IMITATE: An intensive computer-based treatment for aphasia based on action observation and imitation

Lee, Jaime; Fowler, Robert; Rodney, Daniel; Cherney, Leora R.; Small, Steven L.

doi:10.1080/02687030802714157

Cited by 59 publications

(51 citation statements)

References 63 publications

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“…A previous study by our group (Fridriksson et al, 2009) revealed greater improvement in naming following a rehabilitation regiment where non-fluent aphasic patients paired pictures with audio-visual stimuli (showing the mouth of the speaker producing a word) compared to when pictures were paired with auditory only stimuli. Similar effects have been reported by Lee et al (2010) and Sarasso et al (2014). As far as we can tell, Rosenbek and colleagues (1973) were among the first to explicitly utilize speech mimicking as a part of a published approach to treat adult neurogenic speech problems (their approach focused specifically on apraxia of speech).…”

Section: Discussionsupporting

confidence: 70%

Speech entrainment compensates for Broca's area damage

Fridriksson

Basilakos

Hickok

et al. 2015

Cortex

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Speech entrainment (SE), the online mimicking of an audiovisual speech model, has been shown to increase speech fluency in patients with Broca's aphasia. However, not all individuals with aphasia benefit from SE. The purpose of this study was to identify patterns of cortical damage that predict a positive response SE's fluency-inducing effects. Forty-four chronic patients with left hemisphere stroke (15 female) were included in this study. Participants completed two tasks: 1) spontaneous speech production, and 2) audiovisual SE. Number of different words per minute was calculated as a speech output measure for each task, with the difference between SE and spontaneous speech conditions yielding a measure of fluency improvement. Voxel-wise lesion-symptom mapping (VLSM) was used to relate the number of different words per minute for spontaneous speech, SE, and SE-related improvement to patterns of brain damage in order to predict lesion locations associated with the fluency-inducing response to speech entrainment. Individuals with Broca's aphasia demonstrated a significant increase in different words per minute during speech entrainment versus spontaneous speech. A similar pattern of improvement was not seen in patients with other types of aphasia. VLSM analysis revealed damage to the inferior frontal gyrus predicted this response. Results suggest that SE exerts its fluency-inducing effects by providing a surrogate target for speech production via internal monitoring processes. Clinically, these results add further support for the use of speech entrainment to improve speech production and may help select patients for speech entrainment treatment.

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Section: Discussionsupporting

confidence: 70%

Speech entrainment compensates for Broca's area damage

Fridriksson

Basilakos

Hickok

et al. 2015

Cortex

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“…Baker et al [48] did not label their computerized naming treatment as intensive, yet delivered it in conjunction with transcranial direct-current stimulation for 40 min a day, 5 consecutive days for 2 weeks, a dosage consistent with other studies claiming intensive treatment. Lee et al [49] used intensive computerized training also with only one level of intensity, 3 h per day, 6 days per week for 6 weeks. Both studies reported positive gains by participants, but with only one intensity level, the contribution of intensity separate from the treatment protocol cannot be ascertained.…”

Section: Study Design Issuesmentioning

confidence: 99%

Intensity of Aphasia Therapy: Evidence and Efficacy

Cherney

Patterson

Raymer

2011

Curr Neurol Neurosci Rep

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Determining the optimal amount and intensity of treatment is essential to the design and implementation of any treatment program for aphasia. A growing body of evidence, both behavioral and biological, suggests that intensive therapy positively impacts outcomes. We update a systematic review of treatment studies that directly compares conditions of higher and lower intensity treatment for aphasia. We identify five studies published since 2006, review them for methodologic quality, and synthesize their findings with previous ones. For both acute and chronic aphasia, results at the language impairment and communication activity/participation levels tend to be more equivocal than previously demonstrated, with no clear differences between intensive and nonintensive treatment emerging across studies. Future research directions are discussed including research design, definitions of treatment intensity, and behavioral and biological measurement of short- and long-term changes following implementation of an intensive treatment.

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“…Because there was no statistical difference in any measure between those subjects who saw the speaker and those who did not, all data have been aggregated for this report. Complete details about the IMITATE therapy system can be found in Supplemental Material and in earlier work 16,17 .…”

Section: Methodsmentioning

confidence: 99%

“…The Western Aphasia Battery-Revised (WAB) 19 was used as the primary outcome measure, as it was anticipated that benefits of our imitation-based therapy would generalize to other domains of language 16,17,20 . The WAB was administered at each of the four main behavioral assessment sessions by a speech-language pathologist (SLP) blind to treatment group.…”

Section: Methodsmentioning

confidence: 99%

Performance Variability as a Predictor of Response to Aphasia Treatment

Duncan

Schmah

Small

2016

Neurorehabil Neural Repair

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Background Performance variability in individuals with aphasia is typically regarded as a nuisance factor complicating assessment and treatment. Objective We present the alternative hypothesis that intra-individual variability represents a fundamental characteristic of an individual’s functioning and an important biomarker for therapeutic selection and prognosis. Methods Nineteen individuals with chronic aphasia participated in a 6-week trial of imitation-based speech therapy. We assessed improvement both on overall language functioning and repetition ability. Further, we determined which pre-treatment variables best predicted improvement on the repetition test. Results Significant gains were made on the Western Aphasia Battery (WAB) Aphasia Quotient, Cortical Quotient, and two subtests, as well as on a separate repetition test. Using stepwise regression, we found that pre-treatment intra-individual variability was the only predictor of improvement in performance on the repetition test, with greater pre-treatment variability predicting greater improvement. Furthermore, the degree of reduction in this variability over the course of treatment was positively correlated with the degree of improvement. Conclusions Intra-individual variability may be indicative of potential for improvement on a given task, with more uniform performance suggesting functioning at or near peak potential.

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IMITATE: An intensive computer-based treatment for aphasia based on action observation and imitation

Cited by 59 publications

References 63 publications

Speech entrainment compensates for Broca's area damage

Speech entrainment compensates for Broca's area damage

Intensity of Aphasia Therapy: Evidence and Efficacy

Performance Variability as a Predictor of Response to Aphasia Treatment

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