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Cotelli M, Baglio F, Manenti R, Blasi V, Galimberti D, Gobbi E, Pagnoni I, Rossetto F, Rotondo E, Esposito V, De Icco R, Giudice C, Tassorelli C, Catricalà E, Perini G, Alaimo C, Campana E, Benussi L, Ghidoni R, Binetti G, Carandini T, Cappa SF. A Multimodal Approach for Clinical Diagnosis and Treatment of Primary Progressive Aphasia (MAINSTREAM): A Study Protocol. Brain Sci 2023; 13:1060. [PMID: 37508992 PMCID: PMC10377301 DOI: 10.3390/brainsci13071060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/27/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
Primary Progressive Aphasia (PPA) is a syndrome due to different neurodegenerative disorders selectively disrupting language functions. PPA specialist care is underdeveloped. There are very few specialists (neurologists, psychiatrists, neuropsychologists, and speech therapists) and few hospital- or community-based services dedicated to the diagnosis and continuing care of people with PPA. Currently, healthcare systems struggle to provide adequate coverage of care that is too often fragmented, uncoordinated, and unresponsive to the needs of people with PPA and their families. Recently, attention has been gained by non-invasive brain stimulation techniques that allow a personalized treatment approach, such as transcranial Direct Current Stimulation (tDCS). The MAINSTREAM trial looks forward to introducing and evaluating therapeutic innovations such as tDCS coupled with language therapy in rehabilitation settings. A Multimodal Approach for Clinical Diagnosis and Treatment of Primary Progressive Aphasia, MAINSTREAM (ID: 3430931) was registered in the clinicaltrials.gov database (identifier: NCT05730023) on 15 February 2023.
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Affiliation(s)
- Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | | | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Valeria Blasi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Daniela Galimberti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Deparment of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | | | - Emanuela Rotondo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | | | - Roberto De Icco
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- Movement Analysis Research Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Carla Giudice
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- Movement Analysis Research Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- Movement Analysis Research Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Eleonora Catricalà
- ICoN Cognitive Neuroscience Center, Institute for Advanced Studies, IUSS, 27100 Pavia, Italy
| | - Giulia Perini
- Dementia Research Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Cristina Alaimo
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Elena Campana
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Luisa Benussi
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Roberta Ghidoni
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Giuliano Binetti
- MAC-Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Tiziana Carandini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Stefano Francesco Cappa
- Dementia Research Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
- ICoN Cognitive Neuroscience Center, Institute for Advanced Studies, IUSS, 27100 Pavia, Italy
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Grasso SM, Peña ED, Kazemi N, Mirzapour H, Neupane R, Bonakdarpour B, Gorno-Tempini ML, Henry ML. Treatment for Anomia in Bilingual Speakers with Progressive Aphasia. Brain Sci 2021; 11:1371. [PMID: 34827370 PMCID: PMC8615710 DOI: 10.3390/brainsci11111371] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/09/2021] [Accepted: 10/09/2021] [Indexed: 11/17/2022] Open
Abstract
Anomia is an early and prominent feature of primary progressive aphasia (PPA) and other neurodegenerative disorders. Research investigating treatment for lexical retrieval impairment in individuals with progressive anomia has focused primarily on monolingual speakers, and treatment in bilingual speakers is relatively unexplored. In this series of single-case experiments, 10 bilingual speakers with progressive anomia received lexical retrieval treatment designed to engage relatively spared cognitive-linguistic abilities and promote word retrieval. Treatment was administered in two phases, with one language targeted per phase. Cross-linguistic cognates (e.g., rose and rosa) were included as treatment targets to investigate their potential to facilitate cross-linguistic transfer. Performance on trained and untrained stimuli was evaluated before, during, and after each phase of treatment, and at 3, 6, and 12 months post-treatment. Participants demonstrated a significant treatment effect in each of their treated languages, with maintenance up to one year post-treatment for the majority of participants. Most participants showed a significant cross-linguistic transfer effect for trained cognates in both the dominant and nondominant language, with fewer than half of participants showing a significant translation effect for noncognates. A gradual diminution of translation and generalization effects was observed during the follow-up period. Findings support the implementation of dual-language intervention approaches for bilingual speakers with progressive anomia, irrespective of language dominance.
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Affiliation(s)
- Stephanie M. Grasso
- Department of Speech, Language and Hearing Sciences, University of Texas, Austin, TX 78705, USA; (N.K.); (H.M.); (R.N.); (M.L.H.)
| | - Elizabeth D. Peña
- School of Education, University of California, Irvine, CA 92697, USA;
| | - Nina Kazemi
- Department of Speech, Language and Hearing Sciences, University of Texas, Austin, TX 78705, USA; (N.K.); (H.M.); (R.N.); (M.L.H.)
| | - Haideh Mirzapour
- Department of Speech, Language and Hearing Sciences, University of Texas, Austin, TX 78705, USA; (N.K.); (H.M.); (R.N.); (M.L.H.)
| | - Rozen Neupane
- Department of Speech, Language and Hearing Sciences, University of Texas, Austin, TX 78705, USA; (N.K.); (H.M.); (R.N.); (M.L.H.)
| | - Borna Bonakdarpour
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA;
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA;
| | - Maya L. Henry
- Department of Speech, Language and Hearing Sciences, University of Texas, Austin, TX 78705, USA; (N.K.); (H.M.); (R.N.); (M.L.H.)
- Department of Neurology, Dell Medical School, University of Texas, Austin, TX 78705, USA
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Machado TH, Carthery-Goulart MT, Campanha AC, Caramelli P. Cognitive Intervention Strategies Directed to Speech and Language Deficits in Primary Progressive Aphasia: Practice-Based Evidence from 18 Cases. Brain Sci 2021; 11:brainsci11101268. [PMID: 34679333 PMCID: PMC8533834 DOI: 10.3390/brainsci11101268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Practice-based evidence can inform and support clinical decision making. Case-report series about the implementation of programs in real-world clinical settings may contribute to verifying the effectiveness of interventions for treating PPA in specific contexts, as well as illustrating challenges that need to be overcome. OBJECTIVE To describe and provide practice-based evidence on the effectiveness of four cognitive rehabilitation programs designed for individuals with PPA and directed to speech and language impairments, which were implemented in a specialized outpatient clinic. METHODS Multiple single-case study. Eighteen individuals with different subtypes of PPA were each assigned to one out of four training programs based on comprehensive speech and language assessments. The treatments targeted naming deficits, sentence production, speech apraxia, and phonological deficits. Pre- and post-treatment assessments were undertaken to compare trained and untrained items. Gains were generalized to a different task in the first two types of intervention (naming and sentence production). A follow-up assessment was conducted 1-8 months after treatment among 7 participants. RESULTS All individuals presented better performance in the trained items at the post-test for each rehabilitation program accomplished, demonstrating that learning of the trained strategies was achieved during the active phase of treatment. For 13 individuals, statistical significance was reached; while for five, the results were maintained. Results about untrained items, generalization to other tasks, and follow-up assessments are presented. CONCLUSIONS The positive results found in our sample bring some practice-based evidence for the benefits of speech and language treatment strategies for clinical management of individuals with PPA.
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Affiliation(s)
- Thais Helena Machado
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil;
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil;
- Av Prudente de Morais, 290-Sala 1106, Belo Horizonte 30380-002, MG, Brazil
- Correspondence:
| | - Maria Teresa Carthery-Goulart
- Grupo de Estudos em Neurociência da Linguagem e Cognição, Núcleo Interdisciplinar de Neurociência Aplicada, Centro de Matemática, Computação e Cognição da Universidade Federal do ABC, São Bernardo do Campo 09210-580, SP, Brazil;
- Grupo de Neurologia Cognitiva e do Comportamento, Divisão de Clínica Neurológica, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, SP, Brazil
- INCT-ECCE (Instituto Nacional de Ciência e Tecnologia sobre Comportamento, Cognição e Ensino), Rodovia Washington Luís, Km 235, São Carlos 13565-905, SP, Brazil
| | - Aline Carvalho Campanha
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil;
| | - Paulo Caramelli
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil;
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil;
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Pagnoni I, Gobbi E, Premi E, Borroni B, Binetti G, Cotelli M, Manenti R. Language training for oral and written naming impairment in primary progressive aphasia: a review. Transl Neurodegener 2021; 10:24. [PMID: 34266501 PMCID: PMC8282407 DOI: 10.1186/s40035-021-00248-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by a gradual, insidious and progressive loss of language abilities, with naming difficulties being an early and persistent impairment common to all three variants. In the absence of effective pharmacological treatments and given the progressive nature of the disorder, in the past few decades, many studies have investigated the effectiveness of language training to minimize the functional impact of word-finding difficulties in daily life. MAIN BODY We review language treatments most commonly used in clinical practice among patients with different variants of PPA, with a focus on the enhancement of spoken and written naming abilities. Generalization of gains to the ability to name untrained stimuli or to other language abilities and the maintenance of these results over time are also discussed. Forty-eight studies were included in this literature review, identifying four main types of language treatment: a) lexical retrieval treatment, b) phonological and/or orthographic treatment, c) semantic treatment, and d) a multimodality approach treatment. Overall, language training is able to induce immediate improvements of naming abilities in all variants of PPA. Moreover, despite the large variability among results, generalization and long-term effects can be recorded after the training. The reviewed studies also suggest that one factor that determines the choice of a particular approach is the compromised components of the lexical/semantic processing system. CONCLUSION The majority of studies have demonstrated improvements of naming abilities following language treatments. Given the progressive nature of PPA, it is essential to apply language treatment in the early stages of the disease.
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Affiliation(s)
- Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Enrico Premi
- Vascular Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Taylor-Rubin C, Nickels L, Croot K. Exploring the effects of verb and noun treatment on verb phrase production in primary progressive aphasia: A series of single case experimental design studies. Neuropsychol Rehabil 2021; 32:1121-1163. [PMID: 33557713 DOI: 10.1080/09602011.2021.1879174] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Evidence of generalization to connected speech following lexical retrieval treatment in Primary Progressive Aphasia (PPA) is scarce. Consequently, this study systematically investigated changes in verb phrase production following lexical retrieval treatment in a series of single case experimental design studies. Four individuals with PPA (three semantic- and one logopenic variant PPA) who had previously demonstrated that they could integrate verbs and nouns into sentence structures in a cueing paradigm, undertook a sequence of verb and noun lexical retrieval treatments using Repetition and Reading in the Presence of a Picture. Production of treated nouns- and/or verbs-in-isolation significantly improved following treatment for three of the four participants. Verb phrase production did not improve for one of these participants (logopenic PPA), perhaps due to the relatively small treatment dose. Two participants (semantic variant PPA) did, however, demonstrate across-level generalization, with improvement in treated verbs and using those verbs in (untreated) verb phrases. Their verb phrase production improved most after lexical retrieval treatment for both nouns and verbs, suggesting this combined approach may benefit across-level generalization for some individuals in clinical practice.
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Affiliation(s)
- Cathleen Taylor-Rubin
- Department of Cognitive Science, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.,Department of Speech Pathology, South East Sydney Local Health District, Uniting War Memorial Hospital, Sydney, Australia
| | - Lyndsey Nickels
- Department of Cognitive Science, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia
| | - Karen Croot
- School of Psychology, University of Sydney, Sydney, Australia
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Henry ML, Hubbard HI, Grasso SM, Dial HR, Beeson PM, Miller BL, Gorno-Tempini ML. Treatment for Word Retrieval in Semantic and Logopenic Variants of Primary Progressive Aphasia: Immediate and Long-Term Outcomes. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:2723-2749. [PMID: 31390290 PMCID: PMC6802912 DOI: 10.1044/2018_jslhr-l-18-0144] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 10/23/2018] [Accepted: 12/16/2018] [Indexed: 05/25/2023]
Abstract
Purpose Recent studies confirm the utility of speech-language intervention in primary progressive aphasia (PPA); however, long-term outcomes, ideal dosage parameters, and relative benefits of intervention across clinical variants warrant additional investigation. The purpose of this study was to determine whether naming treatment affords significant, lasting, and generalized improvement for individuals with semantic and logopenic PPA and whether dosage manipulations significantly affect treatment outcomes. Method Eighteen individuals with PPA (9 semantic and 9 logopenic variant) underwent lexical retrieval treatment designed to leverage spared cognitive-linguistic domains and develop self-cueing strategies to promote naming. One group (n = 10) underwent once-weekly treatment sessions, and the other group (n = 8) received the same treatment with 2 sessions per week and an additional "booster" treatment phase at 3 months post-treatment. Performance on trained and untrained targets/tasks was measured immediately after treatment and at 3, 6, and 12 months post-treatment. Results Outcomes from the full cohort of individuals with PPA showed significantly improved naming of trained items immediately post-treatment and at all follow-up assessments through 1 year. Generalized improvement on untrained items was significant up to 6 months post-treatment. The positive response to treatment was comparable regardless of session frequency or inclusion of a booster phase. Outcomes were comparable across PPA subtypes, as was maintenance of gains over the post-treatment period. Conclusion This study documents positive naming treatment outcomes for a group of individuals with PPA, demonstrating strong direct treatment effects, maintenance of gains up to 1 year post-treatment, and generalization to untrained items. Lexical retrieval treatment, in conjunction with daily home practice, had a strong positive effect that did not require more than 1 clinician-directed treatment session per week. Findings confirm that strategic training designed to capitalize on spared cognitive-linguistic abilities results in significant and lasting improvement, despite ongoing disease progression, in PPA.
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Affiliation(s)
- Maya L. Henry
- Department of Communication Sciences and Disorders, The University of Texas at Austin
| | - H. Isabel Hubbard
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
- Department of Communication Science and Disorders, University of Kentucky, Lexington
| | - Stephanie M. Grasso
- Department of Communication Sciences and Disorders, The University of Texas at Austin
| | - Heather R. Dial
- Department of Communication Sciences and Disorders, The University of Texas at Austin
| | - Pélagie M. Beeson
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
| | - Bruce L. Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
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Henry ML, Hubbard HI, Grasso SM, Mandelli ML, Wilson SM, Sathishkumar MT, Fridriksson J, Daigle W, Boxer AL, Miller BL, Gorno-Tempini ML. Retraining speech production and fluency in non-fluent/agrammatic primary progressive aphasia. Brain 2019; 141:1799-1814. [PMID: 29718131 DOI: 10.1093/brain/awy101] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 02/19/2018] [Indexed: 12/14/2022] Open
Abstract
The non-fluent/agrammatic variant of primary progressive aphasia (nfvPPA) presents with a gradual decline in grammar and motor speech resulting from selective degeneration of speech-language regions in the brain. There has been considerable progress in identifying treatment approaches to remediate language deficits in other primary progressive aphasia variants; however, interventions for the core deficits in nfvPPA have yet to be systematically investigated. Further, the neural mechanisms that support behavioural restitution in the context of neurodegeneration are not well understood. We examined the immediate and long-term benefits of video implemented script training for aphasia (VISTA) in 10 individuals with nfvPPA. The treatment approach involved repeated rehearsal of individualized scripts via structured treatment with a clinician as well as intensive home practice with an audiovisual model using 'speech entrainment'. We evaluated accuracy of script production as well as overall intelligibility and grammaticality for trained and untrained scripts. These measures and standardized test scores were collected at post-treatment and 3-, 6-, and 12-month follow-up visits. Treatment resulted in significant improvement in production of correct, intelligible scripted words for trained topics, a reduction in grammatical errors for trained topics, and an overall increase in intelligibility for trained as well as untrained topics at post-treatment. Follow-up testing revealed maintenance of gains for trained scripts up to 1 year post-treatment on the primary outcome measure. Performance on untrained scripts and standardized tests remained relatively stable during the follow-up period, indicating that treatment helped to stabilize speech and language despite disease progression. To identify neural predictors of responsiveness to intervention, we examined treatment effect sizes relative to grey matter volumes in regions of interest derived from a previously identified speech production network. Regions of significant atrophy within this network included bilateral inferior frontal cortices and supplementary motor area as well as left striatum. Volumes in a left middle/inferior temporal region of interest were significantly correlated with the magnitude of treatment effects. This region, which was relatively spared anatomically in nfvPPA patients, has been implicated in syntactic production as well as visuo-motor facilitation of speech. This is the first group study to document the benefits of behavioural intervention that targets both linguistic and motoric deficits in nfvPPA. Findings indicate that behavioural intervention may result in lasting and generalized improvement of communicative function in individuals with neurodegenerative disease and that the integrity of spared regions within the speech-language network may be an important predictor of treatment response.
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Affiliation(s)
- Maya L Henry
- Department of Communication Sciences and Disorders, University of Texas, Austin, TX, USA
| | - H Isabel Hubbard
- Department of Neurology, Memory and Aging Center, University of California San Francisco, CA, USA.,Department of Communication Sciences and Disorders, University of Alberta, Canada
| | - Stephanie M Grasso
- Department of Communication Sciences and Disorders, University of Texas, Austin, TX, USA
| | - Maria Luisa Mandelli
- Department of Neurology, Memory and Aging Center, University of California San Francisco, CA, USA
| | - Stephen M Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mithra T Sathishkumar
- Department of Communication Sciences and Disorders, University of Texas, Austin, TX, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Wylin Daigle
- Department of Communication Sciences and Disorders, University of Texas, Austin, TX, USA
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, University of California San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California San Francisco, CA, USA
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Croot K, Raiser T, Taylor-Rubin C, Ruggero L, Ackl N, Wlasich E, Danek A, Scharfenberg A, Foxe D, Hodges JR, Piguet O, Kochan NA, Nickels L. Lexical retrieval treatment in primary progressive aphasia: An investigation of treatment duration in a heterogeneous case series. Cortex 2019; 115:133-158. [DOI: 10.1016/j.cortex.2019.01.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/21/2018] [Accepted: 01/09/2019] [Indexed: 10/27/2022]
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Murray LL, Paek EJ. Behavioral/Nonpharmacological Approaches to Addressing Cognitive-Linguistic Symptoms in Individuals With Dementia. ACTA ACUST UNITED AC 2016. [DOI: 10.1044/persp1.sig15.12] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Despite current barriers to developing and implementing nonpharmacological or behavioral cognitive-linguistic treatments for dementia, a growing evidence base indicates that individuals with dementia may indeed benefit from a range of nonpharmacological intervention approaches in terms of helping them maintain and/or improve their language and cognitive abilities as well as general functioning and emotional well being. With respect to the current dementia literature, this article describes restorative and compensatory approaches for cognitive symptoms, including direct stimulation of cognitive functions and internal and external strategies to maximize use of residual cognitive skills. We also summarize various language treatment techniques designed to address word retrieval deficits or functional communication issues in a range of dementia types and severity. Broader stimulation approaches such as Montessori-based treatment, reminiscence therapy, and exercise/movement therapy are also reviewed given their potential to benefit not only the cognitive-linguistic symptoms of individuals with dementia, but also other aspects of physical, emotional, and behavioral functioning. Last, we conclude by highlighting limitations in the current research literature along with factors to consider for maximizing nonpharmacological treatment effects (i.e., generalization and maintenance of treatment gains) in clinical or research settings.
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Affiliation(s)
- Laura L. Murray
- Department of Speech and Hearing Sciences, Indiana University
Bloomington, IN
| | - Eun Jin Paek
- Department of Speech and Hearing Sciences, Indiana University
Bloomington, IN
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Fried-Oken M, Mooney A, Peters B. Supporting communication for patients with neurodegenerative disease. NeuroRehabilitation 2015; 37:69-87. [PMID: 26409694 PMCID: PMC6380499 DOI: 10.3233/nre-151241] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Communication supports, referred to as augmentative and alternative communication (AAC), are an integral part of medical speech-language pathology practice, yet many providers remain unfamiliar with assessment and intervention principles. For patients with complex communication impairments secondary to neurodegenerative disease, AAC services differ depending on whether their condition primarily affects speech and motor skills (ALS), language (primary progressive aphasia) or cognition (Alzheimer's disease). This review discusses symptom management for these three conditions, identifying behavioral strategies, low- and high-tech solutions for implementation during the natural course of disease. These AAC principles apply to all neurodegenerative diseases in which common symptoms appear. OBJECTIVES To present AAC interventions for patients with neurodegenerative diseases affecting speech, motor, language and cognitive domains. Three themes emerge: (1) timing of intervention: early referral, regular re-evaluations and continual treatment are essential; (2) communication partners must be included from the onset to establish AAC acceptance and use; and (3) strategies will change over time and use multiple modalities to capitalize on patients' strengths. CONCLUSIONS AAC should be standard practice for adults with neurodegenerative disease. Patients can maintain effective, functional communication with AAC supports. Individualized communication systems can be implemented ensuring patients remain active participants in daily activities.
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