ABSTRACT

Background

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.

Aims

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 PPA, N = 37 acute stroke) completed the BNT and HANA. Behavioural performance was compared. A subset of participants (N = 31 PPA, N = 37 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 brain volume. For participants with acute stroke, the image variables were the percentage of each ROI that was lesioned. 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.

Conclusions

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 HANA's utility.

中文翻译：

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对象和动作命名的神经区域：来自急性中风和原发性进行性失语症的补充证据

摘要

背景

失语症患者通常会注意到命名障碍。然而，对象命名比动作命名更受关注。此外，大多数研究包括仅因一种病因（通常是中风）而患有失语症的参与者。我们开发了一项新的评估，即霍普金斯行动命名评估 (HANA)，以评估行动命名障碍。

宗旨

我们的目标是表明 HANA 是一个有用的工具，可以 (1) 识别动作命名障碍和 (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，以比较动作和对象命名。我们考虑了由于原发性进行性失语症 (PPA) 或急性左半球中风而导致失语症的参与者，以更全面地了解对命名至关重要的大脑-行为关系。在行为上，我们假设对象和动作命名性能之间存在双重分离。在神经解剖学上，我们假设不同的神经基质会涉及对象与动作的命名，并且在 PPA 与急性中风的参与者中会识别出不同的损伤缺陷关联。

方法与程序

参与者（N = 138 PPA，N = 37 急性中风）完成了 BNT 和 HANA。比较了行为表现。一部分参与者（N = 31 PPA，N = 37 急性中风）提供了神经影像学数据。整个大脑被自动分割成感兴趣区域 (ROI)。对于患有 PPA 的参与者，图像变量是 ROI 体积，由脑体积标准化。对于患有急性中风的参与者，图像变量是每个受损 ROI 的百分比。可能涉及命名性能的 ROI 之间的关系使用 LASSO 回归建模。

结果与结果

行为结果显示了表现的双重分离：在每组中，一些参与者表现出相对于健康控制的完整表现，而不是对象和/或明显更好的行为表现，而其他人则表现出相反的模式。这些结果支持在评估命名缺陷时评估对象和行为的需要。神经影像学结果确定了与对象与动作命名相关的不同区域，暗示了重叠但不同的区域网络。此外，PPA 参与者与急性中风参与者的结果不同，表明当只考虑一种病因时，可能会遗漏关键信息。

结论

总体而言，该研究更全面地描述了命名的神经基础，强调了评估物体和动作以及考虑不同的损伤病因的重要性。它展示了 HANA 的实用性。