Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, Philadelphia, PA.
Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA.
J Speech Lang Hear Res. 2020 Dec 14;63(12):4082-4095. doi: 10.1044/2020_JSLHR-20-00059. Epub 2020 Nov 12.
Purpose Primary progressive aphasia (PPA) and the amnestic variant of Alzheimer's disease (AD) are neurodegenerative conditions characterized by a profound loss of functional communication abilities. Communicative impairment in AD and PPA is especially apparent in the domain of naming common objects and familiar faces. We evaluated the effectiveness of a language intervention targeting maintenance of an individualized core vocabulary in a longitudinal cohort of older adults experiencing either PPA or AD. Method PPA ( = 9) and AD ( = 1) patients were administered a semantically based language treatment for up to 2 years. Patients repeatedly named and generated semantic features for a personalized lexicon consisting of 100 words. We evaluated naming accuracy and off-line neuropsychological measures at four successive timepoints. Naming accuracy was assessed in patients ( = 7) who completed at least three recurrent evaluations. Off-line neuropsychological performance was assessed across timepoints in all patients. Results Patients demonstrated relative preservation of naming trained words relative to a steep decline for untrained (control) words. The greatest decrements were observed for naming people relative to objects. Conclusion These results suggest that consistent training of a finite set of words can protect a core lexicon composed of crucial target concepts (e.g., a spouse's name). We discuss potential benefits and clinical implications of maintenance-based approaches to promoting language functioning in the context of neurodegeneration.
目的 原发性进行性失语症 (PPA) 和阿尔茨海默病的遗忘型变异 (AD) 是两种神经退行性疾病,其特征是严重丧失了功能交流能力。AD 和 PPA 患者的交流障碍在命名常见物体和熟悉面孔的领域尤为明显。我们评估了一种针对维持个体化核心词汇的语言干预在经历 PPA 或 AD 的老年患者纵向队列中的有效性。方法 PPA(n=9)和 AD(n=1)患者接受了基于语义的语言治疗,最长达 2 年。患者对由 100 个单词组成的个性化词汇表进行反复命名和生成语义特征。我们在四个连续时间点评估了命名准确性和离线神经心理学测量。只有至少完成了三次重复评估的患者(n=7)的命名准确性得到了评估。所有患者的离线神经心理学表现都在各个时间点进行了评估。结果 患者表现出相对于未经训练的(对照组)单词的显著命名准确性,而未经训练的单词则急剧下降。对人物的命名下降最为明显。结论 这些结果表明,对有限的单词集进行持续训练可以保护由关键目标概念组成的核心词汇(例如,配偶的名字)。我们讨论了在神经退行性变的背景下,基于维持的方法对促进语言功能的潜在益处和临床意义。