A Prospective, Controlled Study of Rehabilitation of Anomia in Aphasia

失语症失语症康复的前瞻性对照研究

• 批准号: 8594537
• 负责人: DIANE L. KENDALL
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-10-01 至 2018-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8594537
• 关键词: Acquired Aphasia; Address; Adult; Aftercare; Anomia; Aphasia; Behavioral; Child; Chronic; Communication; Communities; Controlled Study; Data; Educational Background; Evidence based treatment; Exhibits; Foundations; Goals; Growth; Health; High Prevalence; Hour; Impairment; Individual; Knowledge; Language; Language Development; Language Disorders; Language Therapy; Lead; Left; Linguistics; Measures; Modeling; Names; Neural Network Simulation; Patients; Performance; Persons; Phase; Phase I/II Trial; Production; Quality of life; Rehabilitation therapy; Research; Retrieval; Sampling; Semantics; Series; Severities; Societies; Speech; Stroke; Testing; Time; Training; Treatment outcome; Vocabulary; World Health Organization; aphasia rehabilitation; arm; base; control trial; disability burden; dosage; efficacy testing; improved; lexical; phase II trial; phase III trial; phonology; prospective; public health relevance; relating to nervous system; response; sound; theories; treatment effect; treatment program

DESCRIPTION (provided by applicant): One of the most common and debilitating features of aphasia is an impairment in ability to retrieve words, whether it involves naming seen objects, or producing nouns, verbs and other words conveying meaning in spontaneous propositional speech. The long-term goal of this line of research is to establish an effective, viable, evidence-based treatment program for word retrieval deficits in persons with acquired aphasia from stroke. The short-term goal, and focus of this project, is to conduct a final phase II trial that tests the efficacy of an experimental treatent (called phonomotor) against customary and usual treatment (i.e. semantic-based therapy) for anomia in aphasia. In the context of a 2-armed control trial, we propose to deliver 60 total hours of therapy to 80 individuals who have suffered a left hemisphere stroke and exhibit aphasia with significant anomia. Effects of treatment acquisition and generalization will be measured at 3 time points (immediately, 3-months and 1-year post treatment termination). The primary aim will address between group differences of confrontation naming performance of untrained nouns at 3 months. Secondary questions will address generalization of treatment to measures of ecologic validity and discourse production. Through a series of phase I and phase II trials, we have shown that intensively delivered phonomotor treatment not only improves confrontation naming performance on trained words but, as predicted by the theory motivating it, importantly achieves generalization to naming of untrained words, some aspects of discourse production, and indicators of quality of life. The treatment program is motivated by a connectionist model of phonology (Nadeau, 2001; Nadeau, 2006, Nadeau, 2012) and by a two level interactive model of language (Dell, 1987). The theoretical foundation for the phonomotor treatment is as follows: through the systematic training of phonemes (sounds) and phoneme sequences, the neural connectivity supporting phoneme sequence knowledge will be enhanced. Because these sound sequences provide the basis for the words that represent concepts, through bidirectional spread of activation among and between linguistic levels, generalization from treating phonemes can be expected to improve naming of untrained words and discourse production, both immediately after treatment and continued beyond treatment termination.

描述（由申请人提供）： 失语症最常见和最令人衰弱的特征之一是检索单词的能力受损，无论是命名所看到的物体，还是在自发命题性言语中产生名词、动词和其他表达意义的单词。该研究的长期目标是针对中风后天性失语症患者的单词检索缺陷建立有效、可行、循证的治疗方案。该项目的短期目标和重点是进行最终的 II 期试验，测试实验性治疗（称为语音运动）相对于常规治疗（即基于语义的治疗）对失语症失语症的疗效。在一项 2 组对照试验中，我们建议对 80 名患有左半球中风并表现出失语症并伴有严重贫血的患者提供总共 60 小时的治疗。将在 3 个时间点（治疗终止后立即、3 个月和 1 年）测量治疗获得和推广的效果。主要目标是解决 3 个月时未经训练的名词的对抗命名表现的组间差异。次要问题将涉及对生态有效性和话语产生的测量的治疗的概括。通过一系列 I 期和 II 期试验，我们表明，集中进行的语音运动治疗不仅可以提高受过训练的单词的对抗命名性能，而且正如激励它的理论所预测的那样，重要的是实现了对未经训练的单词的命名的泛化，话语产生和生活质量指标。治疗方案的动机是音韵学联结主义模型（Nadeau，2001；Nadeau，2006；Nadeau，2012）和语言的两级交互模型（Dell，1987）。语音运动治疗的理论基础是：通过音素（声音）和音素序列的系统训练，增强支持音素序列知识的神经连接。因为这些声音序列为代表概念的单词提供了基础，通过语言水平之间的双向激活，处理音素的泛化有望改善未经训练的单词的命名和话语产生，无论是在治疗后立即还是在治疗后继续终止。