McCurdy Ryan, Covington Natalie V, Duff Melissa C
Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN.
Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis.
Am J Speech Lang Pathol. 2025 Jan 7;34(1):377-390. doi: 10.1044/2024_AJSLP-23-00249. Epub 2024 Dec 16.
Naming difficulties are commonly reported in the acute and subacute stages of recovery of traumatic brain injury (TBI) and across severity levels. Previous studies, however, have used samples of mixed chronicity (acute and chronic) and severity (mild and severe) and then aggregated data across individuals from these distinct groups. Thus, we have little knowledge about the persistence of naming difficulties into the chronic stage of recovery in individuals with moderate-severe TBI.
To increase the rigor and reproducibility of naming research in TBI, the present study sought to determine the presence and profile of naming disruptions into the chronic stage of moderate-severe TBI using a confrontation naming assessment.
Thirty-three individuals aged 24-55 years in the chronic epoch of moderate-severe TBI and 33 demographically matched noninjured comparison (NC) participants completed the Philadelphia Naming Test (PNT). A mixed-effects logistic regression model predicting the probability of a correct response as a function of group was fit to the data.
Participants with TBI performed well on the PNT (all participants with TBI had over 90% accuracy). However, participants with TBI were statistically less likely to correctly name an item relative to demographically matched NC participants.
This study provides empirical evidence that naming difficulties persist into the chronic epoch of moderate-severe TBI. Despite high accuracy on the PNT, nearly 60% of these individuals with TBI reported continued difficulty with word finding in their daily lives. This discrepancy leaves open the possibility that, at this stage of injury, word-finding issues may be more reliably evoked and studied when the assessment is embedded within cognitively demanding and ecologically valid contexts (i.e., discourse, conversation). Further investigation of naming deficits in chronic moderate-severe TBI using a more naturalistic assessment is warranted.
命名困难在创伤性脑损伤（TBI）恢复的急性期和亚急性期普遍存在，且贯穿不同严重程度。然而，以往研究使用的是混合病程（急性和慢性）和严重程度（轻度和重度）的样本，然后汇总这些不同组个体的数据。因此，我们对中度至重度TBI个体恢复至慢性期时命名困难的持续情况知之甚少。
为提高TBI命名研究的严谨性和可重复性，本研究试图通过对抗性命名评估来确定中度至重度TBI慢性期命名障碍的存在情况和特征。
33名年龄在24 - 55岁之间处于中度至重度TBI慢性期的个体和33名人口统计学匹配的未受伤对照（NC）参与者完成了费城命名测试（PNT）。将预测正确反应概率作为组函数的混合效应逻辑回归模型应用于数据。
TBI参与者在PNT上表现良好（所有TBI参与者的准确率均超过90%）。然而，相对于人口统计学匹配的NC参与者，TBI参与者在统计学上正确命名项目的可能性较小。
本研究提供了实证证据，表明命名困难持续至中度至重度TBI的慢性期。尽管在PNT上准确率较高，但近60%的这些TBI个体报告在日常生活中仍存在找词困难。这种差异表明，在损伤的这个阶段，当评估嵌入在认知要求高且生态有效的情境（即语篇、对话）中时，找词问题可能更可靠地被引发和研究。有必要使用更自然主义的评估方法对慢性中度至重度TBI中的命名缺陷进行进一步研究。
