Interdisciplinary Institute for Music- and Speech-Therapy, Am Lipkamp 14, 47269, Duisburg, Germany.
Aphasia Center North Rhine Westphalia, Essen, Germany.
J Neurol. 2022 Sep;269(9):5070-5084. doi: 10.1007/s00415-022-11163-2. Epub 2022 May 23.
The main objective of this study was to investigate the efficacy of a directed rhythmic-melodic voice training (SIPARI) compared to language therapy with the focus on improvement in expressive linguistic performance. 20 patients suffering from chronic non-fluent aphasia, allocated by coin tossing to either of the groups, participated in 32 single therapy sessions over a period of 4 months. Before and after therapy, independent testers performed a standardized language test (Aachener Aphasie Test). Behavioral assessments revealed that improvements of patients of the experimental group were clinically significant compared to those of the control group. These improvements concerned the description level articulation and prosody for spontaneous speech and the subtests repetition, naming, and comprehension. Based on these improvements, a significant increase in profile level (effect size (ES) = 2.028, p < 0.001) was assessed, an overall and clinically relevant measure of the severity of aphasia. Additional fMRI examinations yielded activation in the left superior frontal gyrus for the post-minus pre- therapy assessments only for participants of the experimental group. Since this brain region is reported to be particularly involved in executive processing, we assume that the directed procedure of the SIPARI treatment with regard to musical, linguistic, and cognitive function potentially holds the key for successful language rehabilitation. While our imaging results hint at a possible explanation for its efficacy, our behavioral results corroborate the efficacy of this therapy in the treatment of chronic non-fluent aphasia patients. DRKS00026730, 19.10.21, retrospectively registered https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00026730.
本研究的主要目的是调查定向节奏旋律语音训练（SIPARI）与以提高表达语言表现为重点的语言治疗相比的疗效。20 名患有慢性非流利性失语症的患者通过抛硬币分配到两组中的任何一组，在 4 个月的时间里接受了 32 次单一治疗。在治疗前后，独立测试者进行了标准化语言测试（亚琛失语症测试）。行为评估显示，实验组患者的改善在临床上明显优于对照组。这些改善涉及自发言语的描述水平发音和韵律以及复述、命名和理解的子测试。基于这些改善，在轮廓水平上评估了显著的增加（效果大小（ES）= 2.028，p < 0.001），这是失语症严重程度的整体和临床相关指标。额外的 fMRI 检查仅在实验组参与者中显示出治疗前后评估中左额上回的激活。由于该脑区被报道特别参与执行处理，我们假设 SIPARI 治疗在音乐、语言和认知功能方面的定向程序可能是成功语言康复的关键。虽然我们的成像结果暗示了其疗效的可能解释，但我们的行为结果证实了这种疗法治疗慢性非流利性失语症患者的疗效。DRKS00026730，2021 年 10 月 19 日，回顾性注册 https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00026730。
