Breining Bonnie L, Faria Andreia V, Caffo Brian, Meier Erin L, Sheppard Shannon M, Sebastian Rajani, Tippett Donna C, Hillis Argye E
Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
Aphasiology. 2022;36(6):732-760. doi: 10.1080/02687038.2021.1907291. Epub 2021 May 11.
Naming impairment is commonly noted in individuals with aphasia. However, object naming receives more attention than action naming. Furthermore, most studies include participants with aphasia due to only one aetiology, commonly stroke. We developed a new assessment, the Hopkins Action Naming Assessment (HANA), to evaluate action naming impairments.
Our aims were to show that the HANA is a useful tool that can (1) identify action naming impairments and (2) be used to investigate the neural substrates underlying naming. We paired the HANA with the Boston Naming Test (BNT) to compare action and object naming. We considered participants with aphasia due to primary progressive aphasia (PPA) or acute left hemisphere stroke to provide a more comprehensive picture of brain-behaviour relationships critical for naming. Behaviourally, we hypothesised that there would be a double dissociation between object and action naming performance. Neuroanatomically, we hypothesised that different neural substrates would be implicated in object vs. action naming and that different lesion-deficit associations would be identified in participants with PPA vs. acute stroke.
METHODS & PROCEDURES: Participants (N=138 with PPA, N=37 with acute stroke) completed the BNT and HANA. Behavioural performance was compared. A subset of participants (N=31 with PPA, N=37 with acute stroke) provided neuroimaging data. The whole brain was automatically segmented into regions of interest (ROIs). For participants with PPA, the image variables were the ROI volumes, normalised by the brain volume. For participants with acute stroke, the image variables were the percentage of each ROI affected by the lesion. The relationship between ROIs likely to be involved in naming performance was modelled with LASSO regression.
OUTCOMES & RESULTS: Behavioural results showed a double dissociation in performance: in each group, some participants displayed intact performance relative to healthy controls on actions but not objects and/or significantly better performance on actions than objects, while others showed the opposite pattern. These results support the need to assess both objects and actions when evaluating naming deficits. Neuroimaging results identified different regions associated with object vs. action naming, implicating overlapping but distinct networks of regions. Furthermore, results differed for participants with PPA vs. acute stroke, indicating that critical information may be missed when only one aetiology is considered.
Overall, the study provides a more comprehensive picture of the neural bases of naming, underscoring the importance of assessing both objects and actions and considering different aetiologies of damage. It demonstrates the utility of the HANA.
命名障碍在失语症患者中很常见。然而，物体命名比动作命名受到更多关注。此外，大多数研究仅纳入由单一病因（通常为中风）导致失语症的参与者。我们开发了一种新的评估方法——霍普金斯动作命名评估（HANA），以评估动作命名障碍。
我们的目的是证明HANA是一种有用的工具，它可以（1）识别动作命名障碍，（2）用于研究命名背后的神经基质。我们将HANA与波士顿命名测试（BNT）配对，以比较动作命名和物体命名。我们纳入了因原发性进行性失语（PPA）或急性左半球中风导致失语症的参与者，以更全面地了解对命名至关重要的脑-行为关系。在行为方面，我们假设物体和动作命名表现之间会存在双重分离。在神经解剖学方面，我们假设物体命名和动作命名涉及不同的神经基质，并且在PPA患者与急性中风患者中会发现不同的损伤-缺陷关联。
参与者（138名PPA患者，37名急性中风患者）完成了BNT和HANA。比较了行为表现。一部分参与者（31名PPA患者，37名急性中风患者）提供了神经影像学数据。全脑自动分割为感兴趣区域（ROI）。对于PPA患者，图像变量是ROI体积，通过脑体积进行标准化。对于急性中风患者，图像变量是每个ROI受病变影响的百分比。使用套索回归对可能参与命名表现的ROI之间的关系进行建模。
行为结果显示表现上存在双重分离：在每组中，一些参与者相对于健康对照组在动作命名上表现正常但物体命名不正常，和/或在动作命名上的表现明显优于物体命名，而另一些参与者则表现出相反的模式。这些结果支持在评估命名缺陷时同时评估物体和动作的必要性。神经影像学结果确定了与物体命名和动作命名相关的不同区域，涉及重叠但不同的区域网络。此外，PPA患者与急性中风患者的结果不同，表明仅考虑一种病因时可能会遗漏关键信息。
总体而言，该研究更全面地描绘了命名的神经基础，强调了同时评估物体和动作以及考虑不同损伤病因的重要性。它证明了HANA的实用性。
