RR&D Research Career Scientist Award Application

RR

• 批准号: 9397765
• 负责人: Julie L. Wambaugh
• 金额: --
• 依托单位: VA SALT LAKE CITY HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-10-01 至 2022-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9397765
• 关键词: Academy; Acquired Communication Disorders; Acute; Address; Age; Aphasia; Apraxias; Area; Articulation; Award; Behavior Therapy; Benchmarking; Biofeedback; Biological Markers; Brain; Brain Injuries; California; Characteristics; Chronic; Clinical; Clinical Research; Clinical Treatment; Combined Modality Therapy; Communication impairment; Development; Disease; Dose; Evidence based practice; Feedback; Focal Brain Injuries; Frequencies; Goals; Guidelines; Head; Health care facility; Healthcare; Healthcare Systems; Hour; Impairment; Investigation; Investigational Therapies; Language; Language Therapy; Lead; Lesion; Literature; Maintenance; Measurement; Mentors; Meta-Analysis; Methods; Neoplasms; Neurologic; Neuronal Plasticity; Outcome; Outcome Measure; Palate; Participant; Patients; Performance; Persons; Phase; Prevalence; Production; Publications; Publishing; Randomized Controlled Clinical Trials; Rehabilitation therapy; Reporting; Research; Research Activity; Research Personnel; Resources; Retrieval; Role; Sampling; Science; Scientist; Severities; Site; Speech; Speech Therapy; Stroke; Symptoms; Testing; Time; Tongue; Training; Treatment Protocols; Treatment outcome; Veterans; Visual; Work; base; career; clinical application; design; doctoral student; improved; interest; motor learning; novel; phrases; predicting response; predictive of treatment response; programs; research clinical testing; response; skills; sound; therapy design; treatment duration; treatment effect; treatment response; wound

The over-arching goal of Dr. Wambaugh's research program is to advance understanding and management of acquired apraxia of speech (AOS) and aphasia. Her current research activities are focused on the development and testing of clinically-applicable therapies for AOS and aphasia using sound theoretical bases for treatment and rigorous experimental methods. Her on-going VA RR&D merit project, “Effects of intensity of treatment on rehabilitation of acquired apraxia of speech” continues her work with Sound Production Treatment (SPT). SPT is a behavioral treatment for AOS which was developed by Dr. Wambaugh; it has been shown to consistently result in improved speech production with persons with AOS representing broad ranges of AOS severity, aphasia severity, chronicity, and age. In order to move SPT toward randomized controlled clinical trials, Dr. Wambaugh has been studying ways to maximize its outcomes. Treatment intensity is a potentially critical factor to consider in the administration of treatment. Dr. Wambaugh and her colleagues are currently evaluating the relative effects of intense administration of SPT (3 hours per day/ 3 days per week / 3 weeks) versus non-intense (“traditional”) SPT (1 hour per day/ 3 days per week/ 9 weeks). Dose frequency and treatment duration are being compared in terms of short and longer term maintenance of production of treated and untreated items (word/phrases). Dr. Wambaugh and her colleague, Dr. Mauszycki, are also comparing the effects of SPT to the effects of electropalatographic (EPG) treatment for AOS. EPG is a method for providing visual biofeedback concerning tongue to palate contact. Some speakers with AOS may have disrupted feedback associated with speech production and may benefit more from visual biofeedback in comparison to clinician-provided feedback. Dr. Wambaugh is also collaborating with researchers from the VA Northern California Health Care System to examine the role of site of lesion in predicting response to SPT and to identify neural plasticity changes associated with treatment. This line of research is the first to address brain biomarkers of treatment response in AOS. Because AOS typically co-occurs with aphasia and it is currently difficult for clinicians to determine how to allocate valuable therapy time among the two disorders, Dr. Wambaugh recently developed a treatment that simultaneously targets speech (AOS) and language (aphasia) symptoms – Combined Aphasia and Apraxia of Speech Treatment (CAAST). Dr. Wambaugh is continuing to refine the CAAST protocol and is conducting additional in-depth analyses of outcomes associated with this treatment with the aim of bringing this new treatment to randomized controlled clinical trials. In another area of aphasia treatment, Dr. Wambaugh has been extending her work with word-retrieval treatments to identify participant characteristics associated with response to treatment. She and her colleagues have recently begun to study practice effects as a predictor of ability to change (and ultimately benefit from treatment). Her pending RR&D merit submission is designed to address practice effects as a predictor of treatment response as well as a factor influencing generalized responding. Dr. Wambaugh's lab is also engaged in the development of reliable outcome measures for use in evaluating treatment outcomes. As part of Dr. Wambaugh's recent SPiRE award, “A novel treatment for aphasia and apraxia of speech: Measurement of Outcomes” her lab has collected repeated speech/language samples (over time) from a group of 30 speakers with AOS-aphasia and will be completing stability analyses for numerous outcome measures.

Wambaugh 博士研究项目的首要目标是促进理解和 获得性言语失用症（AOS）和失语症的治疗她目前的研究活动。 专注于 AOS 临床适用疗法的开发和测试 使用健全的治疗理论基础和严格的实验方法来治疗失语症。 正在进行的 VA RR&D 优秀项目，“治疗强度对获得性康复的影响” 言语失用症”继续她的声音制作治疗（SPT）工作。 Wambaugh 博士开发的针对 AOS 的行为疗法已被证明可以 与代表广泛的 AOS 的人在改善言语表达方面取得了一致的结果 AOS 严重程度、失语严重程度、慢性程度和年龄范围，以便推动 SPT 的发展。 在随机对照临床试验中，Wambaugh 博士一直在研究如何最大限度地发挥其功效。 结果。治疗强度是给药时需要考虑的潜在关键因素。 Wambaugh 博士和她的同事目前正在评估治疗的相对效果。 强化 SPT 管理（每天 3 小时/每周 3 天/3 周）与非强化管理 （“传统”）SPT（每天 1 小时/每周 3 天/9 周）。 正在对生产的短期和长期维持进行比较 已处理和未处理的项目（单词/短语）。 Wambaugh 博士和她的同事 Mauszycki 博士， 还在比较 SPT 的效果与电腭描记 (EPG) 治疗的效果 AOS。EPG 是一种提供有关舌头与上颚接触的视觉生物反馈的方法。 一些患有 AOS 的说话者可能会扰乱与语音生成相关的反馈，并且 与临床医生提供的反馈相比，视觉生物反馈可能会带来更多好处。 Wambaugh 还与 VA 北加州医疗保健中心的研究人员合作 检查病变部位在预测 SPT 反应中的作用并识别神经系统的系统 与治疗相关的可塑性变化是第一个针对大脑的研究。 AOS 治疗反应的生物标志物因为 AOS 通常与失语症同时发生。 目前，忠诚者很难确定如何在患者之间分配宝贵的治疗时间。 Wambaugh 博士最近开发了一种同时针对两种疾病的治疗方法 言语 (AOS) 和语言（失语症）症状 – 失语症和言语失用症相结合 治疗 (CAAST) Wambaugh 博士正在继续完善 CAAST 方案。 对与这种治疗相关的结果进行额外的深入分析，目的是 将这种新疗法引入失语症另一个领域的随机对照临床试验。 Wambaugh 博士一直将她的单词检索治疗工作扩展到 确定与她和她的治疗反应相关的参与者特征。 同事们最近开始研究实践效果，将其作为变革能力的预测指标（以及 最终受益于治疗）。 实践效果作为治疗反应的预测因子以及影响广义的因素 Wambaugh 博士的实验室也致力于开发可靠的结果。 作为 Wambaugh 博士最近 SPiRE 的一部分。 奖，“失语症和言语失用症的新颖治疗方法：结果测量” 实验室从 30 名发言者的小组中收集了重复的语音/语言样本（随着时间的推移） 患有 AOS 失语症，并将完成多项结果指标的稳定性分析。