約有18%的中風患者會罹患慢性失語症，而命名功能缺損是失語症患者最常見的症狀，目前臨床上常以圖片作為教材以治療命名功能缺損，然而，相較於圖片，影片更貼近於現實生活，可能會讓患者從中得到更多提示而適合做為失語症教材。至今，仍未有研究比較這兩者的治療效應之差異，亦少有研究追蹤長期功能性影像。本研究以功能性核磁共振造影與語言能力測驗，評估以動態命名App訓練前、訓練後及維持期失語症受試者的語言能力與活化腦區，並藉由分類以評估不同狀態下受試者的語言能力與腦部活化位置，探討活化區對應之臨床意義。受試者在為期三個月的App訓練後，命名能力皆有提升，然而在維持期僅有較年輕、與訓練時間較長的受試者才能維持其命名能力。在功能性影像觀察到在縱向追蹤時，受試者對照片命名時，腦區活化位逐漸由右腦移至左腦，表示左腦語言區病灶周邊組織已在訓練後恢復並穩固語言功能，且此效應在訓練時間長的受試者上更加明顯。而在未知字詞刺激時活化位與已知字詞越來越相似，亦顯示受試者已重新學會此字詞。在對影片命名時，年長受試者腦部幾乎沒有活化區，動態教材應用在年長失語症患者可能沒有那麼合適，而在較年輕受試者上，仍可觀察到活化區左移之現象。未來針對不同失語症患者，可能可以不同方式做為治療，以達到較佳的治療成效。

Approximately 18% of post stroke people will suffer from chronic aphasia. Naming deficit is one of the common symptoms in aphasia. Currently, picture naming is usually employed as the training material for treatment of aphasia. Nevertheless, videos with motion may be more realistic and suitable than pictures. Up to now, there has been no comparison of the treatment effects for these two training materials. Besides, there is less longitudinal functional research on changes in brain-activated regions. In the study, language behavior tests as well as fMRI images of pre-, post-training, and follow-up were acquired for analysis, and the clinical effects of activated regions were investigated. After 3-month training with video-based teaching material App, all subjects exhibited improvement in naming ability in the post-training language assessment. However, only younger subjects or subjects who had a longer training time improved their naming behavior in follow-up assessment, which was conducted after three months without training with App. In the longitudinal investigation of fMRI, the activated regions shifted from right hemisphere to left hemisphere upon the stimulus of naming a photo, demonstrating that the perilesional area in left hemisphere reorganized and regained solidity gradually after training. Furthermore, the effect was obvious in subjects with a longer training time. The activated regions with the contrast of naming with a known photo versus naming with an unknown photo were similar in the follow-up imaging, showing that the subjects had relearned the ability to name an initially unknown item. In naming with video, there were few activated regions in older subjects, while younger subjects exhibited the aforementioned effect of activated regions shifting to the left hemisphere. Video-based teaching materials may not be appropriate for older patients with aphasia. In future, it may be able to formulate different treatments for different patients with aphasia to achieve improved language recovery.

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