STUTTERING THERAPY AND NEUROPHYSIOLOGICAL INTERACTION - PET

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目及 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 目的：这项研究的背景是一个详尽的实证研究的研究为基础的和计算机管理的治疗成人发育性口吃被称为修改发声间隔（MPI）程序。 在此背景下，本提案中描述的研究将测试一些关于几个关键因素之间关系的假设：口吃行为，口吃的神经学，口吃的认知和情感成分，口吃治疗方法，以及口吃治疗收益的维持。 因此，这项建议同时解决了两个压倒性的需求：有效的口吃治疗成人，和整合的基本知识，如口吃的神经学知识，与治疗研究的信息，以开发全面的神经生理学和行为模型口吃和口吃治疗。 据推测，（a）持久治疗益处的先决条件是在构成口吃神经生理学的新兴模型的区域内使脑血流正常化，以及（B）可以通过建立需要产生具有减少的短发声间隔（PI）比例的语音的语音模式来实现该结果。 研究方法：这些目标将在一项治疗比较研究中实现，该研究采用来自MPI程序和代表成人口吃当前护理标准的延长言语（PS）程序的重复行为、认知和情感评估。 该评估格式将与重复PET扫描结合，以识别这些治疗产生的特定言语运动和神经系统变化，并通过经验推导的口吃系统模型进行描述。 两种治疗包括相同的转移和维持成分，以及在治疗过程中和停止后12个月内进行的诊所内和诊所外评估。 重复的性能相关性分析的衍生脑成像数据将测试的主要理论命题，即系统模型区域功能控制口吃治疗的疗效。 总体研究还构成了一项II期治疗疗效研究，将确定MPI项目III期治疗试验的需求。 受试者将在研究期间接受PET扫描。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. OBJECTIVE: The context for this study is an exhaustive empirical examination of a research-based and computer-managed treatment for adult developmental stuttering known as the Modifying Phonation Intervals (MPI) program. Within that context, the studies described in this proposal will test a number of hypotheses concerning the relationships among several critical factors: stuttering behavior, the neurology of stuttering, the cognitive and affective components of stuttering, stuttering treatment approaches, and the maintenance of stuttering treatment gains. Thus, this proposal simultaneously addresses two overwhelming needs: efficacious stuttering treatments for adults, and the integraton of basic knowledge, such as knowledge about the neurology of stuttering, with information from treatment research to develop comprehensive neurophysiologic and behavioral models of stuttering and stuttering teatment. It is hypothesized that (a) a necesaary prerequisite for durable treatment benefits is normalized cerebral blood flow within regions that constitute an emerging model of the neurophysiology of stuttering and (b) this result can be achieved by establishing a speech pattern that requires the production of speech with a reduced proportion of short phonated intervals (PIs). RESEARCH PLAN AND METHODS: These aims will be met in a treatment comparison study that employs repeated behavioral, cognitive, and affective evaluations derived from the MPI program and a prolonged speech (PS) program that represents the current standard of care for adult stuttering. This evaluation format will be conjoined by repeated PET scanning, to identify specific speech-motor and neural system changes generated by these treatments and described by an empirically derived stuttering system model. Both treatments include identical transfer and maintenance components plus within and beyond-clinic assessments that extend over the course of treatment and 12 months after its cessation. Repeated performance-correlation analyses of the derived brain imaging data will test the principal theoretic proposition that the system model regions functionally control the efficacy of stuttering treatment. The overall study also constitutes a Phase II treatment efficacy study that will determine the need for a Phase III treatment trial of the MPI program. Subjects will have PET scans during the study.