scholarly journals Effects of tDCS on Sound Duration in Patients with Apraxia of Speech in Primary Progressive Aphasia

2021 ◽  
Author(s):  
Charalambos Themistocleous ◽  
Kimberly Webster ◽  
Kyrana Tsapkini
Keyword(s):  
Speech Therapy ◽  
Inferior Frontal Gyrus ◽  
Primary Progressive Aphasia ◽  
Preliminary Evidence ◽  
Apraxia Of Speech ◽  
Post Intervention ◽  
Left Inferior Frontal Gyrus ◽  
Primary Progressive ◽  
Speech Fluency ◽  
Sound Duration

Transcranial direct current stimulation (tDCS) over the left Inferior Frontal Gyrus (IFG) was found to improve apraxia of speech (AOS) in post-stroke aphasia, speech fluency in adults who stutter, naming and spelling in primary progressive (PPA). This paper aims to determine whether tDCS over the left IFG coupled with AOS therapy improves speech fluency in patients with PPA more than sham. Eight patients with non-fluent PPA with AOS symptoms received either active or sham tDCS, along with speech therapy for 15 weekday sessions. Speech therapy consisted of repetition of increasing syllable-length words. Evaluations took place before, immediately after, and two months post-intervention. Words were segmented into vowels and consonants and the duration of each vowel and consonant was measured. Segmental duration was significantly shorter after tDCS than sham for both consonants and vowels. tDCS gains generalized to untrained words. The effects of tDCS sustained over two months post-treatment in trained words. Taken together, these results demonstrate that the tDCS over the left IFG facilitates speech production by reducing segmental duration. The results provide preliminary evidence that tDCS can maximize efficacy of speech therapy in non-fluent PPA with AOS.

scholarly journals Effects of tDCS on Sound Duration in Patients with Apraxia of Speech in Primary Progressive Aphasia

2021 ◽  
Vol 11 (3) ◽  
pp. 335
Author(s):  
Charalambos Themistocleous ◽  
Kimberly Webster ◽  
Kyrana Tsapkini
Keyword(s):  
Speech Therapy ◽  
Inferior Frontal Gyrus ◽  
Primary Progressive Aphasia ◽  
Motor Disorder ◽  
Apraxia Of Speech ◽  
Post Intervention ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Post Stroke ◽  
Sound Duration

Transcranial direct current stimulation (tDCS) over the left inferior frontal gyrus (IFG) was found to improve oral and written naming in post-stroke and primary progressive aphasia (PPA), speech fluency in stuttering, a developmental speech-motor disorder, and apraxia of speech (AOS) symptoms in post-stroke aphasia. This paper addressed the question of whether tDCS over the left IFG coupled with speech therapy may improve sound duration in patients with apraxia of speech (AOS) symptoms in non-fluent PPA (nfvPPA/AOS) more than sham. Eight patients with non-fluent PPA/AOS received either active or sham tDCS, along with speech therapy for 15 sessions. Speech therapy involved repeating words of increasing syllable-length. Evaluations took place before, immediately after, and two months post-intervention. Words were segmented into vowels and consonants and the duration of each vowel and consonant was measured. Segmental duration was significantly shorter after tDCS compared to sham and tDCS gains generalized to untrained words. The effects of tDCS sustained over two months post-treatment in trained and untrained sounds. Taken together, these results demonstrate that tDCS over the left IFG may facilitate speech production by reducing segmental duration. The results provide preliminary evidence that tDCS may maximize efficacy of speech therapy in patients with nfvPPA/AOS.

scholarly journals The left inferior frontal gyrus is causally involved in selective semantic retrieval: Evidence from tDCS in primary progressive aphasia

2020 ◽  
Author(s):  
Zeyi Wang ◽  
Bronte N Ficek ◽  
Kimberly T Webster ◽  
Chiadi U Onyike ◽  
John E Desmond ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Inferior Frontal Gyrus ◽  
Primary Progressive Aphasia ◽  
Superior Temporal Gyrus ◽  
Semantic Fluency ◽  
Semantic Retrieval ◽  
Left Inferior Frontal Gyrus ◽  
Progressive Aphasia ◽  
Temporal Lobes ◽  
Primary Progressive

Lesion and imaging studies have shown that the left inferior frontal gyrus (IFG) is involved in selective semantic retrieval of information from the temporal lobes. However, causal, i.e., interventional, evidence is sparse. In the present study we addressed this question by testing whether transcranial direct current stimulation (tDCS) over the left IFG in a group of individuals with primary progressive aphasia may improve semantic fluency, a task that relies to selective semantic retrieval. Semantic fluency improved significantly more in the tDCS vs. sham condition immediately post-treatment and improvement lasted up to 2 months. We further addressed the question of who will benefit most from such an intervention by testing possible demographic, clinical and functional connectivity variables that may predict the behavioral tDCS effect. We found that patients with stronger baseline functional connectivity between the subareas of the left IFG opercularis and triangularis, and between the middle temporal pole and superior temporal gyrus. were the most likely to benefit from tDCS over the left IFG. We thus provided causal evidence that the left IFG is the neural substrate of selective semantic retrieval and tDCS over the left IFG may improve semantic fluency in individuals with stronger baseline functional connectivity.

Sleep as a predictor of tDCS and language therapy outcomes

SLEEP ◽  
2021 ◽  
Author(s):  
Olivia Herrmann ◽  
Bronte Ficek ◽  
Kimberly T Webster ◽  
Constantine Frangakis ◽  
Adam P Spira ◽  
...  
Keyword(s):  
Inferior Frontal Gyrus ◽  
Primary Progressive Aphasia ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Language Therapy ◽  
Double Blind ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Time In Bed ◽  
Sham Condition

Abstract Study Objectives To determine whether sleep at baseline (before therapy) predicted improvements in language following either language therapy alone or coupled with transcranial direct current stimulation (tDCS) in individuals with primary progressive aphasia (PPA). Methods Twenty-three participants with PPA (mean age 68.13 ± 6.21) received written naming/spelling therapy coupled with either anodal tDCS over the left inferior frontal gyrus (IFG) or sham condition in a crossover, sham-controlled, double-blind design (ClinicalTrials.gov identifier: NCT02606422). The outcome measure was percent of letters spelled correctly for trained and untrained words retrieved in a naming/spelling task. Given its particular importance as a sleep parameter in older adults, we calculated sleep efficiency (total sleep time/time in bed x100) based on subjective responses on the Pittsburgh Sleep Quality Index (PSQI). We grouped individuals based on a median split: high versus low sleep efficiency. Results Participants with high sleep efficiency benefited more from written naming/spelling therapy than participants with low sleep efficiency in learning therapy materials (trained words). There was no effect of sleep efficiency in generalization of therapy materials to untrained words. Among participants with high sleep efficiency, those who received tDCS benefitted more from therapy than those who received sham condition. There was no additional benefit from tDCS in participants with low sleep efficiency. Conclusion Sleep efficiency modified the effects of language therapy and tDCS on language in participants with PPA. These results suggest sleep is a determinant of neuromodulation effects. Clinical Trial: tDCS Intervention in Primary Progressive Aphasia https://clinicaltrials.gov/ct2/show/NCT02606422

Word Fluency Test Performance in Primary Progressive Aphasia and Primary Progressive Apraxia of Speech

2021 ◽  
pp. 1-8
Author(s):  
Lucia Scheffel ◽  
Joseph R. Duffy ◽  
Edythe A. Strand ◽  
Keith A. Josephs
Keyword(s):  
Test Performance ◽  
Primary Progressive Aphasia ◽  
High Sensitivity ◽  
Clinical Group ◽  
Apraxia Of Speech ◽  
Word Fluency ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
The Relationship ◽  
Fluency Task

Purpose This study compared performance on three-word fluency measures among individuals with primary progressive aphasia (PPA) and primary progressive apraxia of speech (PPAOS), and examined the relationship between word fluency and other measures of language and speech. Method This study included 106 adults with PPA and 30 adults with PPAOS. PPA participants were divided into three clinical subgroups: semantic (svPPA), logopenic (lvPPA), and nonfluent/agrammatic with or without apraxia of speech (nfPPA). Category fluency, letter fluency, and action/verb fluency tasks were administered to all participants. Results The four clinical groups performed abnormally on the word fluency measures, although not to a degree that represented high sensitivity to their PPA or PPAOS diagnosis. All PPA subgroups produced fewer words compared to individuals with PPAOS on all word fluency measures. Moderate correlations were found between word fluency and aphasia severity and naming performance in some of the clinical groups. Conclusions Word fluency measures are often challenging for individuals with PPA and PPAOS, but they are not of equal difficulty, with letter fluency being the most difficult. Differences among word fluency tests also vary to some degree as a function of the clinical group in question, with least impairment in PPAOS. However, the findings of this study do not support statistically significant differences in word fluency task performance among the PPA subgroups. Correlations suggest that word fluency performance in PPA is at least partly related to aphasia severity.

scholarly journals Electroencephalography in primary progressive aphasia and apraxia of speech

Aphasiology ◽  
2018 ◽  
Vol 33 (11) ◽  
pp. 1410-1417 ◽  
Author(s):  
Rene L. Utianski ◽  
John N. Caviness ◽  
Gregory A. Worrell ◽  
Joseph R. Duffy ◽  
Heather M. Clark ◽  
...  
Keyword(s):  
Primary Progressive Aphasia ◽  
Apraxia Of Speech ◽  
Progressive Aphasia ◽  
Primary Progressive

scholarly journals Thinking Outside the Stroke: Treating Primary Progressive Aphasia (PPA)

2012 ◽  
Vol 17 (2) ◽  
pp. 37-49 ◽  
Author(s):  
Becky Khayum ◽  
Christina Wieneke ◽  
Emily Rogalski ◽  
Jaimie Robinson ◽  
Mary O’Hara
Keyword(s):  
Quality Of Life ◽  
Brain Injury ◽  
Cognitive Abilities ◽  
Speech Therapy ◽  
Primary Progressive Aphasia ◽  
Supportive Services ◽  
Language Abilities ◽  
Progressive Aphasia ◽  
Primary Progressive

In this article, we explore the symptoms, cause, treatment potential, and supportive services for individuals diagnosed with Primary Progressive Aphasia (PPA). Although it is possible to regain certain cognitive abilities with stroke or brain injury, in PPA, language abilities worsen and other symptoms emerge with time, shortening the lifespan. The goal of speech therapy for PPA is not to regain lost language, but rather to maximize communication for as long as possible. In this article, we offer information and tools for speech-language pathologists to help people living with PPA achieve these goals and improve overall quality of life.

scholarly journals Tau uptake in agrammatic primary progressive aphasia with and without apraxia of speech

2018 ◽  
Vol 25 (11) ◽  
pp. 1352-1357 ◽  
Author(s):  
R. L. Utianski ◽  
J. L. Whitwell ◽  
C. G. Schwarz ◽  
J. R. Duffy ◽  
H. Botha ◽  
...  
Keyword(s):  
Primary Progressive Aphasia ◽  
Apraxia Of Speech ◽  
Progressive Aphasia ◽  
Primary Progressive

scholarly journals Apraxia of speech involves lesions of dorsal arcuate fasciculus and insula in patients with aphasia

2019 ◽  
Vol 10 (2) ◽  
pp. 162-169
Author(s):  
Karen Chenausky ◽  
Sébastien Paquette ◽  
Andrea Norton ◽  
Gottfried Schlaug
Keyword(s):  
Rating Scale ◽  
Inferior Frontal Gyrus ◽  
Superior Temporal Gyrus ◽  
Arcuate Fasciculus ◽  
Apraxia Of Speech ◽  
Boston Naming Test ◽  
Left Inferior Frontal Gyrus ◽  
Frontal Aslant Tract ◽  
Distinguishing Features ◽  
Naming Test

ObjectiveTo determine the contributions of apraxia of speech (AOS) and anomia to conversational dysfluency.MethodsIn this observational study of 52 patients with chronic aphasia, 47 with concomitant AOS, fluency was quantified using correct information units per minute (CIUs/min) from propositional speech tasks. Videos of patients performing conversational, how-to and picture-description tasks, word and sentence repetition, and diadochokinetic tasks were used to diagnose AOS using the Apraxia of Speech Rating Scale (ASRS). Anomia was quantified by patients' scores on the 30 even-numbered items from the Boston Naming Test (BNT).ResultsTogether, ASRS and BNT scores accounted for 51.4% of the total variance in CIUs/min; the ASRS score accounted for the majority of that variance. The BNT score was associated with lesions in the left superior temporal gyrus, left inferior frontal gyrus, and large parts of the insula. The global ASRS score was associated with lesions in the left dorsal arcuate fasciculus (AF), pre- and post-central gyri, and both banks of the central sulcus of the insula. The ASRS score for the primary distinguishing features of AOS (no overlap with features of aphasia) was associated with less AF and more insular involvement. Only ∼27% of this apraxia-specific lesion overlapped with lesions associated with the BNT score. Lesions associated with AOS had minimal overlap with the frontal aslant tract (FAT) (<1%) or the extreme capsule fiber tract (1.4%). Finally, ASRS scores correlated significantly with damage to the insula but not to the AF, extreme capsule, or FAT.ConclusionsResults are consistent with previous findings identifying lesions of the insula and AF in patients with AOS, damage to both of which may create dysfluency in patients with aphasia.

scholarly journals Speech Therapy in Primary Progressive Aphasia: A Pilot Study

2012 ◽  
Vol 2 (1) ◽  
pp. 321-331 ◽  
Author(s):  
Luísa Farrajota ◽  
Carolina Maruta ◽  
João Maroco ◽  
Isabel Pavão Martins ◽  
Manuela Guerreiro ◽  
...  
Keyword(s):  
Pilot Study ◽  
Speech Therapy ◽  
Primary Progressive Aphasia ◽  
Progressive Aphasia ◽  
Primary Progressive

scholarly journals Lack of Frank Agrammatism in the Nonfluent Agrammatic Variant of Primary Progressive Aphasia

2016 ◽  
Vol 6 (3) ◽  
pp. 407-423 ◽  
Author(s):  
Naida L. Graham ◽  
Carol Leonard ◽  
David F. Tang-Wai ◽  
Sandra Black ◽  
Tiffany W. Chow ◽  
...  
Keyword(s):  
Primary Progressive Aphasia ◽  
Diagnostic Feature ◽  
Apraxia Of Speech ◽  
Volumetric Mri ◽  
Motor Speech ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Grammatical Morphemes ◽  
Grammatical Errors ◽  
Diagnosis Method

Background/Aims: Frank agrammatism, defined as the omission and/or substitution of grammatical morphemes with associated grammatical errors, is variably reported in patients with nonfluent variant primary progressive aphasia (nfPPA). This study addressed whether frank agrammatism is typical in agrammatic nfPPA patients when this feature is not required for diagnosis. Method: We assessed grammatical production in 9 patients who satisfied current diagnostic criteria. Although the focus was agrammatism, motor speech skills were also evaluated to determine whether dysfluency arose primarily from apraxia of speech (AOS), instead of, or in addition to, agrammatism. Volumetric MRI analyses provided impartial imaging-supported diagnosis. Results: The majority of cases exhibited neither frank agrammatism nor AOS. Conclusion: There are nfPPA patients with imaging-supported diagnosis and preserved motor speech skills who do not exhibit frank agrammatism, and this may persist beyond the earliest stages of the illness. Because absence of frank agrammatism is a subsidiary diagnostic feature in the logopenic variant of PPA, this result has implications for differentiation of the nonfluent and logopenic variants, and indicates that PPA patients with nonfluent speech in the absence of frank agrammatism or AOS do not necessarily have the logopenic variant.

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