Addressing Phonological Deficit in Primary Progressive Aphasia With Behavioral Intervention and Transcranial Direct Current Stimulation.

Purpose: Despite recognition of the underlying phonological impairment observed in the logopenic and nonfluent variants of primary progressive aphasia (PPA), there is relatively little treatment research directed toward strengthening phonological skills. In this study, we focused on remediating phon...

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Publicado en:Journal of Speech, Language & Hearing Research Vol. 68; no. 5; pp. 2348 - 2386
Autores principales: Nickels, Katlyn, Beeson, Pélagie M., Kielar, Aneta
Formato: Artículo
Publicado: American Speech-Language-Hearing Association May2025
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2025
      vid: 68
      iid: 5
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      pub: American Speech-Language-Hearing Association
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        185140626
        10.1044/2024_JSLHR-24-00250
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        atl: Addressing Phonological Deficit in Primary Progressive Aphasia With Behavioral Intervention and Transcranial Direct Current Stimulation.
      aug:
        au:
          Nickels, Katlyn
          Beeson, Pélagie M.
          Kielar, Aneta
        affil:
          Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson.
          Department of Neurology, The University of Arizona, Tucson.
          BIO5 Institute, The University of Arizona, Tucson.
      su:
        Arizona
        Communicative competence
        Comparative grammar
        Disabilities
        Blind experiment
        Executive function
        Randomized controlled trials
        Problem solving
        Memory
        Phonetics
        Semantics
        Psychological tests
        Behavior therapy
        Articulation disorders
        Vowels
        Research funding
        T-test (Statistics)
        Statistical sampling
        Consonants
        Aphasia
        Treatment effectiveness
        Magnetic resonance imaging
        Mann Whitney U Test
        Crossover trials
        Pre-tests & post-tests
        Longitudinal method
        Neuropsychological tests
        Speech evaluation
        Transcranial direct current stimulation
        Comparative studies
        Orthography & spelling
      sug:
        subj:
          Communicative competence
          Comparative grammar
          Disabilities
          Blind experiment
          Executive function
          Randomized controlled trials
          Problem solving
          Memory
          Phonetics
          Semantics
          Psychological tests
          Behavior therapy
          Arizona
          Diagnostic Imaging Centers
          Marketing Research and Public Opinion Polling
          Articulation disorders
          Vowels
          Research funding
          T-test (Statistics)
          Statistical sampling
          Consonants
          Aphasia
          Treatment effectiveness
          Magnetic resonance imaging
          Mann Whitney U Test
          Crossover trials
          Pre-tests & post-tests
          Longitudinal method
          Neuropsychological tests
          Speech evaluation
          Transcranial direct current stimulation
          Comparative studies
          Orthography & spelling
      ab: Purpose: Despite recognition of the underlying phonological impairment observed in the logopenic and nonfluent variants of primary progressive aphasia (PPA), there is relatively little treatment research directed toward strengthening phonological skills. In this study, we focused on remediating phonological deficits in logopenic and nonfluent PPA. Specifically, we hypothesized that behavioral intervention intended to strengthen phonological manipulation skills and sound–letter correspondences—coupled with transcranial direct current stimulation (tDCS)—would improve language abilities, especially in the written modality. Method: Twelve individuals with logopenic or nonfluent variants of PPA and 24 neurotypical adults completed neuropsychological assessment that documented spoken and written language deficits in those with PPA. Phonological skills were consistently impaired in relation to other language processes. Following a double-blind, crossover design, six individuals with PPA were randomized to receive active tDCS with phonological intervention during the first treatment phase, and after a 2-month break, they received a second phase of behavioral intervention paired with sham tDCS. The other six individuals were randomized to receive sham first and active tDCS second. Language skills were evaluated before and after each treatment phase and 2 months after the intervention. Results: Both treatment groups (tDCS-first and sham-first) made significant improvement in phonological transcoding skills in response to behavioral intervention, but those who received active tDCS first showed stronger gains in phonological manipulation ability. This group also showed positive changes in written narratives, which contained more grammatical sentences with increased meaningful content and more accurate spelling. Conclusions: These data provide compelling evidence supporting an approach that targets phonological deficits in logopenic and nonfluent PPA. Specifically, we found that improved phonological skills resulted in better functional communication ability (text-level writing) relevant to everyday life. Positive outcomes were strongest when tDCS was combined with behavioral treatment from the beginning, suggesting that this combination may potentiate positive changes that extend beyond the initial stimulation period.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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