Optimizing and understanding semantic feature analysis treatment for aphasia: A randomized controlled comparative-effectiveness trial

优化和理解失语症的语义特征分析治疗：一项随机对照比较有效性试验

• 批准号: 10610579
• 负责人: Michael Walsh Dickey
• 金额: $ 1.02万
• 依托单位: VETERANS HEALTH FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10610579
• 关键词: Address; Administrative Supplement; Aftercare; Aphasia; Base of the Brain; Brain; Brain imaging; Cognitive; Communication; Development; Equilibrium; Functional Magnetic Resonance Imaging; Generations; Goals; Healthcare; Hour; Image; Impairment; Language; Language Tests; Measures; Mentorship; Methods; Names; Neurocognitive; Outcome; Outcome Measure; Parents; Participant; Patients; Pattern; Performance; Persons; Randomized; Reporting; Research Personnel; Scanning; Schedule; Semantics; Site; Speech; Standardization; Test Result; Time; Word Processing; clinically relevant; comparative effectiveness trial; efficacious treatment; experience; follow-up; improved; improved outcome; language processing; lexical; neuromechanism; phonology; recruit; secondary outcome; success; treatment response; treatment trial; visual tracking

The parent study for this administrative supplement is a randomized comparative effectiveness trial that examines whether active manipulation of a key component of semantic feature analysis (SFA) treatment for word-finding difficulty in aphasia improves outcomes. The component in question is the number of semantic features that persons with aphasia are asked to generate on each treatment trial. Study participants (n=40) will be recruited and randomized to receive either a many-features version of SFA or a few-features version. In the many-features condition, participants will be asked to generate 11 semantic features for each word practiced. Participants assigned to the few-features condition will be asked to generate 5 features for each word practiced. The total treatment time will be equated in the two conditions. Because each trial will take less time in the few-features condition, participants in this group will cycle through the lists of treated items more often, providing them with more opportunities to practice the phonological form of the targets, at the expense of more elaborated feature generation practice. Correspondingly, the many-features group will receive more practice generating semantic features, at the expense of having fewer opportunities to practice the target word forms. Study participants will be housed locally at the Pittsburgh site for five weeks during which they will receive 60 hours of SFA treatment. At two timepoints before beginning treatment, at treatment exit, and at 1-month follow-up, their ability to name pictures of treated and untreated, semantically related nouns will be assessed. Other secondary outcomes, including measures of connected speech and patient-reported communication ability will also be collected on the same schedule. In order to address unresolved questions about the underlying cognitive and neural mechanisms of SFA, a subset of participants will also receive concurrent pre- and post-treatment assessment of automatic word processing ability using eye-tracking methods and functional magnetic resonance imaging (fMRI). The language testing results will be used to determine the appropriate balance of feature generation practice vs. word form practice to optimize SFA outcomes. The eye-tracking results will be used to infer whether SFA’s positive effects can be attributed to improved activation of lexical-semantic representations, improved ability to inhibit competing representations, or both. The fMRI results will be used to identify the brain networks and activation changes associated with changes in naming ability resulting from SFA. This study will provide theoretically and clinically relevant information about how aphasia treatment should be delivered and the neurocognitive mechanisms underlying its effects. The aim of this administrative supplement project is to examine whether task-based brain activation patterns associated with language performance are stable across the two pre-treatment scanning sessions i to condition the interpretation of changes observed following treatment.

该行政补充的家长研究是一项随机比较有效性试验 检查是否主动操纵语义特征分析的关键组成部分（SFA）处理 失语症中的单词发现难度改善了结果。所讨论的组成部分是语义的数量 要求患有失语症的人在每个治疗试验中都会产生。研究参与者（n = 40）将 被招募并随机分配以获得SFA的多种功能版本或一些功能版本。在 许多功能条件，将要求参与者为每个练习的单词生成11个语义功能。 分配给几个功能条件的参与者将被要求为每个单词生成5个功能 练习。在这两个条件下，总治疗时间将等效。因为每个审判将花费更少的时间 在少数功能的条件下，该小组的参与者将更频繁地浏览经过处理的项目列表， 为他们提供更多的机会来练习目标的语音形式，以更多 详细的特征生成实践。相应地，多场小组将获得更多练习 产生语义特征，以牺牲练习目标单词形式的机会更少。 研究参与者将在匹兹堡现场安置五个星期，在此期间 60小时的SFA治疗。在开始治疗之前的两个时间点，在治疗出口和1个月 随后，将评估他们命名处理和未经治疗的，语义相关名词的图片的能力。 其他次要结果，包括连接语音和患者报告的沟通的措施 能力还将按照相同的时间表收集。为了解决有关未解决的问题 SFA的潜在认知和神经机制，一部分参与者还将同时获得 以及使用眼神跟踪方法对自动文字处理能力的治疗后评估和 功能磁共振成像（fMRI）。 语言测试结果将用于确定功能生成的适当平衡 实践与单词形式实践以优化SFA结果。吸引人的结果将用于推断 SFA的积极影响是否可以归因于词汇语义表示的激活， 提高了抑制竞争表征或两者兼而有之的能力。 fMRI结果将用于识别大脑 网络和激活变化与SFA导致的命名能力变化相关。这项研究会 提供有关如何提供失语治疗的理论和临床相关信息， 神经认知机制是其作用的基础。这个行政补充项目的目的是 检查基于任务的大脑激活模式与语言表现相关的模式是否稳定 两次预处理扫描会议I，以调节观察到的变化的解释以下 治疗。