Rehabilitation and Prophylaxis of Anomia in Primary Progressive Aphasia

The goal of this study is to remediate word-finding problems in patients who have Primary Progressive Aphasia (PPA) or Alzheimer's Disease and to delay the further progression of word-finding impairment. The current approach is novel in that it contains a prophylaxis component in which the investigators attempt to strengthen neural connections that remain functional, making them more resistant to degradation as the disease progresses. While the study is specific in its targeting of word-finding problems, a successful outcome would bode well for other studies aimed at prevention or reversal of declining cognitive functions in dementia. One set of participants with PPA will receive practice with picture naming in two conditions: viewing the picture and repeating the name; and viewing the picture with its written name, plus reading and writing the name. Another set of participants with PPA or Alzheimer's Disease will be trained in two different conditions: learning about the word's semantic features (meaning); and learning about the word's lexical features (letters and sounds). Naming of pictures trained in each of these conditions will be compared, at three time intervals post-training, with naming of pictures tested before the study but never trained. It is predicted that the pairing of the picture with its written name, combined with the motor task of writing the name, will result in a greater ability to name the picture at a later date than simple practice viewing the picture and repeating the name. Furthermore, it is predicted that participants who have difficulty understanding concepts will be more likely to respond to semantic treatment, while participants who have difficulty connecting words with concepts will be more likely to respond to lexical treatment.

Study Overview

• Status: Active, not recruiting
• Conditions: Alzheimer Disease; Aphasia, Primary Progressive; Anomia
• Intervention / Treatment: Behavioral: Phonological; Behavioral: Orthographic; Behavioral: Untrained; Behavioral: Semantic; Behavioral: Lexical

• Study Type: Interventional
• Enrollment (Actual): 84
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • District of Columbia
    • Washington, District of Columbia, United States, 20057
      • Georgetown University Medical Center
  • Maryland
    • Baltimore, Maryland, United States, 21287
      • Johns Hopkins University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 40 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Diagnosis of Primary Progressive Aphasia (PPA; including Frontotemporal Dementia, Semantic Dementia, or a similar condition) or Diagnosis of Alzheimer's Disease
• At least 10 years of education
• Ability to follow spoken instructions
• Medically stable
• First language is English, or fluent in English since childhood
• Willing to participate over a period of two years

Exclusion Criteria:

• No history of additional neurological problems
• No history of substance abuse or psychiatric problems

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Phonological, Orthographic, Untrained	Behavioral: Phonological; This treatment involves picture viewing and word repetition.; Behavioral: Orthographic; This treatment involves picture viewing, reading, and writing.; Behavioral: Untrained; These words are not trained during the treatment phase.
Experimental: Semantic, Lexical, Untrained	Behavioral: Untrained; These words are not trained during the treatment phase.; Behavioral: Semantic; This treatment involves learning about the semantic features (meaning) of each trained word.; Behavioral: Lexical; This treatment involves learning about the lexical features (letters and sounds) of each trained word.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in picture naming accuracy for words within each treatment condition during treatment	The change in picture naming accuracy for trained words will be compared with the change in picture naming accuracy for words that were tested at baseline but never trained during the treatment phase.	baseline, 7 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in picture naming accuracy for words within each treatment condition between baseline and first follow-up assessment	The change in picture naming accuracy for trained words will be compared with the change in picture naming accuracy for words that were tested at baseline but never trained during the treatment phase.	baseline, 14 months
Change in picture naming accuracy for words within each treatment condition between baseline and second follow-up assessment	The change in picture naming accuracy for trained words will be compared with the change in picture naming accuracy for words that were tested at baseline but never trained during the treatment phase.	baseline, 21 months

Collaborators and Investigators

• Sponsor: Georgetown University
• Collaborators: Johns Hopkins University; National Institute on Aging (NIA); National Institute on Deafness and Other Communication Disorders (NIDCD)
• Investigators: Principal Investigator: Aaron Meyer, PhD, Georgetown University

Publications and helpful links

Helpful Links

• Center for Aphasia Research and Rehabilitation website

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2011
• Primary Completion (Actual): June 30, 2023
• Study Completion (Estimated): June 30, 2024

Study Registration Dates

• First Submitted: January 28, 2016
• First Submitted That Met QC Criteria: February 2, 2016
• First Posted (Estimated): February 5, 2016

Study Record Updates

• Last Update Posted (Actual): September 25, 2023
• Last Update Submitted That Met QC Criteria: September 22, 2023
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Metabolic Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurologic Manifestations; Neurobehavioral Manifestations; Neurocognitive Disorders; Neurodegenerative Diseases; TDP-43 Proteinopathies; Proteostasis Deficiencies; Dementia; Tauopathies; Language Disorders; Communication Disorders; Speech Disorders; Frontotemporal Lobar Degeneration; Alzheimer Disease; Aphasia; Frontotemporal Dementia; Aphasia, Primary Progressive; Pick Disease of the Brain; Anomia
• Other Study ID Numbers: R01DC011317 (U.S. NIH Grant/Contract)