Effect Of Verb Network Strengthening Treatment on Lexical Retrieval in Aphasia

描述(由申请人提供)： 中风是当今美国导致残疾的主要原因，失语症是一种影响语言产生和理解的语言障碍，仍然是中风康复过程中最具破坏性的方面之一。每年将有近80万美国人中风，其中多达40%的人还会患上失语症。失语症最突出的症状是难以提取单词，特别是在造句和连词(例如，讲故事、对话)方面。目前的项目考察了动词网络强化疗法(VNeST)对中度失语症患者在句子和连接的语音中提取单词的能力的影响。VNeST的主要目标是1)增加句子中名词和动词的特异性，2)在各种语言任务中最大限度地提高未经训练的单词的水平，3)用显著和相关的治疗材料和活动吸引和挑战参与者。15名失语症患者将接受为期10周的VNeST，每周4小时。治疗任务包括提取与目标动词相关的名词。例如，对于动词measure，参与者会想出测量的人和他们测量的东西(例如，木匠/木材、厨师/糖)。然后，他们将回答与这些事情可能发生的原因、地点和时间有关的问题(例如，对于木匠/测量，他们可能会说“获得正确的木板长度”，(为什么)“在建筑工地”，(在哪里)和“当建造房子”(在哪里))。当参与者无法完成任何给定任务时，会向他们提供提示和帮助。随着参与者的进步，线索会减少。在治疗之前，将对受试者进行测试，以确定他们在以下上下文中提取单词的能力：1)命名物体和动作的图片，2)句子，3)连接的语音。参与者和家人或朋友(即代理人)还将完成一份关于参与者在日常任务中如何进行沟通的问卷(例如，回答是或否，提供医疗信息)。在治疗阶段，将检查与治疗相关的项目的句子产生能力，以确定单词提取能力如何随着治疗的变化而变化。治疗结束后，将重新检查治疗前检查的所有措施(包括问卷)，以确定是否观察到改善。此外，参与者将在治疗完成3个月后再完成一次测试，以确定治疗后是否保持改善。最后，将检查整个治疗阶段随时间改善的分析，以确定随时间推移的改善率(或缺乏改善率)。所有统计分析将使用分组数据(即分组设计)，但也将对每个参与者的改进情况进行额外检查(即单一受试者设计)。因此，整个实验设计是小组分析和单一受试者分析的混合体。这项研究的发现将有助于为失语症的治疗实践提供信息，并可能允许有更多参与者参与临床试验的更大规模的研究。

DESCRIPTION (provided by applicant): Stroke is the leading cause of disability in the United States today, and aphasia, a language disorder that affects production and comprehension of language, remains one of the most devastating aspects of stroke recovery. Nearly 800,000 Americans will experience a stroke each year, and up to 40% of those will also experience aphasia. The most prominent symptom of aphasia is difficulty retrieving words, especially in sentence production and connected speech (e.g., telling a story, having a conversation). The current project examines the effect Verb Network Strengthening Treatment (VNeST), a language therapy, on the ability of persons with moderate aphasia to retrieve words in sentences and connected speech. The primary goals of VNeST are to 1) increase the specificity of nouns and verbs in sentences, 2) maximize improvement to untrained words across a variety of language tasks, and 3) engage and challenge participants with salient and relevant treatment materials and activities. Fifteen persons with aphasia will receive VNeST for 10 weeks for 4 hours per week. Treatment tasks involve the retrieval of nouns related to a target verb. For example, for the verb measure, participants would come up with people who measure and what they measure (e.g., carpenter/lumber, chef/sugar). They would then answer questions related to why, where, and when these things might occur (e.g., for carpenter/measure, they might say "to get the right length of board," (why) "at a construction site," (where) and "when building a house" (where)). Cues and assistance are provided to the participants when they are unable to complete any given task. As the participants improve, cues are reduced. Prior to treatment, testing will be conducted on participants to establish their abilities to retrieve words in the following contexts: 1) naming pictures of objects and actions, 2) sentences, and 3) connected speech. Participants and a family member or friend (i.e., proxy) will also complete a questionnaire about how the participant is able to communicate in everyday tasks (e.g., indicating yes or no, providing medical information). During the treatment phase, sentence production abilities on items related to treatment will be examined in order to determine how word retrieval abilities are changing with treatment. After the completion of treatment, all measures examined prior to treatment (including the questionnaire) will be re-examined in order to determine whether improvement was observed. Additionally, participants will complete testing one more time 3 months after the completion of treatment to determine if post-treatment improvements were maintained. Finally, an analysis of improvement over time across the treatment phase will be examined in order to determine the rate of improvement (or lack of it) over time. All statistical analyses will use group data (i.e., group design), but additional examination of improvements for each participant (i.e., single subject design) will also be conducted. Thus, the overall experimental design is a mix of group and single subject analyses. The findings from this study will help to inform aphasia treatment practices and potentially allow for a larger study with more participants in a clinical trial.