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Poster E23, Friday, November 10, 10:00 – 11:15 am, Harborview and Loch Raven Ballrooms

Interventions for Primary Progressive Aphasia: A scoping review

Yara Inuy1, Vânia de Aguiar1;1Department of clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland

BACKGROUND: Primary progressive aphasia (PPA) is a neurodegenerative disorder characterised by a progressive deterioration of language skills. It affects the ability to communicate, as well as quality of life. Several studies have tested a variety of language interventions for PPA, reporting beneficial gains following the therapy. However, no evidence-based clinical recommendations have been put forward to date. The paucity in the literature poses a challenge for clinical practice, as it leads to scarce understanding of the neuroplastic potential of individuals with PPA, and limited knowledge regarding the cognitive mechanisms of improvement, which could be used to optimise treatments. As a consequence, there can be negative assumptions as to whether language rehabilitation for PPA is worthwhile. This study provides a comprehensive detail of the available literature on language rehabilitation in PPA, characterising goals and procedures of interventions and examining the scope of interventions in relation to models of healthcare provision. METHOD: A scoping review was conducted, which adopted both qualitative and quantitative methods. Through literature search and following exclusion criteria, 33 eligible language intervention studies were identified. Treatment characteristics were coded using the TIDiER checklist (Hoffman et al., 2014). A thematic content analysis was undertaken to map the characteristics of interventions regarding therapy goals and procedures. Secondly, a quantitative content analysis was used to study whether there was an unbalance in the number of impairment-oriented intervention studies when compared to function-oriented studies. Finally, clinical guidelines summarising research findings and rating the level of recommendation for each treatment approach were elaborated, using the SORT taxonomy (Ebell et al., 2004). RESULTS: The majority of the articles included in the dataset were single case studies. Furthermore, a statistically significant predominance of studies focusing on impairment-oriented interventions over function-directed was demonstrated. The intervention studies primarily focused on improving word retrieval for nouns, although a few studies had other intervention goals. In terms of procedures, the majority of the research activity on interventions for PPA shares similarities with the studies on treatments for aphasia following stroke. Behavioural tasks focus mostly on lexical-semantic naming therapy, word-picture matching, and less often, sentence and discourse level tasks as well as tasks involving written output. Pharmacological and neuromodulatory techniques have been trialled in recent research, as treatment adjuvants. All studies reported significant treatment effects. Despite the variety of treatment approaches studied, there few studies for each treatment procedure, and the level of evidence is weak for most procedures investigated. DISCUSSION AND CONCLUSION: A wide variety of goals and procedures is reported in intervention studies for PPA, showing positive treatment effects for the individuals treated in those studies. However, for each approach the evidence is limited, with lack of replication of treatment findings, and the evidence base consisting mostly of single-case studies, single-case series, or studies with small cohorts. Hence, the evidence of effectiveness for treatments is weak. In addition, the small number of function-oriented studies indicates that the functional outcomes of these interventions are not well understood.

Topic Area: Language Therapy

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