Cognitive Reserve and Response to Speech-Language Intervention in Bilingual Speakers With Primary Progressive Aphasia

The University of Texas System (UT)

Status: Enrolling

Conditions: Primary Progressive Aphasia; Neurodegenerative Diseases; Communication Disorders; Neurocognitive Disorders; Dementia, Frontotemporal; Alzheimer Disease; Language Disorders; Bilingual Aphasia; Speech Disorders; Dysarthria; Frontotemporal Lobar Degeneration; Dementia; Aphasia; Apraxia, Motor

Treatments: Behavioral: Lexical Retrieval Training (LRT); Behavioral: Video-Implemented Script Training for Aphasia (VISTA)

Study type: Interventional

Funder types: Other

Identifiers

NCT05741853

R01AG080470

Details and patient eligibility

About

Difficulties with speech and language are the first and most notable symptoms of primary progressive aphasia (PPA). While there is evidence that demonstrates positive effects of speech-language treatment for individuals with PPA who only speak one language (monolinguals), there is a significant need for investigating the effects of treatment that is optimized for bilingual speakers with PPA. This stage 2 efficacy clinical trial seeks to establish the effects of culturally and linguistically tailored speech-language interventions administered to bilingual individuals with PPA.

The overall aim of the intervention component of this study is to establish the relationships between the bilingual experience (e.g., how often each language is used, how "strong" each language is) and treatment response of bilinguals with PPA. Specifically, the investigators will evaluate the benefits of tailored speech-language intervention administered in both languages to bilingual individuals with PPA (60 individuals will be recruited). The investigators will conduct an assessment before treatment, after treatment and at two follow-ups (6 and 12-months post-treatment) in both languages. When possible, a structural scan of the brain (magnetic resonance image) will be collected before treatment in order to identify if brain regions implicated in bilingualism are associated with response to treatment. In addition to the intervention described herein, 30 bilingual individuals with PPA will be recruited to complete behavioral cognitive-linguistic testing and will not receive intervention. Results will provide important knowledge about the neural mechanisms of language re-learning and will address how specific characteristics of bilingualism influence cognitive reserve and linguistic resilience in PPA.

Enrollment: 60 estimated patients

Sex: All

Ages: 40+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Meets diagnostic criteria for Primary Progressive Aphasia (PPA; Gorno-Tempini et al., 2011)
• Bilingual in Spanish and Catalan or bilingual in Spanish and English
• Different proficiency levels across languages are expected, any prior experience in both languages is acceptable
• Intervention study: Score of 15 or higher on the Mini-Mental State Examination
• Note that this project will also recruit individuals to participate in assessment only, for these individuals the following inclusion criteria applies: Score of 10 or higher on the Mini-Mental State Examination

Exclusion criteria

• Other central nervous system or medical diagnosis that can cause symptoms
• Other psychiatric diagnosis that can cause symptoms
• Significant, uncorrected visual or hearing impairment that would interfere with participation
• Prominent initial non-speech-language impairments (cognitive, behavioral, motoric)
• Intervention Study: Score of less than 15 on the Mini-Mental State Examination
• Note that this project will also recruit individuals to participate in assessment only, for these individuals the following inclusion criteria applies: Score of less than 10 on the Mini-Mental State Examination

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 2 patient groups

Lexical Retrieval Training

Experimental group

Description:

Naming intervention for individuals with logopenic or semantic variant PPA.

Treatment:

Behavioral: Video-Implemented Script Training for Aphasia (VISTA)

Behavioral: Lexical Retrieval Training (LRT)

Video Implemented Script Training for Aphasia

Experimental group

Description:

Script training intervention for individuals with nonfluent/agrammatic PPA.

Treatment:

Behavioral: Video-Implemented Script Training for Aphasia (VISTA)

Behavioral: Lexical Retrieval Training (LRT)