Speech and Language Interventions for Italian People With PP...

About this study

Primary progressive aphasia (PPA) is an umbrella term used to refer to several clinical variants that manifest as an insidious deterioration of speech/language skills, usually due to frontotemporal lobar degeneration and/or Alzheimer's disease. Consensus criteria have been proposed by an international community regarding the sub-classification of PPA into three variants: (1) semantic variant PPA, characterized by impaired confrontation naming and single-word comprehension; (2) logopenic variant PPA), characterised by word-finding difficulties and sentence repetition deficits; and (3) non-fluent variant, characterised by agrammatism with or without apraxia of speech. Speech and language therapists (SLTs) play a crucial role in the diagnostic process and in setting a therapeutic path along with monitoring the evolution of the clinical picture. Despite growing evidence supporting the benefits of speech-language intervention, the frequency with which individuals with PPA are referred for speech and language services, is suboptimal likely due to skepticism regarding the value of speech and language therapy in the context of neurodegeneration, the scarcity of SLTs with expertise in the treatment of PPA, the lack of awareness regarding the role of the SLT amongst referrers, and the geographical barriers that impede access to in-person speech and language services. In Italy, patients with PPA are rarely offered treatment options due to a lack of understanding of the disorder on the part of health professionals and erroneous assumptions regarding the utility of treatment in patients facing a worsening prognosis. The primary aim of this pilot study is to develop tailored speech and language interventions for patients with different variants of PPA by addressing their linguistic and cognitive difficulties. Secondly, to explore the intervention's effect also on untreated tasks and assess the long-term maintenance of the proposed interventions by monitoring patients for up to six months. Finally, in each PPA variant, the investigators aim to investigate which variables among the sociodemographic, clinical, linguistic/cognitive, and brain MRI features at baseline predict successful clinical results, as well as which structural and functional brain changes are associated with speech and language improvements.

Condition: Primary Progressive Aphasia(PPA)
Tested: Behavioral Treatment
Sponsor: Istituti Clinici Scientifici Maugeri SpA

Who can join

Age: 40 to 85 years
Sex: All sexes
Healthy volunteers: Accepted

Inclusion 10

Minimum age: 40 years
Maximum age: 85 years
Study condition: Primary Progressive Aphasia(PPA)
Diagnosis of PPA according to the current clinical criteria (Gorno-Tempini et al., 2011)
Mild PPA defined using the Progressive Aphasia Severity Scale (PASS)
Age between 40 and 85 years
Patients with Italian mother tongue
Patients with the ability to sign the informed consent
Patients with the ability to comply with the study procedures
Patients with stable pharmacological treatment for at least 4 weeks.

Exclusion 5

Mini-Mental State Exam (MMSE) Score \<15
Presence of other neurological or psychiatric diseases, including cerebrovascular disease
Severe and uncorrected hearing loss or visual disturbances
Inability to repeat multi-syllable words (4 syllables)
Concurrent participation in other pharmacological and non-pharmacological experimental studies

Where

2 sites, 2 recruiting

Istituti Clinici Scientifici Maugeri IRCCS

Bari, Italy

Recruiting

IRCCS Ospedale San Raffaele

Milan, Italy