Treatment for Anomia in Bilingual Speakers with Progressive Aphasia

Stephanie M Grasso, Elizabeth D Peña, Nina Kazemi, Haideh Mirzapour, Rozen Neupane, Borna Bonakdarpour, Maria Luisa Gorno-Tempini, Maya L Henry, Stephanie M Grasso, Elizabeth D Peña, Nina Kazemi, Haideh Mirzapour, Rozen Neupane, Borna Bonakdarpour, Maria Luisa Gorno-Tempini, Maya L Henry

Abstract

Anomia is an early and prominent feature of primary progressive aphasia (PPA) and other neurodegenerative disorders. Research investigating treatment for lexical retrieval impairment in individuals with progressive anomia has focused primarily on monolingual speakers, and treatment in bilingual speakers is relatively unexplored. In this series of single-case experiments, 10 bilingual speakers with progressive anomia received lexical retrieval treatment designed to engage relatively spared cognitive-linguistic abilities and promote word retrieval. Treatment was administered in two phases, with one language targeted per phase. Cross-linguistic cognates (e.g., rose and rosa) were included as treatment targets to investigate their potential to facilitate cross-linguistic transfer. Performance on trained and untrained stimuli was evaluated before, during, and after each phase of treatment, and at 3, 6, and 12 months post-treatment. Participants demonstrated a significant treatment effect in each of their treated languages, with maintenance up to one year post-treatment for the majority of participants. Most participants showed a significant cross-linguistic transfer effect for trained cognates in both the dominant and nondominant language, with fewer than half of participants showing a significant translation effect for noncognates. A gradual diminution of translation and generalization effects was observed during the follow-up period. Findings support the implementation of dual-language intervention approaches for bilingual speakers with progressive anomia, irrespective of language dominance.

Keywords: bilingualism; intervention; primary progressive aphasia; treatment.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Performance from pre-treatment to each subsequent timepoint on a subset of cognitive and linguistic measures by language dominance. * Note. Standard error bars included for descriptive purposes. Significance determined via paired permutation tests. One-tailed tests used for BNT from pre to post-treatment; two-tailed tests used for all other timepoints/measures (p < 0.05). Dom. = dominant language, Nondom. = nondominant language, BNT = Boston Naming Test; MMSE = Mini-Mental State Exam, WAB-R = Western Aphasia Battery- Revised.
Figure A2
Figure A2
Survey Responses: “Compared to pre-treatment how would you rate your ability to…”.
Figure 1
Figure 1
Results of whole brain voxel-based morphometry analysis showing atrophy patterns for each participant relative to controls (n = 30, FWE < 0.05, k = 100, total intracranial volume and age included as covariates). Note that scans were available for only five participants. rtFTD = right temporal variant of frontotemporal dementia; SV = semantic variant; LV = logopenic variant.
Figure 2
Figure 2
Schematic depicting chronology and duration of participation. rtFTD = right temporal variant of frontotemporal dementia; SV = semantic variant; LV = logopenic variant.
Figure 3
Figure 3
Within-language treatment and generalization effects at each time point relative to pre-treatment. (a). Depicts the percentage of cases demonstrating a significant effect at each time point relative to pre-treatment. (b). Depicts the average percent change at each time point relative to pre-treatment. At mid-treatment, seven of nine participants had received treatment in their dominant language and three had received treatment in their nondominant language; the figure shows performance for these subsets at mid-tx for trained items. See Supplemental Materials for data at the single-subject level. Mid = mid-treatment; mo = month.
Figure 4
Figure 4
Cross-linguistic transfer effects by cognate status at each time point relative to pre-treatment. (a). Depicts the percentage of cases demonstrating a significant effect at each time point relative to pre-treatment. (b). Depicts the average percent change at each time point relative to pre-treatment. Performance on trained items across languages represents translation effects. At mid-treatment, seven of nine participants had received treatment in their dominant language and three had received treatment in their nondominant language; the figure shows performance for these subsets at mid-tx for trained and untrained items. See Supplementary Materials for data at the single-subject level. Mid = mid-treatment; mo = month.
Figure 5
Figure 5
Cross-linguistic transfer for cognates versus noncognates at each time point relative to pre-treatment. (a). Depicts the percentage of cases demonstrating a significant difference in the magnitude of transfer between cognates and noncognates at each time point relative to pre-treatment. (b). Depicts the average difference in the magnitude of change between cognates and noncognates at each time point relative to pre-treatment. Performance on trained items represents translation effects. Performance on untrained items represents generalization effects. At mid-treatment, seven of nine participants had received treatment in their dominant language and two of three who had received treatment in their nondominant language had sufficient data for these contrasts; the figure shows performance for these subsets at mid-tx for trained and untrained items. See Supplemental Materials for data at the single-subject level. Mid = mid-treatment; mo = month.

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