Efficacy and Optimization of Speech Entrainment Practice for People with Aphasia

失语症患者言语诱导练习的效果和优化

• 批准号: 10204333
• 负责人: Marja-Liisa Mailend
• 金额: $ 16.3万
• 依托单位: ALBERT EINSTEIN HEALTHCARE NETWORK
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10204333
• 关键词: Acquired Communication Disorders; Activities of Daily Living; Address; Adopted; Affect; Aftercare; American; Aphasia; Attention; Auditory; Behavioral; Brain; Case Series; Characteristics; Chronic; Clinical; Clinical Trials; Cognitive; Communication; Communities; Comprehension; Cues; Data Set; Family member; Foundations; Goals; Grant; Guidelines; Hearing; Human; Individual; Investigation; Language; Language Disorders; Learning; Left; Lesion; Linguistics; Methods; Modality; Modeling; Movement; Oral cavity; Outcome; Output; Participant; Patients; Performance; Production; Quality of life; Randomized; Research; Research Design; Role; Schedule; Speech; Stroke; Techniques; Testing; Time; Training; Treatment outcome; Visual; aphasia recovery; aphasia rehabilitation; design; effective therapy; efficacy study; experience; improved; indexing; individualized medicine; interest; language impairment; predicting response; programs; relating to nervous system; response; secondary outcome; trait; treatment effect; treatment response

PROJECT SUMMARY Among the 795 000 Americans who have a stroke each year, about 84 000 experience chronic aphasia—an impairment of language production, and often to a lesser extent, comprehension, that can severely impact the quality of life for people living with aphasia and their family members. Research has shown that people with chronic aphasia can benefit from treatment, but significant communication challenges often persist beyond conclusion of therapy. This project aims to test and develop a promising treatment technique, termed speech entrainment, to enhance treatment outcomes for people with aphasia. Speech entrainment refers to speaking in unison with a model speaker by imitating the model in real time. Research has shown that speech entrainment is a ground-breaking technique for prompting connected speech in people with aphasia. Even those whose independent speech is limited to a few single words may be able to increase their speech output many-fold in a speech entrainment context. This immediate stimulation effect is well-documented. What remains poorly understood is whether practicing speech production along with an entrainment model will enhance independent speech at a later point in time when the entrainment support is removed. In addition, conditions that optimize outcomes and characteristics of those who benefit have not been investigated beyond the immediate stimulation. Thus, this project aims to (1) experimentally establish the direct effect of speech entrainment practice on independent speech production post-treatment, (2) identify conditions that enhance treatment benefits, and (3) define the cognitive-linguistic and neuroanatomic profiles that are associated with a positive treatment response. These aims are addressed in a within-subject efficacy study, where 40 people with aphasia produce different stories with entrainment support. Speaking without entrainment is evaluated one day before and one day after speech entrainment practice. Different practice stories will be randomized within participants to three experimental conditions to assess the effect of treatment (trained vs. untrained), training schedule (massed vs. distributed presentation of stories), and entrainment modality (practice with auditory-only or audiovisual model). Correct information units per minute for each story will be tallied to evaluate the differences between conditions and the associations with patient characteristics. For consistency with prior research, number of different words per minute will serve as a secondary outcome. The proposed research addresses a clinical need by testing and optimizing a promising treatment technique for enhancing aphasia rehabilitation. In addition, this study serves as pilot research for a subsequent R01 grant. Guided by the findings from this study, the subsequent clinical trial establishes the efficacy of speech entrainment practice in a full-scaled treatment study, implemented at intensities that are designed to test long-term benefits.

项目摘要 在每年中风的79.5万美国人中，大约84 000经历了慢性 失语症 - 语言生产的损害，通常在较小程度上可以理解，可以 严重影响失语症及其家人的生活质量。研究表明 患有慢性失语症的人可以从治疗中受益，但是经常会有重大的沟通挑战 持续无法结束治疗的结论。该项目旨在测试和开发有希望的治疗技术， 被称为言语启蒙，以增强失语症患者的治疗结果。语音启蒙 指的是与模型演讲者一致讲话，通过实时模仿模型。研究表明 言语放映是一种突破性的技术，用于促使失语症患者的互联语音。 甚至那些独立演讲仅限于几个单词的人也可能能够增加他们的演讲 在语音入口上下文中输出多倍。这种即时刺激效果已得到充分记录。什么 仍然了解不足 在稍后的时间点上删除了放宽支持时，请增强独立的语音。此外， 优化优化受益者的结果和特征的条件尚未得到调查 即时刺激。这是该项目旨在（1）实验建立语音的直接影响 治疗后独立语音生产的盛立实践，（2）确定增强的条件 治疗益处，以及（3）定义与A相关的认知语言和神经解剖学特征 阳性治疗反应。这些目标是在一项受试者内有效性研究中解决的，有40人 失语症会带来不同的故事。评估没有盛立的说话。 前一天和言语盛立练习后的一天。不同的练习故事将在其中随机化 参加三个实验条件的参与者评估治疗的影响（受过训练与未经训练），培训 时间表（大规模与故事的分布式演讲）和娱乐方式（仅听觉练习 或视听模型）。每个故事每分钟正确的信息单元将进行讨论以评估 条件与患者特征的关联之间的差异。与先验一致 研究，每分钟不同单词的数量将是次要结果。拟议的研究 通过测试和优化有希望的治疗技术来满足临床需求，以增强失语症 康复。此外，这项研究是随后的R01赠款的试点研究。由 这项研究的结果，随后的临床试验确定了语音入口实践的有效性 一项全面的治疗研究，以旨在测试长期收益的强度实施。