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

优化和理解失语症的语义特征分析治疗：一项随机对照比较有效性试验

• 批准号: 10466962
• 负责人: Michael Walsh Dickey
• 金额: $ 48.14万
• 依托单位: VETERANS HEALTH FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10466962
• 关键词: Address; Affect; Aftercare; Alzheimer' s Disease; American; Aphasia; Area; Behavioral; Bilateral; Brain; Brain imaging; Brain region; Categories; Clinical; Cognitive; Communication; Communication impairment; Data; Equilibrium; Foxes; Functional Magnetic Resonance Imaging; Funding; Generations; Growth; Homologous Gene; Hour; Impairment; Language; Language Tests; Left; Lesion; Maintenance; Malignant Neoplasms; Measures; Methods; Modeling; Names; Neurocognitive; Nickel; Outcome; Outcome Measure; Participant; Patients; Performance; Persons; Process; Psycholinguistics; Randomized; Reporting; Resolution; Response Generalization; Rest; Retrieval; Semantics; Site; Speech; Standardization; System; Test Result; Testing; Time; Training; Variant; Word Processing; base; clinically relevant; comparative effectiveness study; comparative effectiveness trial; efficacious treatment; follow-up; health related quality of life; improved; improved outcome; language processing; lexical; lexical retrieval; neural correlate; neuromechanism; novel; phonology; post intervention; predicting response; recruit; response; sample fixation; secondary outcome; semantic processing; success; treatment response; treatment trial; visual tracking

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.

这项随机比较有效性试验检查了对关键组件的主动操纵 语义特征分析(SFA)治疗失语症中的找词困难可改善预后。钥匙 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 每一次治疗试验。研究参与者(n=40)将被招募并随机接受多项- 功能版本的SFA或少数功能版本。在多功能条件下，参与者将被要求 为每个练习的单词生成11个语义特征。分配到功能较少条件的参与者将 被要求为每个练习的单词生成5个特征。总的治疗时间将等同于这两个 条件。由于每个试验在功能较少的情况下花费的时间较少，因此该组的参与者将 更频繁地在治疗项目列表中循环，为他们提供更多练习 目标的语音形式，以牺牲更详细的特征生成练习为代价。 相应地，多特征组将获得更多生成语义特征的练习，在 失去了练习目标词形的机会。 研究参与者将在匹兹堡当地住宿五周，在此期间他们将接受 SFA治疗60小时，治疗前后评估他们命名接受治疗的照片的能力 和未经处理的、语义相关的名词。其他次要成果，包括衡量相互关联 还将收集言语和患者报告的沟通能力。为了解决悬而未决的问题 关于SFA的潜在认知和神经机制的问题，参与者还将收到 使用眼球跟踪的自动文字处理能力的并行前后评估 方法和功能磁共振成像(FMRI)。参与者还将被要求返回到 匹兹堡接受为期一个月的语言、眼球跟踪和功能磁共振测试。 语言测试结果将用于确定特征生成的适当平衡 练习与单词形式练习相比，以优化SFA结果。眼睛跟踪结果将被用来推断 SFA的积极作用是否可以归因于词汇-语义表征的激活， 改进了抑制竞争表示法或两者兼而有之的能力。FMRI结果将被用来识别 大脑网络和激活变化与SFA导致的命名能力变化相关。这 研究将为失语症的治疗提供理论和临床上的相关信息 以及其效果背后的神经认知机制。