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.

本行政补充的母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（SFA）治疗的关键组成部分， 失语症中的单词查找困难改善了结果。这个问题的组成部分是语义的数量 失语症患者被要求在每次治疗试验中产生的特征。研究参与者（n=40）将 被招募并随机接受SFA的多功能版本或少功能版本。在 在多特征条件下，参与者将被要求为每个练习的单词生成11个语义特征。 被分配到少数特征条件的参与者将被要求为每个单词生成5个特征 练习。两种情况下的总治疗时间相等。因为每次审判所花的时间 在特征较少的情况下，该组中的参与者将更频繁地循环通过被处理项目的列表， 为他们提供更多的机会来练习目标的语音形式， 阐述了特征生成的实践。相应地，多功能组将得到更多的实践 生成语义特征，代价是练习目标词形式的机会更少。 研究参与者将在匹兹堡研究中心当地居住五周，在此期间，他们将接受 60小时的SFA治疗。在开始治疗前的两个时间点、治疗退出时和1个月时 随后，将评估他们命名经治疗和未经治疗的、语义相关的名词的图片的能力。 其他次要结局，包括连接语音和患者报告的沟通措施 能力也将在同一时间表上收集。为了解决有关 潜在的认知和神经机制的SFA，一个子集的参与者也将同时接受预- 以及使用眼动追踪方法对自动文字处理能力进行治疗后评估， 功能性磁共振成像（fMRI）。 语言测试结果将用于确定功能生成的适当平衡 实践与文字形式的实践，以优化SFA的结果。眼动追踪的结果将被用来推断 SFA的积极作用是否可以归因于词汇语义表征的激活， 提高抑制竞争性表征的能力，或两者兼而有之。功能磁共振成像的结果将被用来识别大脑 与SFA引起的命名能力变化相关的网络和激活变化。本研究将 提供有关如何进行失语症治疗的理论和临床相关信息， 其影响背后的神经认知机制。这一行政补充项目的目的是 检查与语言表现相关的基于任务的大脑激活模式是否在整个过程中稳定 两个治疗前扫描阶段i用于调节以下观察到的变化的解释 治疗