Nonpharmacological interventions for cognitive impairments following primary progressive aphasia: a systematic review of the literature

Maria Teresa Carthery-Goulart, Amanda da Costa da Silveira, Thais Helena Machado, Leticia Lessa Mansur, Maria Alice de Mattos Pimenta Parente, Mirna Lie Hosogi Senaha, Sonia Maria Dozzi Brucki, Ricardo Nitrini, Maria Teresa Carthery-Goulart, Amanda da Costa da Silveira, Thais Helena Machado, Leticia Lessa Mansur, Maria Alice de Mattos Pimenta Parente, Mirna Lie Hosogi Senaha, Sonia Maria Dozzi Brucki, Ricardo Nitrini

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.

Keywords: cognitive rehabilitation; intervention; primary progressive aphasia; speech and language therapy; treatment.

Conflict of interest statement

Disclosure: The authors report no conflicts of interest.

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