Tobey Emily A, Devous Michael D, Buckley Kristi, Overson Gary, Harris Thomas, Ringe Wendy, Martinez-Verhoff Julie
Callier Advanced Hearing Research Center, The University of Texas at Dallas, Dallas, TX 75235, USA.
Ear Hear. 2005 Aug;26(4 Suppl):45S-56S. doi: 10.1097/00003446-200508001-00007.
The purpose of this report was to examine the preliminary data collected under a larger on-going feasibility study conducted with cochlear implant patients exploring the potential benefit of pharmacologically-enhanced aural rehabilitation therapy as a means of increasing speech tracking skills.
Eight adult cochlear implant participants participated in a randomized, double-blind study and received either 10 mg d-amphetamine (Treatment group, N = 4) or a placebo (Placebo group, N = 4) 60 minutes prior to a 1.5 hour intensive aural rehabilitation session occurring twice a week for two months. Treatment consisted of a multi-step rehabilitation program individualized for each participant to develop auditory-only speech tracking skills. Prior to and at the conclusion of the therapy sessions, SPECT rCBF imaging and speech tracking assessments were conducted.
Speech tracking scores of the placebo and treatment groups were similar before the aural habilitation intervention. In the placebo group, speech tracking performance increased 13.5% for visual plus auditory and auditory only presentations as a function of aural habilitation alone. The 10 mg d-amphetamine-facilitated program resulted in minimal increases in visual plus auditory tracking scores (2%) but led to a 43% increase for auditory-only speech tracking. Regional cerebral blood flow measures indicated no substantial improvement of brain activation in the placebo group while both the extent and magnitude of primary and associative auditory cortex activations increased significantly with the pharmacologically enhanced treatment program.
These data support previous studies indicating an accelerated acquisition of speech and language abilities in stroke patients receiving traditional speech therapy in combination with d-amphetamine. Data, however, are preliminary and further study is warranted.
本报告旨在研究在一项正在进行的针对人工耳蜗植入患者的更大规模可行性研究中收集的初步数据，该研究探索了药物增强听觉康复治疗作为提高言语追踪技能手段的潜在益处。
八名成年人工耳蜗植入参与者参加了一项随机双盲研究，在每周两次、为期两个月、每次1.5小时的强化听觉康复训练前60分钟，分别接受10毫克右旋苯丙胺（治疗组，N = 4）或安慰剂（安慰剂组，N = 4）。治疗包括为每个参与者量身定制的多步骤康复计划，以培养仅通过听觉的言语追踪技能。在治疗课程开始前和结束时，进行了单光子发射计算机断层扫描（SPECT）局部脑血流（rCBF）成像和言语追踪评估。
在听觉康复干预之前，安慰剂组和治疗组的言语追踪分数相似。在安慰剂组中，仅通过听觉康复，视觉加听觉以及仅听觉呈现的言语追踪表现提高了13.5%。10毫克右旋苯丙胺促进的方案使视觉加听觉追踪分数略有增加（2%），但仅听觉言语追踪增加了43%。局部脑血流测量表明，安慰剂组的脑激活没有实质性改善，而在药物增强治疗方案中，初级和联合听觉皮层激活的范围和程度均显著增加。
这些数据支持了先前的研究，表明在接受传统言语治疗并联合使用右旋苯丙胺的中风患者中，言语和语言能力的获得加速。然而，数据是初步的，需要进一步研究。
