Rehabilitation and Prophylaxis of Anomia in Primary Progressive Aphasia

The goal of this study is to remediate word-finding problems in patients who have Primary Progressive Aphasia (PPA) or Alzheimer's Disease (AD) and to delay the further progression of word-finding impairment. The current approach is novel in that it contains a prophylaxis component in which the investigators attempt to strengthen neural connections that remain functional, making them more resistant to degradation as the disease progresses. While the study is specific in its targeting of word-finding problems, a successful outcome would bode well for other studies aimed at prevention or reversal of declining cognitive functions in dementia. Participants receive practice with picture naming of nouns and verbs in two conditions: viewing the picture and repeating the name; and viewing the picture with its written name, plus reading and writing the name. Semantic and lexical cues are provided. Naming of pictures trained in each of these conditions are compared, at three time intervals post-training, with naming of pictures tested before the study but never trained. It is predicted that the pairing of the picture with its written name, combined with the motor task of writing the name, will result in a greater ability to name the picture at a later date than simple practice viewing the picture and repeating the name. Furthermore, it is predicted that participants who have difficulty understanding concepts will be more likely to respond to semantic treatment, while participants who have difficulty connecting words with concepts will be more likely to respond to lexical treatment.

Individuals who are interested are asked take part in standardized memory, language, and reading tests, standardized depression screening questionnaire, and a general medical screening questionnaire to determine if they qualify for the study. If the therapy is appropriate, based on results from these assessments and background information, individuals begin treatment. Therapy sessions occur two times per week for four weeks. There are monthly follow up therapy sessions for months 2-6, months 9-13, and months 16- 20. No session lasts more than 2-3 hours Participants complete home practice therapy several times per week. Participants return for follow up testing at months 8, 15, and 22. If eligible, participants have an MRI. The duration of the study is approximately 30 months to complete a total of 24 assessment sessions, 23 treatment sessions, and 180 home practice sessions, depending on your availability.


Recruitment

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Funded by National Institutes of Health/National Institute on Deafness and Other Communication Disorders R01 DC011317