Auditory masking effects on speech fluency in aphasia and apraxia of speech

描述（由申请人提供）：本研究的目的是测试听噪音（即听觉反馈掩蔽）对失语症和言语失用症的卒中幸存者的言语流畅性的影响。患有非流利型失语症的人通常患有言语失用症，这会影响言语运动的运动编程，导致扭曲，速度慢，言语不流利，阻碍了交流的向前流动。在听噪音的同时说话（例如听觉掩蔽）可以减少口吃者的不流利并提高语速。这种方法已经在失语症患者中进行了测试，对测试的一部分人的语音产生产生了积极的影响。我们认为，除了失语症之外，还有言语失用症的人最有可能从听觉掩蔽中受益，但大多数以前的研究都没有测试参与者的言语失用症。此外，尽管掩蔽最有可能影响言语不流利，但以前的研究没有测量不流利。拟议的工作有两个具体目标。目的1将确定听觉掩蔽对失语症和言语失用症的脑卒中幸存者的言语流畅性的影响。目标2将确定预测积极反应的个体因素，包括存在 言语失用症的类型、病变特征和失语症的类型（如Broca's、Wernicke's）。基于体素的病变分析技术将用于确定与听觉掩蔽的阳性和阴性反应相关的病变部位。这项研究的完成将消除研究听觉掩蔽作为临床干预技术的障碍，同时也是行为神经科学家探索失语症和言语失用症患者言语运动控制系统的研究工具。 公共卫生相关性：言语产生障碍是失语症和言语失用症中风幸存者充分参与生活角色的主要障碍。这项拟议的研究将证明听觉掩蔽对言语不流利的短期影响，并确定预测积极反应的个体因素，使未来的工作能够开发听觉掩蔽作为针对言语长期改善的治疗辅助手段。为患有失语症和言语失用症的成年人提供额外的治疗选择将具有明显的益处，可以改善生活质量，并允许个人更积极地参与他们的治疗。 通过改善沟通做出医疗决策。

DESCRIPTION (provided by applicant): The objective of this research is to test the effects of listening to noise (i.e. auditory feedback masking) on speech fluency in stroke survivors with aphasia and apraxia of speech. People with nonfluent types of aphasia frequently have apraxia of speech, which affects the motor programming of speech movements, causing distortions, slow rate, and speech disfluencies that impede the forward flow of communication. Speaking while listening to noise (e.g. auditory masking) is known to reduce disfluencies and increase speech rate in people who stutter. This method has been tested in people with aphasia, resulting in positive effects on speech production for a subset of those tested. We contend that individuals who have apraxia of speech in addition to aphasia are most likely to benefit from auditory masking, but most previous studies did not test participants for apraxia of speech. In addition, though masking is most likely to affect speech disfluencies, previous studies did not measures disfluencies. The proposed work has two specific aims. Aim 1 will determine the effect of auditory masking on speech fluency in stroke survivors with aphasia and apraxia of speech. Aim 2 will identify individual factors that predict a positive response, including presence of apraxia of speech, lesion characteristics, and type of aphasia (e.g. Broca's, Wernicke's). Voxel-based lesion analysis techniques will be used to determine sites of lesion associated with positive and negative response to auditory masking. Completion of this study will remove barriers to studying auditory masking as a technique for clinical intervention, but also as a research tool for behavioral neuroscientists probing the speech motor control system in speakers with aphasia and apraxia of speech. PUBLIC HEALTH RELEVANCE: Impaired speech production is a major obstacle to full participation in life roles by stroke survivors with aphasia and apraxia of speech. The proposed study will demonstrate the short-term effects of auditory masking on speech disfluencies and identify individual factors that predict a positive response, enabling future work to develop auditory masking as a treatment adjuvant targeting long-term improvement in speech. Providing an additional treatment option for adults with aphasia and apraxia of speech will have the clear benefit of improving quality of life and allowing individuals to participate more actively in their health care decisions through improved communication.