Evaluating a Combined Communication and Counseling Intervention in Primary Progressive Aphasia: A Pilot Feasibility Study

项目摘要 失语症是一种神经性沟通障碍，由大脑中语言区域的损伤引起，包括 急性神经侮辱或神经退行性疾病1.鉴于沟通能力与 在身份、能力和自我表现方面，失语症的出现往往会导致负面的心理社会 2患有原发性进行性失语(PPA)的人是一个特别脆弱的群体，因为 他们面临着与疾病进展的沟通能力持续和不可避免的下降。当有一个 越来越多的研究与言语-语言干预对PPA、咨询的效用有关 解决这一临床人群的情感需求的方法尚未得到充分研究。 在这项研究中，我们建议将心理社会方法与言语-语言干预结合起来，以 患有PPA的个体。具体地说，我们将分析一种新的干预措施的可接受性和可行性 实施失语症改良认知行为疗法(CBT)和定制语音- 对9名患有轻度PPA的参与者进行语言治疗(即剧本训练或词汇提取训练)。 在研究期间，我们将完善一本新的、适用于失语症的CBT手册，并将进行混合方法分析 将初步治疗结果与实际情况联系起来。此外，我们还将完成探索性分析比较 从拟议的研究队列到言语-语言的言语-语言和心理社会结果 仅干预队列作为治疗受益的初始特征。这项研究将作为一项重要的 处于计划研究路线的初步阶段，为更大规模的疗效研究奠定基础。 该项目将通过提供以下证据来推进失语症行为康复的科学 整体治疗，不仅解决沟通障碍，而且还包括咨询 使患者能够以最佳方式应对与失语症相关的心理社会挑战的技术。 这与公共卫生有关，因为失语症直接影响到大约200-400万美国人。 这项建议与美国国立卫生研究院的使命直接一致，因为该项目致力于将残疾降至最低 并改善那些受到神经疾病影响的人的生活。 该奖学金将为申请者提供多方面的培训经历，并提供学习新知识的机会。 研究方法、数据分析程序和临床原则。申请人的保证人及 培训团队的贡献成员拥有独特但互补的研究和临床方面的专业知识 包括定量和定性研究、实验设计、统计分析、演讲语言等领域 干预和咨询方法。总而言之，这种全面的、跨学科的培训 经验将支持申请者达到这项资助的研究目标，并将使她准备成为 一位独立的失语症研究人员。

Project Summary Aphasia is a neurogenic communication disorder caused by damage to language regions in the brain, including acute neurological insult or neurodegenerative disease.1 Given that the ability to communicate is entwined with identity, competency, and self-expression, the advent of aphasia often results in negative psychosocial repercussions.2 Individuals with primary progressive aphasia (PPA) are an especially vulnerable population, as they face an ongoing and inevitable decline in communication ability with disease progression. While there is a growing body of research pertaining to the utility of speech-language intervention for PPA, counseling approaches that address the emotional needs of this clinical population are under-studied. In this study, we propose to implement psychosocial approaches alongside speech-language intervention for individuals with PPA. Specifically, we will analyze the acceptability and feasibility of a novel intervention that implements aphasia-modified cognitive behavioral therapy (CBT) approaches alongside tailored speech- language treatment (i.e., script training or lexical retrieval training) in a group of nine participants with mild PPA. During the study, we will refine a novel, aphasia-adapted CBT manual and will conduct mixed methods analyses to contextualize preliminary treatment outcomes. Additionally, we will complete exploratory analyses comparing speech-language and psychosocial outcomes from the proposed study cohort to a speech-language intervention-only cohort as an initial characterization of treatment benefit. This study will serve as an important preliminary stage in a programmatic line of research, setting the stage for larger-scale efficacy research. This project will advance the science of behavioral rehabilitation in aphasia by providing evidence regarding holistic treatment that not only addresses communication impairment, but also incorporates counseling techniques that empower patients to optimally navigate the psychosocial challenges associated with aphasia. This is relevant to public health, as aphasia directly impacts an estimated 2-4 million Americans.27 The aims of this proposal are in direct alignment with the mission of the NIH, as this project endeavors to minimize disability and improve the lives of those who have been impacted by a neurological disorder. This fellowship will provide the applicant with a multifaceted training experience with opportunities to learn new research methodologies, data analysis procedures, and clinical principles. The applicant’s sponsor and contributing members of the training team possess expertise in distinct yet complementary research and clinical areas, including quantitative and qualitative research, experimental design, statistical analysis, speech-language intervention, and counseling methodologies. Taken together, this comprehensive, interdisciplinary training experience will support the applicant in meeting the research aims of this grant and will prepare her to become an independent aphasia researcher.