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: 10666552
• 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/10666552
• 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 Development; Language Disorders; Learning; Left; Lesion; Linguistics; Methods; Modality; Modeling; Movement; Neuroanatomy; Oral cavity; Outcome; Output; Participant; Patients; Performance; Persons; 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; neural; programs; remediation; 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.

项目概要 每年有 795,000 名美国人中风，其中约 84,000 人患有慢性中风 失语症——语言产生障碍，通常在较小程度上影响理解能力，这可以 研究表明，严重影响失语症患者及其家人的生活质量。 慢性失语症患者可以从治疗中受益，但通常会面临重大的沟通挑战 该项目旨在测试和开发一种有前途的治疗技术， 称为言语夹带，以提高失语症患者的治疗效果。 指的是通过实时模仿模型来与模型说话者齐声说话 研究表明。 言语夹带是一种突破性的技术，可促进失语症患者进行连贯言语。 即使那些只能独立发言的人也可以增加他们的发言量 这种直接的刺激效果是有据可查的。 目前仍不清楚练习语音生成与夹带模型是否会 当夹带支持被移除时，可以在稍后的时间点增强独立语音。 优化受益者的结果和特征的条件尚未得到进一步研究 因此，该项目的目的是（1）通过实验确定言语的直接效果。 独立言语产生后处理的夹带实践，（2）确定增强的条件 治疗益处，以及（3）定义与治疗相关的认知语言学和神经解剖学特征 一项针对 40 人的受试者内疗效研究解决了这些目标。 失语症在有夹带支持的情况下产生不同的故事被评估为一种。 演讲练习的前一天和后一天将随机安排不同的练习故事。 参与者在三种实验条件下评估治疗效果（训练与未训练）、训练 时间表（故事的集中与分布式呈现）和夹带方式（仅听觉练习） 或视听模型）。将统计每个故事每分钟的正确信息单位以评估 病情之间的差异以及与患者特征的关联。为了与之前的一致性。 研究中，每分钟不同单词的数量将作为次要结果。 通过测试和优化一种有前途的增强失语症的治疗技术来满足临床需求 此外，这项研究也是后续 R01 资助项目的试点研究。 根据这项研究的结果，随后的临床试验证实了言语诱导练习的有效性 一项全面的治疗研究，其实施强度旨在测试长期效益。