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.
Every year approximately 15,000 Veterans are hospitalized for stroke, and up to 40% of those Veterans will experience stroke-related language impairment (i.e., aphasia). Stroke-induced aphasia results in increased healthcare costs and decreased quality of life. As our population of Veterans continues to age, there will be an increasing number for Veterans living with the aphasia and its consequences. Those Veterans deserve to receive aphasia treatment designed to facilitate the best possible outcomes. In the proposed study, we will investigate optimal treatment intensity and predictors of treatment response for a novel word retrieval treatment. The knowledge we gain will have direct implications for the selecting the right treatment approach for the right Veteran.
