ブローカ失語症患者に対する動詞想起の促通訓練と文産生について―単語訓練と文訓練の比較

Comparison of single-word therapy versus sentence therapy for verb retrieval and sentence production in a single case of Broca's aphasia

　われわれは，動詞想起と文産生に困難さを示したブローカ失語症患者に，動詞想起の改善を目的に2種類の訓練を実施し比較した．1つは名詞で利用される訓練を応用した単語訓練であり，もう1つは項構造治療に文構成を加えた文訓練である．その結果，①動詞想起には単語訓練と文訓練の両方で有意な効果があったが，単語訓練のほうが良好だった．本症例において文訓練が負荷として作用しtrade-off現象が生じたためと考察された．②単語訓練と文訓練の両方で文産生への般化がみられたが，後者の場合に文形態として質的に高い文が産生された．単語訓練の後では1項を含む文の増加が，そして文訓練後には1項だけでなく2項を含む文の増加と助詞の省略の減少が観察された．このため，文産生自体には動詞に関係する語彙を構造化する文訓練が有効であることが示唆された．③プローブテストで非訓練語の成績に変化が認められなかったことから，改善は訓練効果と考えられた．

　We compared the effects of two types of therapy, single-word therapy and sentence therapy, on a Broca's aphasic patient who had difficulty with verb retrieval and sentence production.　The single-word therapy used in our study mirrors the techniques used to facilitate noun retrieval.　The sentence therapy combined the techniques of argument structure therapy with sentence construction tasks.　Both types of therapy significantly improved the patient's verb retrieval in treatment, with the single-word therapy being more effective.　It was speculated that the sentence therapy was more demanding for the patient with syntactic defects and this might have suppressed the effect of the therapy.　Secondly, the effects of both therapies generalized to sentence production, but the sentence therapy resulted in the increase of more complex sentences with fewer omissions of particles.　These results indicate that therapies focused on relating nouns to the target verb are effective for improving sentence production.　Lastly, the improvement in the production of verbs featured in this study was thought to be caused by the therapy because insignificant changes were observed in the production of untreated verbs in probe tests.