Towards a Clinical Test Battery for the Assessment of Verbal Short-term Memory Abilities With Linguistic Variations in Patients With Poststroke Aphasia.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 9
- 试验地点
- 4
- 主要终点
- verbal short-term memory in poststroke aphasia
研究概览
简要总结
Background and aim
There is a growing awareness that people with aphasia (language problems) after a stroke often have difficulties with their short-term memory (STM). As a result, the explanation underlying aphasia has recently been seen as a language processing disorder, where multiple cognitive processes interact. To evaluate the cognitive processes underlying aphasia, there is a need for reliable and valid assessment tools. However, the quality of tests usually used to assess STM problems in aphasia patients is questioned because they are not specifically designed to be used in aphasia patients. This raises some concern, as impairments of STM can be predictive for the recovery and rehabilitation of aphasia patients. As an important exception, a recent study has developed a new English evaluation tool (i.e., The Temple Assessment of Language and (Verbal) Short-term Memory in Aphasia; TALSA) that examines language and STM aspects specifically developed for persons with aphasia.
However, the existence of a Dutch evaluation tool specifically designed to assess language and STM problems in people with aphasia after a stroke is lacking. Therefore, the aim of the current study is to develop a Dutch clinical version of the TALSA battery that may lead to better diagnosis and treatment of STM problems in persons with aphasia. The development of the test focuses on its clinical feasibility (e.g. test duration, difficulty of the items and response modality). Pilot testing of the Dutch STM assessment instrument in the clinical and healthy population is very important to adapt the test where necessary. In addition, the quality of the test should also be carefully evaluated.
Method
The first step towards the development of a Dutch STM assessment instrument is the careful selection of the most crucial subtests of the original TALSA battery. Not all subtests will be selected due to the long testing time of the TALSA battery, and as mentioned earlier, the Dutch STM assessment tool focuses on clinical feasibility of the test.
The second step is pilot testing the Dutch STM assessment instrument in persons with aphasia and healthy persons. Persons with aphasia will be recruited at the Stroke unit of Ghent University Hospital. All eligible patients will be asked to provide written informed consent to participate in this study. Three tests will be administered, namely the Oxford Cognitive Screen, the Token Test and the Dutch STM assessment tool. It is important that these tests are taken on the same day or on two consecutive days, depending on the circumstances (e.g. fatigue). The Token Test and Oxford Cognitive Screen provide a picture of the patient's cognitive profile. Throughout the process of pilot testing, the Dutch STM assessment tool will be adapted and improved where necessary. In order to verify or adjust the difficulty of the items, it is crucial that the STM assessment instrument is also tested on a small number of healthy control subjects (recruited via social media platforms).
详细描述
- Introduction
1.1. Background
The literature has witnessed a steady increase in the number of studies investigating the role of short-term memory (STM) and working memory (WM) impairments in aphasia patients, which clearly shows that aphasia patients have impairments in verbal STM and WM. Throughout the years, views on the nature of aphasia have changed from the loss of linguistic representations (e.g., semantic and phonological representations) into impairments in the processing (i.e., access and retrieval) of language representations. Therefore, the emphasis of research has been refined in identifying the component operations of language processing, such as the mechanisms behind the access and retrieval of words or the temporal course of language processing. These operations rely on other cognitive functions, such as the STM.
Psycholinguistic models describe the role of the STM in language as the maintenance of activation of linguistic representations over the time course of processing words. Particularly, the interactive activation model takes levels of linguistic representations (e.g., semantic, lexical and phonological) and its connections into account. Specifically, according to this influential model, word retrieval is mediated by interactive spreading activation that activates the target word and semantically or phonologically related words. Two important concepts (i.e., connection strength and decay rate) play an important role in spreading and maintaining activation over time in the semantic-lexical-phonological network. In aphasia, the impairments are thought to occur through deficits in linguistic representations, and moreover, through deficits in connection weight and decay rate (i.e., processing impairment). Errors occur if connection strength is weak (activation spreads too slowly) or if the decay rate is too rapid (representations are activated but decay too fast). Therefore, the interactive activation model can explain different patterns of word retrieval errors (i.e., semantical or phonological) in aphasia.
In order to examine the role of the STM in language processing, there is an excessive need for reliable assessment tools. However, the psychometric properties of tests commonly used to assess STM problems in individuals with aphasia have been called into question. A common issue across these tests is that small standardized samples are used, which lead to validity and reliability problems of normative data. This raises some concerns since there is growing awareness that impairments in STM functions may be predictive of certain aspects of language function, recovery and rehabilitation in aphasia patients. Therefore, it is of crucial importance that STM assessment tools are reliable and valid in order to replicate, compare and further examine these findings.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 85 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- 未提供
排除标准
- 未提供
结局指标
主要结局
verbal short-term memory in poststroke aphasia
时间窗: 2 hours
assessment of verbal short-term memory in patients with poststroke aphasia: feasability, psychometric properties and normative data
次要结局
未报告次要终点