STUTTERING THERAPY AND NEUROPHYSIOLOGICAL INTERACTION - PET

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 目的：这项研究的背景是对一种基于研究和计算机管理的成人发育性口吃治疗的详尽的经验性检验，该治疗方法被称为修改发音间隔(MPI)计划。在这一背景下，本提案中描述的研究将检验关于几个关键因素之间关系的一些假设：口吃行为、口吃的神经学、口吃的认知和情感成分、口吃的治疗方法以及口吃治疗成果的维持。因此，这项建议同时满足了两个压倒性的需求：有效的成人口吃治疗，以及将基础知识(如关于口吃的神经学知识)与治疗研究的信息相结合，以开发口吃和口吃治疗的全面神经生理学和行为模型。假设(A)持久治疗益处的必要前提是在构成口吃神经生理学新兴模型的区域内使脑血流正常化，以及(B)这一结果可以通过建立一种需要产生较少短发音间隔(PI)的语音模式来实现。 研究计划和方法：这些目标将在一项治疗对比研究中实现，该研究采用来自MPI计划和代表当前成人口吃护理标准的延长言语(PS)计划的重复行为、认知和情感评估。这一评估格式将与重复的PET扫描相结合，以确定由这些治疗产生的特定语音-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。这两种治疗方法包括相同的转移和维护部分，以及内部和外部--在治疗过程中和停止后12个月内进行的临床评估。对衍生的脑成像数据的重复性能相关性分析将检验系统模型区域功能控制口吃治疗效果的主要理论命题。整个研究还构成了第二阶段治疗效果研究，将确定是否需要进行MPI计划的第三阶段治疗试验。受试者将在研究期间进行正电子发射计算机断层扫描。

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.