Optimizing and understanding semantic feature analysis treatment for aphasia: A randomized controlled comparative-effectiveness trial

这项随机比较有效性试验检查是否积极操纵一个关键组成部分， 语义特征分析（SFA）治疗失语症的单词查找困难改善了结果。关键 我们所讨论的成分是失语症患者被要求生成的语义特征的数量 每次治疗试验。将招募研究参与者（n=40），并随机接受多种- SFA的功能版本或少数功能版本。在多特征条件下，参与者将被要求 为每个练习的单词生成11个语义特征。被分配到少数特征条件的参与者将 被要求为每个练习的单词生成5个特征。总治疗时间将等同于两个 条件由于在特征较少的情况下，每次试验所需的时间较少，因此该组的参与者将 更频繁地循环处理项目列表，为他们提供更多练习的机会， 语音形式的目标，在牺牲更详细的功能生成的做法。 相应地，多特征组将得到更多的生成语义特征的实践， 牺牲了很少的机会练习目标词的形式。 研究参与者将在匹兹堡研究中心当地居住五周，在此期间，他们将接受 60小时SFA治疗，治疗前和治疗后评估其命名治疗图片的能力 和未经处理的语义相关的名词。其他次要结果，包括相关指标 还将收集语音和患者报告的沟通能力。为了解决未解决的 关于SFA的潜在认知和神经机制的问题，参与者还将获得 使用眼动追踪的自动文字处理能力的同时治疗前和治疗后评估 方法和功能磁共振成像（fMRI）。与会者还将被要求返回 匹兹堡进行为期一个月的随访语言、眼动追踪和fMRI测试。 语言测试结果将用于确定功能生成的适当平衡 实践与文字形式的实践，以优化SFA的结果。眼动追踪的结果将被用来推断 SFA的积极作用是否可以归因于词汇语义表征的激活， 提高抑制竞争性表征的能力，或两者兼而有之。fMRI结果将用于识别 大脑网络和激活变化与SFA引起的命名能力变化相关。这 这项研究将提供理论和临床相关信息，说明失语症的治疗应该是 传递和其影响的神经认知机制。

This randomized comparative effectiveness trial examines whether active manipulation of a key component of semantic feature analysis (SFA) treatment for word-finding difficulty in aphasia improves outcomes. The key component in question is the number of semantic features that persons with aphasia are asked to generate on each treatment trial. Study participants (n=40) will be recruited and randomized to receive either a many- features version of SFA or a few-features version. In the many-features condition, participants will be asked to generate 11 semantic features for each word practiced. Participants assigned to the few-features condition will be asked to generate 5 features for each word practiced. The total treatment time will be equated in the two conditions. Because each trial will take less time in the few-features condition, participants in this group will cycle through the lists of treated items more often, providing them with more opportunities to practice the phonological form of the targets, at the expense of more elaborated feature generation practice. Correspondingly, the many-features group will receive more practice generating semantic features, at the expense of few opportunities to practice the target word forms. Study participants will be housed locally at the Pittsburgh site for five weeks during which they will receive 60 hours of SFA treatment with pre- and post-treatment assessment of their ability to name pictures of treated and untreated, semantically related nouns. Other secondary outcomes, including measures of connected speech and patient-reported communication ability will also be collected. In order to address unresolved questions about the underlying cognitive and neural mechanisms of SFA, participants will also receive concurrent pre- and post-treatment assessment of automatic word processing ability using eye-tracking methods and functional magnetic resonance imaging (fMRI). Participants will also be asked to return to Pittsburgh for one-month follow-up language, eye-tracking, and fMRI testing. The language testing results will be used to determine the appropriate balance of feature generation practice vs. word form practice to optimize SFA outcomes. The eye-tracking results will be used to infer whether SFA’s positive effects can be attributed to improved activation of lexical-semantic representations, improved ability to inhibit competing representations, or both. The fMRI results will be used to identify the brain networks and activation changes associated with changes in naming ability resulting from SFA. This study will provide theoretically and clinically relevant information about how aphasia treatment should be delivered and the neurocognitive mechanisms underlying its effects.