Dosage and predictors of naming treatment response in aphasia

失语症治疗反应的剂量和预测因素

• 批准号: 9136710
• 负责人: Michael Walsh Dickey
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-10-01 至 2018-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9136710
• 关键词: Address; Affect; Ambulatory Care Facilities; Anterior; Aphasia; Area; Articulation Disorders; Attention; Basal Ganglia; Behavior; Behavior Therapy; Behavioral; Brain; Chronic; Clinical; Cognitive; Communities; Conflict (Psychology); Data; Decision Making; Disease; Dose; Economic Burden; Education; Elderly; Enrollment; Exhibits; Family; Healthcare; Healthcare Systems; Hippocampus (Brain); Hour; Impairment; Incidence; Individual; Language; Left; Lesion; Life; Linguistics; Location; MRI Scans; Magnetic Resonance Imaging; Measures; Memory; Modeling; Names; Neurologic; Outcome; Outcome Measure; Participant; Patients; Performance; Persons; Production; Psycholinguistics; Recruitment Activity; Rehabilitation therapy; Reporting; Research; Resources; Role; Sampling; Semantics; Services; Societies; Stimulus; Stimulus Generalization; Stroke; Testing; Time; To specify; Training; Treatment Effectiveness; Treatment outcome; United States; Value of Life; Variant; Veterans; Work; cognitive performance; cognitive testing; cost effective; design; dosage; education research; effectiveness research; follow-up; improved; lexical; phonology; point of care; post stroke; predictive marker; predictive of treatment response; prognostic; programs; psychosocial adjustment; relating to nervous system; response; standardize measure; stroke survivor; success; time interval; treatment response

DESCRIPTION (provided by applicant): Language and communicative impairments following stroke (aphasia) affect more than 30% of stroke survivors, with an incidence of over 180,000 new cases annually. The consequences of aphasia are far reaching and can affect psychosocial adjustment, family role participation, vocational opportunities, and the ability to function independently in society. Recent estimates suggest that VHA outpatient clinics see 2000 new cases of aphasia each year, meaning that approximately 20,000 enrolled VHA patients and 100,000 United States Veterans are currently living with the condition. In response to this need, the VA Pittsburgh Healthcare System Geriatric Research, Education, and Clinical Center (GRECC) initiated the Program for Intensive Residential Aphasia Treatment and Education (PIRATE) in January 2009. PIRATE is a clinical demonstration project that provides approximately 100 hours of cognitive- linguistically oriented aphasia treatment to community dwelling Veterans over a 4-week period. PIRATE currently serves 18 Veterans per year in bi-monthly sessions. Resource limitations associated with PIRATE and aphasia treatment in general require that treatments be offered in the most cost-effective doses to those Veterans most likely to benefit from them. The proposed treatment-effectiveness research addresses these issues by examining the dose-response relationship for semantically-oriented naming treatment, and identifying cognitive, psycholinguistic and neuroanatomical predictors of treatment success. Study participants (n=50, over a 4-year period) will be recruited nationwide from Veterans enrolled in PIRATE. They will have their naming performance measured prior to PIRATE entry, during each week of treatment, and at program exit/follow-up. A battery of cognitive measures and structural magnetic resonance images of their brains will also be collected prior to treatment. Participants' performance on trained and untrained lexical items and a standardized measure of naming performance will be compared across time intervals to specify the therapy amounts for which maximum treatment benefits are achieved. Their treatment outcomes will also be correlated with specific cognitive test scores and the location and extent of their brain lesions to identify cognitive and neurological markers predictive of positive treatment response. Treatment response will also be compared across participants with different psycholinguistic profiles, to determine which groups of patients show greatest benefit from semantically-oriented naming treatment. The proposed research should provide answers to two interlocking questions: for whom is aphasia therapy most effective, and how much of it is needed to optimize treatment outcomes. These answers have the potential to set transformative new standards for how aphasia treatment is delivered within VHA.

描述（由申请人提供）： 中风后的语言和交流障碍（失语症）影响了30％以上的中风幸存者，每年发病率超过180,000例。失语症的后果已经到来，可能会影响社会心理调整，家庭角色参与，职业机会以及在社会中独立运作的能力。 最近的估计表明，VHA门诊诊所每年参见2000例新的失语症病例，这意味着目前约有20,000名入学的VHA患者和100,000名美国退伍军人患有这种情况。 In response to this need, the VA Pittsburgh Healthcare System Geriatric Research, Education, and Clinical Center (GRECC) initiated the Program for Intensive Residential Aphasia Treatment and Education (PIRATE) in January 2009. PIRATE is a clinical demonstration project that provides approximately 100 hours of cognitive- linguistically oriented aphasia treatment to community dwelling Veterans over a 4-week period. 海盗目前每年每两月每年为18名退伍军人服务。一般而言，与海盗和失语症治疗相关的资源限制要求以最具成本效益的剂量为那些最有可能从中受益的退伍军人提供治疗。 拟议的治疗效应研究通过检查了以语义为导向的命名治疗的剂量反应关系，并确定了治疗成功的认知，心理语言和神经解剖学预测指标，从而解决了这些问题。研究参与者（n = 50，在4年期间）将在全国范围内从海盗入学的退伍军人中招募。他们将在海盗进入，治疗的每周以及计划退出/随访之前测量其命名性能。在治疗之前，还将收集一系列的认知措施和结构性磁共振图像。参与者在训练有素和未经训练的词汇项目上的表现以及将在时间间隔中比较标准化的命名性能措施，以指定获得最大治疗益处的治疗量。他们的治疗结果也将与特定的认知测试评分以及其脑部病变的位置和程度相关，以鉴定认知和神经系统标志物可预测阳性治疗反应。还将比较具有不同心理语言特征的参与者的治疗反应，以确定哪些患者在语义导向的命名治疗中表现出最大的好处。 拟议的研究应为两个互锁问题提供答案：为谁是失语症治疗最有效的，以及优化治疗结果所需的多少。这些答案有可能设定变革性的新标准，以实现VHA中的失语治疗方式。