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

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.METHODSA 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.RESULTSOur 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.CONCLUSIONPositive 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.

How to constrain and maintain a lexicon for the treatment of progressive semantic naming deficits: Principles of item selection for formal semantic therapy

“…The choice to train on specific exemplars is not without controversy, however. Training on a single exemplar has the potential to promote under-generalization (for reviews of generalization in svPPA see Carthery-Goulart et al, 2013; Jokel, Graham, Rochon, & Leonard, 2014). One way to counteract such effects is through multi-modal training on high-level conceptual attributes of the target items rather than exclusive reliance on repeated naming (see Suárez-González et al, 2014).…”

Prophylaxis and remediation of anomia in the semantic and logopenic variants of primary progressive aphasia

“…Multiple studies have focused on the treatment of anomia in svPPA, and these studies have typically found that anomia treatment has a positive effect (see reviews by Cathery-Goulart et al, 2013; Croot, Nickels, Laurence, & Manning, 2009; Jokel, Graham, Rochon, & Leonard, 2014). Treatment approaches have included semantic, phonological, and orthographic interventions, as well as hybrid treatments.…”

Validação da escala de estadiamento e progressão da demência frontotemporal (FTD-FRS)

“…As afasias, distúrbios adquiridos de linguagem, podem gerar limitações impactantes na vida de um indivíduo (Carthery-Goulart et al, 2013). A perda abrupta da linguagem, que ocorre nas afasias de instalação aguda decorrentes de um acidente vascular cerebral, traumatismo crânio-encefálico e outras enfermidades no sistema nervoso central, pode transformar de um momento para o outro a capacidade de comunicação de um indivíduo.…”

“…As alterações de comportamento são leves de início, mas aos poucos podem se tornar tão intensas quanto àquelas descritas na DFTvc (Garrard et al, 2000;Senaha et al, 2007;Carthery-Goulart et al, 2013).…”

“…Entretanto, a sintaxe encontra-se preservada (Grossman, 2010). Apesar de apresentar um perfil cognitivo e anatômico menos definido do que as outras variantes da APP, há dados que indicam que possa ser um subtipo de DLFT distinto, inclusive como uma patologia subjacente da Doença de Alzheimer (DA), associado a déficits nas habilidades da alça fonológica, com prejuízo no armazenamento temporário de informações verbais como, no sistema de suporte à decodificação do componente fonológico da linguagem (Mesulam et al, 2007;Senaha et al, 2013).…”