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基于认知神经科学原理推进原发性进行性失语症的神经心理康复:一项范围综述和数据的系统分析

Advancing Neuropsychological Rehabilitation in Primary Progressive Aphasia Based on Principles of Cognitive Neuroscience: A Scoping Review and Systematic Analysis of the Data.

作者信息

Gkintoni Evgenia, Michou Emilia

机构信息

Department of Psychiatry, University General Hospital of Patras, 26504 Patras, Greece.

Department of Speech and Language Therapy, University of Patras, 26504 Patras, Greece.

出版信息

Brain Sci. 2024 Dec 8;14(12):1234. doi: 10.3390/brainsci14121234.

Abstract

This systematic review of neuropsychological rehabilitation strategies for primary progressive aphasia will consider recent developments in cognitive neuroscience, especially neuroimaging techniques such as EEG and fMRI, to outline how these tools might be integrated into clinical practice to maximize treatment outcomes. A systematic search of peer-reviewed literature from the last decade was performed following the PRISMA guidelines across multiple databases. A total of 63 studies were included, guided by predefined inclusion and exclusion criteria, with a focus on cognitive and language rehabilitation in PPA, interventions guided by neuroimaging, and mechanisms of neuroplasticity. Integration of neuroimaging techniques contributes to the increase in the efficacy of interventions with critical information about the neural mechanisms underlying language deficits in the aphasias. Traditional rehabilitation strategies, technology-assisted interventions, and non-invasive brain stimulation techniques hold considerable promise for language improvement. Neuroimaging was also found to be necessary in subtype-specific differentiation toward tailoring therapeutic intervention. Evidence also shows that directed and sustained interventions using neuroplasticity can have long-term effects in managing the symptoms of PPA. The present review underlines the necessity of including cognitive neuroscience techniques within neuropsychological rehabilitation to enhance therapeutic outcomes in PPA. In addition, neuroimaging modalities such as EEG and fMRI are also of great importance in understanding the underlying neurobiology of language disturbances and guiding tailored interventions. Long-term benefits of these approaches should be evaluated, including their applicability in routine clinical practice.

摘要

这项针对原发性进行性失语症神经心理康复策略的系统评价将考量认知神经科学的最新进展,尤其是脑电图(EEG)和功能磁共振成像(fMRI)等神经影像技术,以概述如何将这些工具整合到临床实践中,从而最大限度地提高治疗效果。按照PRISMA指南,在多个数据库中对过去十年的同行评审文献进行了系统检索。根据预先定义的纳入和排除标准,共纳入63项研究,重点关注原发性进行性失语症的认知和语言康复、神经影像引导的干预措施以及神经可塑性机制。神经影像技术的整合有助于提高干预效果,为失语症语言缺陷背后的神经机制提供关键信息。传统康复策略、技术辅助干预措施和非侵入性脑刺激技术在改善语言方面颇具前景。研究还发现,神经影像对于针对特定亚型进行治疗干预的个体化定制也很有必要。有证据表明,利用神经可塑性进行有针对性的持续干预对管理原发性进行性失语症的症状可能具有长期效果。本综述强调了在神经心理康复中纳入认知神经科学技术以提高原发性进行性失语症治疗效果的必要性。此外,脑电图和功能磁共振成像等神经影像模式在理解语言障碍的潜在神经生物学机制以及指导个体化干预方面也非常重要。应评估这些方法的长期益处,包括它们在常规临床实践中的适用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/28ad/11727489/6c6c83460d6c/brainsci-14-01234-g001.jpg

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