Intention Treatment for Anomia: Investigating Dose Frequency Effects and Predictors of Treatment Response to Improve Efficacy and Clinical Translation

单词检索困难是中风患者最常见的语言主诉之一- 诱发失语症与单词提取障碍相关的负面后果包括健康状况的增加 护理成本和生活质量下降。存在各种各样的处理方法来提高单词检索， 大多数处理导致训练单词的立即改善。然而，长期改善 而对未经训练的词语或行为的改进则不太常见。此外，我们目前对 关于最佳的治疗管理参数，我们对治疗的预测因素知之甚少， 反应我们目前的医疗保健系统资源不足，无法为患有 慢性失语症充分利用失语症治疗的临床资源， 为了最大限度地提高退伍军人失语症的治疗效果，我们必须：1）开发临床上可翻译的治疗方法， 广泛和持久的影响和2）开发临床上可获得的方法来确定谁将获得受益 一种特殊的治疗方法。本Merit Review申请中的拟议研究采用了这两个 通过调查剂量频率（集中与分布式实践）效应和确定 语言、认知和神经预测对意图处理（INT）的反应，一种新的单词检索 治疗我们的初步研究为拟议研究提供了有力支持，我们预计这项研究将 提高INT作为其他词检索辅助工具的有效性、临床可译性和潜力 治疗。从更广泛的角度来看，我们的研究结果将有助于指导选择正确的治疗方法， 老兵这项工作对失语症康复的临床实践有直接的影响，并有可能 对VA医疗保健系统和患有失语症的退伍军人产生重大的积极影响。

Difficulty retrieving words is one of the most common language complaints in individuals with stroke- induced aphasia. The negative consequences related to word retrieval impairment include increased health care costs and decreased quality of life. A variety of treatment approaches exist to improve word retrieval, and most of the treatments result in immediate improvement on trained words. However, long-term improvement and improvement on untrained words or behaviors is less common. Additionally, we currently know very little about optimal treatment administration parameters and we know even less about predictors of treatment response. Our current healthcare system is not resourced to provide ongoing treatment for individuals with chronic aphasia. To make the best use of the clinical resources available for aphasia treatment, and to maximize outcomes for Veterans with aphasia, we must: 1) develop clinically translatable treatments that yield widespread and lasting effects and 2) develop clinically accessible ways of identifying who will acquire benefit from a specific treatment approach. The proposed study in this Merit Review Application takes on these two challenges by investigating dose frequency (massed vs. distributed practice) effects and identifying the language, cognitive and neural predictors of response to Intention treatment (INT), a novel word retrieval treatment. Our preliminary studies provide strong support for the proposed study, which we expect will increase the efficacy, clinical translatability, and potential for use of INT as an adjuvant to other word retrieval treatments. From a broader perspective, our results will help guide selection of the right treatment for the right Veteran. This work has direct implications for clinical practice in aphasia rehabilitation and has the potential to make a significant positive impact on the VA Healthcare System and on Veterans living with aphasia.