The proposed research will harness sleep-related memory consolidation to help patients with Alzheimer?s or related neurodegenerative diseases who suffer from specific word-finding difficulties. This sort of anomic impairment can be one of the most distressing symptoms for patients and for their families, perhaps especially when patients fail to remember the names of their closest family members. Until a cure is available, effective methods for cognitive rehabilitation are needed for these patients. Methods to decrease these word-finding difficulties could improve quality of life for patients. We hypothesize that manipulating sleep-related memory reactivation could help to alleviate these symptoms, and potentially other cognitive symptoms. We thus plan to use the same approach we have developed in our R01 study and apply it to the treatment of word-finding difficulties. A burgeoning literature describes how memory reactivation during sleep enhances memory. The R01 aims to enhance motor rehab with sleep-based memory consolidation, but there is potential for wider applicability beyond motor rehab?here we propose to expand to cognitive rehab. The best test case for this effort is with word-finding difficulties. Previous studies in our lab and others have shown that presenting sound cues during sleep, a method termed targeted memory reactivation (TMR), improves various types of memory. Our recently published meta-analysis also supports this conclusion. Here, we aim to capitalize on this effect to determine if it could benefit a broader group of patients. We first identify a list of words that have become difficult to produce, individualized for each patient. Patients undergo daily testing of word production using a tablet. They sleep at home, avoiding the difficulties patients experience in the sleep lab environment and allowing longitudinal studies. As in our R01 procedure, we monitor sleep using actigraphy, wrist EKG, and wireless EEG. During sleep, our technology controls the unobtrusive presentation of specific words, avoiding arousal. We hypothesize that our procedure will selectively decrease anomic impairments, mirroring other examples of boosting memory during sleep. This novel approach to cognitive rehab in neurodegenerative disease uses methods developed for our R01, extending their applicability to a broader clinical population. TMR will be applied at home over 4 weeks, allowing for repeated testing and powerful within-patient analyses for words cued overnight versus not. The project will pave the way for future advances in employing sleep-based reinforcement strategies to supplement waking treatment regimens in order to provide valuable benefits for patients.
Patients with Alzheimer?s or related diseases suffer from debilitating cognitive symptoms, including memory problems and word-finding difficulties. Effective methods for cognitive rehabilitation are needed for these patients. This proposal focuses on a novel method to help such patients and improve quality of life for patients and their families.
