Establishing Evidence-based Treatment for Speech and Language in Primary Progressive Aphasia

建立原发性进行性失语症言语和语言的循证治疗

• 批准号: 10793142
• 负责人: Maya Henry
• 金额: $ 9.67万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10793142
• 关键词: Address; Adjuvant; Adult; Affect; Aftercare; Aging; Behavior Therapy; Behavioral; Brain; Brain region; California; Caring; Clinical; Clinical Management; Cognitive; Collaborations; Communication; Communication impairment; Continuity of Patient Care; Cross-Over Trials; Dementia; Deterioration; Disease; Doctor of Philosophy; Double-Blind Method; Elements; Enrollment; Evidence based treatment; Family; Frequencies; Geography; Goals; Grant; Impairment; Individual; Inferior frontal gyrus; Intervention; Knowledge; Laboratories; Language; Left; Literature; Magnetic Resonance Imaging; Measures; Memory; Methods; Names; Nature; Nerve Degeneration; Neurobiology; Neurodegenerative Disorders; New Mexico; Outcome; Outcome Measure; Participant; Patient Outcomes Assessments; Patients; Persons; Phase; Phenotype; Population; Predictive Factor; Primary Progressive Aphasia; Production; Productivity; Public Health; Quality of life; Randomized; Rehabilitation therapy; Research; San Francisco; Severities; Site; Societies; Speech; Structure of middle temporal gyrus; Structure of supramarginal gyrus; Techniques; Technology; Transcranial magnetic stimulation; Universities; Variant; Work; base; clinical care; cohort; dosage; evidence base; follow-up; improved; innovation; multi-component intervention; neural; neuroregulation; novel; person centered; personalized diagnostics; predict responsiveness; psychosocial; recruit; rehabilitation strategy; response; skills; stem; telerehabilitation; therapy design; transcranial direct current stimulation; treatment center; treatment optimization; treatment response; virtual therapy

Project Summary/Abstract Primary progressive aphasia (PPA) is a disorder characterized by gradual decline in communication ability caused by neurodegeneration of brain regions that support speech and language. PPA is a devastating condition that can affect adults as young as their 50’s, depriving them of the ability to communicate and function in society. The cognitive and neural bases of PPA have been well characterized and a growing evidence base supports the utility of speech-language treatment for this population. Based on this body of work, we are now poised to broaden and optimize treatment options for persons with PPA, adding cutting-edge neuromodulatory and behavioral techniques that leverage current technological and conceptual advances. The long-term objective of this project is to establish a more comprehensive continuum of care for persons with PPA by evaluating novel neuromodulatory and speech-language treatment methods addressing the communication deficits in PPA. The study has three main goals: 1) to evaluate the acceptability and benefit of remotely-supervised transcranial direct current stimulation (RS-tDCS) in conjunction with proven restitutive treatments for naming and speech production/fluency for persons with PPA 2) to identify baseline neural factors that relate to responsiveness to tDCS in PPA and 3) to evaluate the benefit of a novel, multifaceted, person-centered intervention designed to improve functional communication for individuals with PPA. In order to accomplish these aims, we will enroll 126 individuals with PPA who will undergo comprehensive assessment and virtual treatment, with a subset of participants receiving RS-tDCS in conjunction with speech-language intervention. The necessary recruitment and expertise to support the aims of this study will be facilitated by a longstanding collaboration with the University of California, San Francisco’s Memory and Aging Center and through a new collaboration with the University of New Mexico. This work will provide fundamental evidence regarding the efficacy of rehabilitation strategies across the severity continuum and phenotypic spectrum in PPA, with the potential to improve clinical care for individuals with this debilitating condition.

项目总结/摘要 原发性进行性失语症是一种以交流能力逐渐下降为特征的疾病 是由支持语言的大脑区域的神经退化引起的。PPA是一种毁灭性的疾病 这可能会影响到50多岁的成年人，剥夺他们在社会中沟通和发挥作用的能力。 PPA的认知和神经基础已经得到了很好的表征，越来越多的证据支持 对这一人群进行言语治疗的效用。基于这些工作，我们现在准备 扩大和优化PPA患者的治疗选择，增加尖端的神经调节和 利用当前技术和概念进步的行为技术。的长期目标 该项目旨在通过评估新的PPA， 神经调节和言语语言治疗方法解决PPA的沟通缺陷。的 研究有三个主要目的：1）评估远程监督经颅直接 电流刺激（RS-tDCS）结合经证实的命名和言语恢复治疗 生产/流畅性的人与PPA 2），以确定基线神经因素，涉及到的反应， PPA中的tDCS和3）评估一种新颖的、多方面的、以人为本的干预措施的益处， 改善PPA患者功能性沟通。为了实现这些目标，我们将招收126名 将接受全面评估和虚拟治疗的PPA患者， 参与者接受RS-tDCS与语音语言干预。必要的招聘 和专业知识，以支持这项研究的目标将促进长期合作， 加州大学旧金山弗朗西斯科的记忆和衰老中心，并通过与 新墨西哥州大学。这项工作将提供有关康复疗效的基本证据 在PPA的严重程度连续体和表型谱的策略，有可能改善临床 照顾有这种衰弱状况的人。