Effect of Lexical Retrieval Cascade Treatment on Naming and Discourse of Individuals with Logopenic Variant of Primary Progressive Aphasia (lvPPA)

Abstract

ABSTRACT. This study provided a systematic review on nonpharmacological interventions applied to patients diagnosed with Primary Progressive Aphasia (PPA) and its variants: Semantic (SPPA), Nonfluent (NFPPA) and Logopenic (LPPA) to establish evidence-based recommendations for the clinical practice of cognitive rehabilitation for these patients. Methods: A PubMed and LILACS literature search with no time restriction was conducted with the keywords PPA (and its variants) AND rehabilitation OR training OR intervention OR therapy OR treatment OR effectiveness. To develop its evidence-based recommendations, a research committee identified questions to be addressed and determined the level of evidence for each study according to published criteria (Cicerone et al., 2000). Overall evidence for treatments was summarized and recommendations were derived. Results: Our search retrieved articles published from 1995 to 2013: 21 for SPPA, 8 for NFPPA, 3 for LPPA and 8 for PPA with no specification. Thirty-five studies were rated as Class III, consisting of studies with results obtained from one or more single-cases and that used appropriate single-subject methods with adequate quantification and analysis of results. The level of evidence of three functional interventions could not be established. One study was rated as Class II and consisted of a nonrandomized case-control investigation. Conclusion: Positive results were reported in all reviewed studies. However, in order to be recommended, some investigation regarding the intervention efficacy was required.Results of the present review allows for recommendation of some nonpharmacological interventions for cognitive deficits following PPA as Practice Options. Suggestions for further studies on PPA interventions and future research are discussed. Key words: primary progressive aphasia, treatment, speech and language therapy, intervention, cognitive rehabilitation. Este estudo ofereceu uma revisão sistemática de intervenções não-farmacológicas aplicadas a pacientes com Afasia Progressiva Primária (APP) e suas variantes: Semântica (APPS), Não-fluente (APPNF) e Logopênica (APPL) com o objetivo de estabelecer recomendações baseadas em evidências para a prática clínica de reabilitação cognitiva para estes pacientes. Métodos: Conduziu-se busca por literatura, sem restrição de período, no PubMed e LILACS com as palavraschave PPA (e variantes) AND rehabilitation OR training OR intervention OR therapy OR treatment OR effectiveness. Para desenvolver recomendações baseadas em evidências um comitê de pesquisadores identificou as questões relevantes para investigação e determinou o nível de evidência para cada estudo de acordo com critérios publicados (Cicerone et al., 2000). A evidência total para os tratamentos foi sumarizada e recomendações redigidas.

Language training for oral and written naming impairment in primary progressive aphasia: a review

“…Regarding the long-term maintenance of effects, lexical retrieval treatment [65,66,[76][77][78][79][80][81][82][83][84] and semantic treatment [56, 61, 74, 89, 91-93, 95, 97-99, 101, 103, 105] generally produce maintained effects over time without differences between subtypes of PPA. In contrast, only one study evaluated the maintenance of gains after phonological and orthographic treatment in nf/avPPA, svPPA and l/phvPPA and recorded improvement maintenance at follow-up only in svPPA patients [72].…”

“…Specifically, two studies have reported evidence of lexical retrieval treatment only in subjects with a diagnosis of nf/avPPA [66,76], three only in patients with svPPA [65,75,78] and two only in patients with l/ phvPPA [80,81]. The other six studies included participants with different variants of PPA, such as nf/avPPA, svPPA, l/phvPPA and mixed PPA [18,77,79,[82][83][84] and aimed to examine the effects of lexical retrieval treatment on oral and/or written naming abilities by comparing different subtypes of PPA.…”

Treatment for Lexical Retrieval Impairments in Primary Progressive Aphasia: A Research Update with Implications for Clinical Practice

“…Cueing hierarchy techniques have shown promising item generalization in some studies 9,48 but not others. 39,40 Generalization to untreated tasks (object description and naming to description, 33,41 semantic feature verification 58 ) has been reported following COEN training with individuals with svPPA. Other individuals with svPPA demonstrated generalization of treatment for partially known items using a Look, Listen, Repeat technique 28 to untreated tasks including video description, word-picture matching, and-importantly in respect to the benefit of the treatment for everyday life-to actions in response to household requests (e.g., Can you bring me two plates?).…”

“…34 We can compare these results with those obtained using Lexical Retrieval Cascade, 9 a well-described cueing hierarchy technique that has also been investigated in several studies. 39,40 Small sets of approximately five or six items are treated intensively in each session, with the participants moving onto a new set when they reach a predetermined accuracy criterion (e.g., 80% correct). Lexical Retrieval Cascade studies show immediate gains after only a few sessions of treatment, a frequently reported pattern; 50,51 thus, over successive sessions, new sets can be introduced and mastered.…”

“…Several researchers offer thoughtful accounts of how to select such words. 40,53,62 Methods included asking individuals with PPA and their communication partners about important conversation topics and particular classes of items that cause frustration (e.g., names of family members), visiting the home and photographing the person's own items for inclusion in treatment materials, and sampling the person's ability to communicate about personally important topics to identify words for prophylactic treatment or relearning treatment.…”