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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

基本信息

批准号：
10460339
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
项目类别：
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/10460339
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 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 predicting response programs relating to nervous system response secondary outcome trait treatment effect treatment response

项目摘要

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.

项目总结