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tDCS-supported phonological therapy improved word retrieval in a patient with semantic variant of primary progressive aphasia (svPPA)
Poster B82 in Poster Session B, Tuesday, October 24, 3:30 - 5:15 pm CEST, Espace Vieux-Port
Maxi Wollenberg1, Sabine Weiss1,2, Horst M. Müller1; 1Exp. Neurolinguistics Group, Bielefeld University, 2Clinical Linguistics, Bielefeld University
Introduction: Primary progressive aphasia (PPA) is a common form of presenile dementia and belongs to the frontotemporal dementias (FTD) [1]. Individuals affected by PPA suffer from a progredient language loss. Depending on the location of the cortical degeneration, different subtypes of PPA can be distinguished [2]. The semantic variant of PPA (svPPA) is typically caused by atrophy of the left temporal lobe. Persons affected by svPPA develop difficulties in language comprehension and production due to the loss of semantic knowledge [3]. To facilitate word retrieval in these patients, multimodal therapies that also focus on orthographic or phonological features are used in addition to semantic-based therapies [4]. Furthermore, there is evidence of facilitation of word retrieval in patients with semantic deficits following phonological component analysis (PCA) [5]. In the current study, we treated a 58-year-old female suffering from svPPA using the PCA with the aim of improving the patient’s naming abilities by strengthening language networks. Additionally, we combined the PCA with anodal transcranial direct current stimulation (tDCS) over the left anterior temporal lobe to enhance a potential therapeutic effect. Methods: The patient trained in four intervention blocks, each consisting of a baseline test, 10 working days of practicing, and two intermediate tests approximately 3 and 13 days after the last training. Additionally, comprehensive diagnostic sessions on overall cognitive and language abilities were conducted one month before the PCA-tDCS intervention started and two months after it ended (pre- and post-test). Results: Using binomial logistic regression, we found that practicing predicted better naming performance during the two intermediate tests (Estimate = - .899, SE = .185, Z = - 4.85, p < .001). Additionally, the second testing time point (approx. 13 after the intervention) significantly predicted better naming skills of untrained items compared to baselines (Estimate = .389, SE = .184, Z = 2.1, p = .036). This pattern was interpreted as a generalization effect that may have occurred because of the combination of tDCS and therapy. The observed improvements remained stable for at least 14 days. Furthermore, the last baseline test predicted better naming skills when compared to the first baseline (Estimate = - 0.695 SE = .308, Z = - 2.26, p = .024). This indicates sustainability of improvements longer than 14 days. The pre- and post-test revealed stable language and cognitive abilities, with a trend of decreasing grammar skills, but also improved phonematic and semantic word fluency, as well as a trend toward better scores on the Boston Naming Test. Conclusion: To date, there are only a few therapeutic approaches for svPPA. Our findings suggest that PCA combined with tDCS could improve or maintain word retrieval in this progressive disease. References: [1] Bang, J., Spina, S. & Miller, B.L. (2015). The Lancet, 386(10004), 1672-1682. [2] Gorno-Tempini, M.L. et al. (2011). Neurology, 76(11), 1006-1014. [3] Reilly, J. & Peele, J.E. (2008). Semin Speech Lang, 29(1), 32-43. [4] Henry, M.L. et al. (2019). J Speech Lang Hear Res, 62, 2723-2749. [5] Leonard, C., Rochon, E. & Laird, L. (2008). Aphasiology, 22, 92-947.
Topic Areas: Speech-Language Treatment, Disorders: Acquired