研究中健康成人队列每年下降 0.23 分。命名恢复大致呈线性,初始 BNT 得分(即初始严重程度)和发病后时间有显著的主效应;初始严重程度中等的个体变化最大。
结论
这些发现表明,无论人口统计学因素如何,随着时间的推移,命名改善的预后均为阳性,并为那些在慢性期寻求康复的人提供了临床预测的估计。