RR&D Research Career Scientist Award Application

RR

• 批准号: 9397765
• 负责人: Julie L. Wambaugh
• 金额: --
• 依托单位: VA SALT LAKE CITY HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-10-01 至 2022-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9397765
• 关键词: Academy; Acquired Communication Disorders; Acute; Address; Age; Aphasia; Apraxias; Area; Articulation; Award; Behavior Therapy; Benchmarking; Biofeedback; Biological Markers; Brain; Brain Injuries; California; Characteristics; Chronic; Clinical; Clinical Research; Clinical Treatment; Combined Modality Therapy; Communication impairment; Development; Disease; Dose; Evidence based practice; Feedback; Focal Brain Injuries; Frequencies; Goals; Guidelines; Head; Health care facility; Healthcare; Healthcare Systems; Hour; Impairment; Investigation; Investigational Therapies; Language; Language Therapy; Lead; Lesion; Literature; Maintenance; Measurement; Mentors; Meta-Analysis; Methods; Neoplasms; Neurologic; Neuronal Plasticity; Outcome; Outcome Measure; Palate; Participant; Patients; Performance; Persons; Phase; Prevalence; Production; Publications; Publishing; Randomized Controlled Clinical Trials; Rehabilitation therapy; Reporting; Research; Research Activity; Research Personnel; Resources; Retrieval; Role; Sampling; Science; Scientist; Severities; Site; Speech; Speech Therapy; Stroke; Symptoms; Testing; Time; Tongue; Training; Treatment Protocols; Treatment outcome; Veterans; Visual; Work; base; career; clinical application; design; doctoral student; improved; interest; motor learning; novel; phrases; predicting response; predictive of treatment response; programs; research clinical testing; response; skills; sound; therapy design; treatment duration; treatment effect; treatment response; wound

The over-arching goal of Dr. Wambaugh's research program is to advance understanding and management of acquired apraxia of speech (AOS) and aphasia. Her current research activities are focused on the development and testing of clinically-applicable therapies for AOS and aphasia using sound theoretical bases for treatment and rigorous experimental methods. Her on-going VA RR&D merit project, “Effects of intensity of treatment on rehabilitation of acquired apraxia of speech” continues her work with Sound Production Treatment (SPT). SPT is a behavioral treatment for AOS which was developed by Dr. Wambaugh; it has been shown to consistently result in improved speech production with persons with AOS representing broad ranges of AOS severity, aphasia severity, chronicity, and age. In order to move SPT toward randomized controlled clinical trials, Dr. Wambaugh has been studying ways to maximize its outcomes. Treatment intensity is a potentially critical factor to consider in the administration of treatment. Dr. Wambaugh and her colleagues are currently evaluating the relative effects of intense administration of SPT (3 hours per day/ 3 days per week / 3 weeks) versus non-intense (“traditional”) SPT (1 hour per day/ 3 days per week/ 9 weeks). Dose frequency and treatment duration are being compared in terms of short and longer term maintenance of production of treated and untreated items (word/phrases). Dr. Wambaugh and her colleague, Dr. Mauszycki, are also comparing the effects of SPT to the effects of electropalatographic (EPG) treatment for AOS. EPG is a method for providing visual biofeedback concerning tongue to palate contact. Some speakers with AOS may have disrupted feedback associated with speech production and may benefit more from visual biofeedback in comparison to clinician-provided feedback. Dr. Wambaugh is also collaborating with researchers from the VA Northern California Health Care System to examine the role of site of lesion in predicting response to SPT and to identify neural plasticity changes associated with treatment. This line of research is the first to address brain biomarkers of treatment response in AOS. Because AOS typically co-occurs with aphasia and it is currently difficult for clinicians to determine how to allocate valuable therapy time among the two disorders, Dr. Wambaugh recently developed a treatment that simultaneously targets speech (AOS) and language (aphasia) symptoms – Combined Aphasia and Apraxia of Speech Treatment (CAAST). Dr. Wambaugh is continuing to refine the CAAST protocol and is conducting additional in-depth analyses of outcomes associated with this treatment with the aim of bringing this new treatment to randomized controlled clinical trials. In another area of aphasia treatment, Dr. Wambaugh has been extending her work with word-retrieval treatments to identify participant characteristics associated with response to treatment. She and her colleagues have recently begun to study practice effects as a predictor of ability to change (and ultimately benefit from treatment). Her pending RR&D merit submission is designed to address practice effects as a predictor of treatment response as well as a factor influencing generalized responding. Dr. Wambaugh's lab is also engaged in the development of reliable outcome measures for use in evaluating treatment outcomes. As part of Dr. Wambaugh's recent SPiRE award, “A novel treatment for aphasia and apraxia of speech: Measurement of Outcomes” her lab has collected repeated speech/language samples (over time) from a group of 30 speakers with AOS-aphasia and will be completing stability analyses for numerous outcome measures.

Wambaugh博士的研究计划的首要目标是促进理解， 获得性言语失用症（AOS）和失语症的管理。目前的研究活动 专注于AOS临床适用疗法的开发和测试， 失语症的治疗要有坚实的理论基础和严谨的实验方法。她 正在进行的VA RR&D优秀项目，“治疗强度对后天性 言语失用症”继续她的工作与声音生产治疗（SPT）。SPT是一个 Wambaugh博士开发的AOS行为治疗;它已被证明 AOS患者的言语表达能力得到改善， AOS严重程度、失语症严重程度、慢性程度和年龄的范围。为了使防止酷刑小组委员会 随机对照临床试验，Wambaugh博士一直在研究如何最大限度地提高其 结果。治疗强度是给药时需要考虑的潜在关键因素， 治疗Wambaugh博士和她的同事目前正在评估 SPT强化给药（每天3小时/每周3天/ 3周）与非强化给药 （“传统”）SPT（每天1小时/每周3天/ 9周）。给药频率和治疗 持续时间正在比较的短期和长期维持生产的 处理和未处理的物品（单词/短语）。Wambaugh博士和她的同事Mauszycki博士 还比较了SPT和EPG治疗的效果， AOS EPG是用于提供关于舌与腭接触的视觉生物反馈的方法。 一些患有AOS的说话者可能会中断与言语产生相关的反馈， 与临床医生提供的反馈相比，可以从视觉生物反馈中受益更多。博士 Wambaugh还与弗吉尼亚州北方加州卫生保健中心的研究人员合作 系统检查病变部位在预测对SPT的反应中的作用， 与治疗相关的可塑性变化。这一系列的研究是第一个解决大脑 AOS中治疗反应的生物标志物。因为AOS通常与失语症同时发生， 目前临床医生很难确定如何分配宝贵的治疗时间， Wambaugh博士最近开发了一种治疗方法， 言语（AOS）和语言（失语症）症状-失语症和言语失用症 治疗（CAAST）。Wambaugh博士正在继续完善CAAST方案， 对与这种治疗相关的结果进行额外的深入分析， 将这种新疗法引入随机对照临床试验。在失语症的另一个区域 治疗，Wambaugh博士一直在扩大她的工作与字检索治疗， 确定与治疗反应相关的参与者特征。她和她 同事们最近开始研究实践效果作为改变能力的预测器（和 最终受益于治疗）。她的待定RR&D优点提交旨在解决 实践效果作为治疗反应的预测因子以及影响广义 响应. Wambaugh博士的实验室也致力于开发可靠的结果， 用于评价治疗结果的指标。作为Wambaugh博士最近SPiRE的一部分， 奖，“失语症和言语失用症的新治疗：结果的测量”她 实验室从一组30个说话者中收集了重复的语音/语言样本（随着时间的推移 他将完成许多结果指标的稳定性分析。