Augmenting Verb-Naming Therapy With Neuromodulation Decelerates Language Loss in Primary Progressive Aphasia.

IF 2.3 3区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

American Journal of Speech-Language Pathology Pub Date : 2025-01-07 Epub Date: 2024-12-12 DOI:10.1044/2024_AJSLP-24-00016

Shannon M Sheppard, Emily B Goldberg, Rajani Sebastian, Emilia Vitti, Kristina Ruch, Erin L Meier, Argye E Hillis

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引用次数: 0

Abstract

Purpose: The purpose of the study was to evaluate Verb Network Strengthening Treatment (VNeST) paired with the transcranial direct current stimulation (tDCS) of the left inferior frontal gyrus, which was compared to VNeST paired with a sham stimulation in primary progressive aphasia (PPA).

Method: A double-blind, within-subject, sham-controlled crossover design was used. Eight participants with PPA were enrolled. Participants were enrolled in two treatment phases, one with VNeST plus real tDCS and one with VNeST plus sham. Participants received fifteen 1-hr sessions of VNeST in each phase. Linear mixed-effects models were used to compare changes between baseline and two follow-up time points (1 week and 8 weeks posttreatment) in naming trained verbs, untrained verbs, and untrained nouns; sentence production and comprehension; and producing content units and complete utterances in discourse.

Results: VNeST was effective for significantly improving naming trained verbs and producing more complete utterances in discourse at 1 week posttreatment in both tDCS and sham conditions. A significant tDCS advantage yielded generalization of treatment effects to untrained verbs (at 1 week and 8 weeks posttreatment), sentence production (at 1 week posttreatment), and sentence comprehension (at 8 weeks posttreatment). Untrained verb naming and sentence comprehension declined when VNeST was not augmented with tDCS.

Conclusions: Our findings provide emerging evidence that VNeST paired with tDCS can improve word finding, and other language abilities, in people with PPA. VNeST without neuromodulation can improve trained verb naming, but untrained verbs will likely decline faster when VNeST is not augmented with tDCS. Future research is required with a larger sample size to continue investigating the potential of treating word finding with VNeST and tDCS in PPA.

Supplemental material: https://doi.org/10.23641/asha.27914325.

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用神经调控增强动词命名疗法可减缓原发性进行性失语症患者的语言损失

目的：本研究的目的是评估动词网络强化治疗（VNeST）与经颅直流电刺激（tDCS）配对治疗原发性进行性失语症（PPA）的效果：方法：采用双盲、受试者内、假对照交叉设计。八名 PPA 患者参加了研究。参与者分为两个治疗阶段，一个是 VNeST 加真实 tDCS 治疗阶段，另一个是 VNeST 加假治疗阶段。在每个阶段，参与者都接受了 15 次 1 小时的 VNeST 治疗。采用线性混合效应模型比较基线和两个随访时间点（治疗后 1 周和 8 周）之间在以下方面的变化：命名训练过的动词、未训练过的动词和未训练过的名词；句子的生成和理解；在话语中生成内容单元和完整语篇：在治疗后 1 周，TDCS 和假治疗条件下的 VNeST 均能有效地显著改善训练动词的命名，并在话语中产生更完整的语句。tDCS 的明显优势将治疗效果推广到了未训练的动词（治疗后 1 周和 8 周）、造句（治疗后 1 周）和句子理解（治疗后 8 周）。如果不使用 tDCS 增强 VNeST，未经训练的动词命名和句子理解能力会下降：我们的研究结果提供了新的证据，证明 VNeST 搭配 tDCS 可以改善 PPA 患者的找词能力和其他语言能力。不使用神经调节的 VNeST 可以改善训练有素的动词命名，但如果不使用 tDCS 增强 VNeST，未经训练的动词可能会下降得更快。未来的研究需要更大的样本量，以继续调查使用 VNeST 和 tDCS 治疗 PPA 找词的潜力。补充材料：https://doi.org/10.23641/asha.27914325。

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来源期刊

American Journal of Speech-Language Pathology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION

CiteScore

4.30

自引率

11.50%

发文量

353

审稿时长

>12 weeks

期刊介绍： Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work. Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.