A Prospective, Controlled Study of Rehabilitation of Anomia in Aphasia

失语症失语症康复的前瞻性对照研究

• 批准号: 8594537
• 负责人: DIANE L. KENDALL
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-10-01 至 2018-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8594537
• 关键词: Acquired Aphasia; Address; Adult; Aftercare; Anomia; Aphasia; Behavioral; Child; Chronic; Communication; Communities; Controlled Study; Data; Educational Background; Evidence based treatment; Exhibits; Foundations; Goals; Growth; Health; High Prevalence; Hour; Impairment; Individual; Knowledge; Language; Language Development; Language Disorders; Language Therapy; Lead; Left; Linguistics; Measures; Modeling; Names; Neural Network Simulation; Patients; Performance; Persons; Phase; Phase I/II Trial; Production; Quality of life; Rehabilitation therapy; Research; Retrieval; Sampling; Semantics; Series; Severities; Societies; Speech; Stroke; Testing; Time; Training; Treatment outcome; Vocabulary; World Health Organization; aphasia rehabilitation; arm; base; control trial; disability burden; dosage; efficacy testing; improved; lexical; phase II trial; phase III trial; phonology; prospective; public health relevance; relating to nervous system; response; sound; theories; treatment effect; treatment program

DESCRIPTION (provided by applicant): One of the most common and debilitating features of aphasia is an impairment in ability to retrieve words, whether it involves naming seen objects, or producing nouns, verbs and other words conveying meaning in spontaneous propositional speech. The long-term goal of this line of research is to establish an effective, viable, evidence-based treatment program for word retrieval deficits in persons with acquired aphasia from stroke. The short-term goal, and focus of this project, is to conduct a final phase II trial that tests the efficacy of an experimental treatent (called phonomotor) against customary and usual treatment (i.e. semantic-based therapy) for anomia in aphasia. In the context of a 2-armed control trial, we propose to deliver 60 total hours of therapy to 80 individuals who have suffered a left hemisphere stroke and exhibit aphasia with significant anomia. Effects of treatment acquisition and generalization will be measured at 3 time points (immediately, 3-months and 1-year post treatment termination). The primary aim will address between group differences of confrontation naming performance of untrained nouns at 3 months. Secondary questions will address generalization of treatment to measures of ecologic validity and discourse production. Through a series of phase I and phase II trials, we have shown that intensively delivered phonomotor treatment not only improves confrontation naming performance on trained words but, as predicted by the theory motivating it, importantly achieves generalization to naming of untrained words, some aspects of discourse production, and indicators of quality of life. The treatment program is motivated by a connectionist model of phonology (Nadeau, 2001; Nadeau, 2006, Nadeau, 2012) and by a two level interactive model of language (Dell, 1987). The theoretical foundation for the phonomotor treatment is as follows: through the systematic training of phonemes (sounds) and phoneme sequences, the neural connectivity supporting phoneme sequence knowledge will be enhanced. Because these sound sequences provide the basis for the words that represent concepts, through bidirectional spread of activation among and between linguistic levels, generalization from treating phonemes can be expected to improve naming of untrained words and discourse production, both immediately after treatment and continued beyond treatment termination.

描述（由申请人提供）： 失语症的最常见和令人衰弱的特征之一是检索单词的能力的损害，是涉及命名可见的对象，还是产生名词，动词和其他单词在自发命题语音中传达含义的含义。这项研究线的长期目标是在中风中获得失语症患者的单词检索缺陷，建立一个有效，可行，基于证据的治疗计划。该项目的短期目标和重点是进行II阶段试验，该试验测试了对习惯和常规治疗（即基于语义的治疗）对失语症的习惯和常规治疗（即基于语义的治疗）的功效。在一项2臂对照试验的背景下，我们建议为80名遭受左半球中风并表现出严重无症状的失语症的人提供60个小时的治疗。治疗采集和概括的影响将在3个时间点（立即，3个月和1年后治疗终止）进行测量。主要目的将解决3个月未经训练名词的对抗命名性能的群体差异。次要问题将解决对生态有效性和话语产生量度的治疗的概括。通过一系列的第一阶段和II期试验，我们表明，强烈交付的Phonomotor治疗不仅改善了训练有素的单词上的对抗命名命名性能，而且正如促使该词的理论所预测的那样，重要的是，重要的是，重要的是，对未经训练的单词的概括，对话语产生的某些方面以及生活质量的指标进行了概括。该治疗计划是由语音学模型的动机（Nadeau，2001; Nadeau，2006，Nadeau，2012年）和语言的两个级别交互模型（Dell，1987）。手法处理的理论基础如下：通过对音素（声音）和音素序列的系统训练，将增强支持音素序列知识的神经连接性。由于这些声音序列为表示概念的单词提供了基础，因此通过语言水平之间和语言水平之间的双向激活传播，可以预期，可以改善对未经训练的单词和话语产生的命名。