Efficacy and Optimization of Speech Entrainment Practice for People with Aphasia

项目摘要 在每年795000名中风的美国人中，约有84000人患有慢性中风。 失语症-语言产生的障碍，通常在较小程度上，理解，可以 严重影响失语症患者及其家人的生活质量。研究表明 慢性失语症患者可以从治疗中受益，但重大的沟通挑战往往 持续超过治疗结束。该项目旨在测试和开发一种有前途的处理技术， 称为言语诱导，以提高失语症患者的治疗效果。言语诱导 是指通过在真实的时间内模仿模型而与模型说话者一致地说话。研究表明 语音诱导是一种突破性的技术，用于促进失语症患者的连接语音。 即使是那些独立说话仅限于几个单词的人， 在语音夹带上下文中输出许多倍。这种即时刺激效应是有据可查的。什么 仍然知之甚少的是，是否练习语音生产沿着与夹带模型将 当去除夹带支持时，在稍后的时间点增强独立语音。此外，本发明还提供了一种方法， 优化受益者的结果和特征的条件尚未得到研究， 即时刺激。因此，本项目旨在（1）实验性地建立语音的直接效果 夹带实践对独立语音产生后处理，（2）确定条件， 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。 积极的治疗反应。这些目标在一项受试者内疗效研究中得到了解决， 与失语症产生不同的故事与夹带的支持。说话不夹带被评价为一个 一天前，一天后，语音夹带实践。不同的实践故事将随机在 参与者接受三种实验条件，以评估治疗效果（培训与未培训），培训 时间表（故事的集中与分散呈现）和诱导模式（仅与诱导模式一起练习） 或视听模型）。将计算每个故事每分钟的正确信息单位，以评估 条件之间的差异以及与患者特征的关联。为了与先前的一致性 研究，每分钟不同单词的数量将作为次要结果。拟议研究 通过测试和优化一种有前途的治疗技术来增强失语症， 康复活动.此外，本研究作为后续R 01补助金的试点研究。为指导 根据这项研究的结果，随后的临床试验确立了言语诱导练习在 一项全面的治疗研究，以旨在测试长期效益的强度实施。

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.