Better conversations: a language and communication intervention for aphasia in posterior cortical atrophy

Volkmer, Anna; Farrington-Douglas, Claire; Crutch, Sj; Beeke, Suzanne; Warren, Jd; Yong, Kxx

doi:10.1080/13554794.2022.2125326

Cited by 8 publications

(6 citation statements)

References 47 publications

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“…Whilst behavioural interventions designed to specifically address language impairment in PCA are not currently available, approaches devised for lvPPA [95] may have promise, with consideration of concurrent visual needs (e.g. tendency to miss eye gaze, small gestures and expressions) [96]. Anecdotally used high-tech approaches supporting communication include tablet devices allowing for video calls minimising need to navigate (e.g.…”

Section: Memory and Languagementioning

confidence: 99%

Diagnosis and Management of Posterior Cortical Atrophy

Yong

Graff‐Radford

Ahmed

et al. 2023

Curr Treat Options Neurol

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Purpose of review The study aims to provide a summary of recent developments for diagnosing and managing posterior cortical atrophy (PCA). We present current efforts to improve PCA characterisation and recommendations regarding use of clinical, neuropsychological and biomarker methods in PCA diagnosis and management and highlight current knowledge gaps. Recent findings Recent multi-centre consensus recommendations provide PCA criteria with implications for different management strategies (e.g. targeting clinical features and/or disease). Studies emphasise the preponderance of primary or co-existing Alzheimer’s disease (AD) pathology underpinning PCA. Evidence of approaches to manage PCA symptoms is largely derived from small studies. Summary PCA diagnosis is frequently delayed, and people are likely to receive misdiagnoses of ocular or psychological conditions. Current treatment of PCA is symptomatic — pharmacological and non-pharmacological — and the use of most treatment options is based on small studies or expert opinion. Recommendations for non-pharmacological approaches include interdisciplinary management tailored to the PCA clinical profile — visual-spatial — rather than memory-led, predominantly young onset — and psychosocial implications. Whilst emerging disease-modifying treatments have not been tested in PCA, an accurate and timely diagnosis of PCA and determining underlying pathology is of increasing importance in the advent of disease-modifying therapies for AD and other albeit rare causes of PCA.

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Section: Memory and Languagementioning

confidence: 99%

Diagnosis and Management of Posterior Cortical Atrophy

Yong

Graff‐Radford

Ahmed

et al. 2023

Curr Treat Options Neurol

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“…As an example, a communication function such as coherent and connected propositional speech is key to effective communication in English, Chinese or Turkish (etc) even though the specific linguistic vehicles may vary widely between languages. This in turn will potentially have far-reaching implications beyond the scope of PPA, extending to people living with other dementia types, who also have speech, language and Open communication such as Posterior Cortical Atrophy, 37 Frontotemporal Dementia, Young Onset Alzheimer's Disease, Typical Alzheimer's Disease and Lewy Body Dementia. 38…”

Section: Discussionmentioning

confidence: 99%

COS-PPA: protocol to develop a core outcome set for primary progressive aphasia

Volkmer,

Copland,

Henry

et al. 2024

BMJ Open

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IntroductionThe term primary progressive aphasia (PPA) describes a group of language-led dementias. Disease-modifying treatments that delay, slow or reverse progression of PPA are currently lacking, though a number of interventions to manage the symptoms of PPA have been developed in recent years. Unfortunately, studies exploring the effectiveness of these interventions have used a variety of different outcome measures, limiting comparability. There are more constructs, apart from word retrieval, that are important for people with PPA that have not received much attention in the research literature. Existing core outcome sets (COS) for dementia and non-progressive aphasia do not meet the needs of people with PPA, highlighting a need to develop a specific COS for PPA.Methods and analysisThis protocol describes a three-stage study to identify a COS for PPA interventions in research and clinical practice. The stage 1 systematic review will identify existing speech, language and communication measures used to examine the effectiveness of interventions for PPA in the research literature. Employing a nominal group technique, stage 2 will identify the most important outcomes for people with PPA and their families. The data collected in stages 1 and 2 will be jointly analysed with the project PPI group and will inform the stage 2 modified Delphi consensus study to identify a core outcome measurement set for PPA among a range of research disciplines undertaking intervention studies for people with PPA.Ethics and disseminationEthical approval for stage 2 of the study has been sought individually in each country at collaborating institutions and is stated in detail in the manuscript. Stage 3 has been granted ethical approval by the Chairs of UCL Language and Cognition Department Ethics, Project ID LCD-2023-06. Work undertaken at stages 1, 2 and 3 will be published in open-access peer-reviewed journal articles and presented at international scientific conferences.PROSPERO registration numberCRD42022367565.

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“…However, these patients can present with impairments affecting other cognitive domains or develop abnormalities in these other domains over time. Early anomia, reduced verbal fluency, trouble with sentence repetition, and slowed speech rate (i.e., features of the language variant of AD), as well as phonological errors, can occur in patients with the visual variant of AD ( Crutch et al, 2013 ; Tetzloff et al, 2021 ; Volkmer et al, 2022 ), and have been observed in 50% of patients ( Singh et al, 2023 ). These language features relate to overlapping neuroanatomical features, particularly with atrophy in the left temporoparietal regions in patients with the visual variant of AD ( Wicklund et al, 2013 ; Tetzloff et al, 2021 ).…”

Section: Clinical Overlap Across Atypical Ad Variantsmentioning

confidence: 99%

“…I would also argue that there lacks rationale for focusing on just one clinical variant (i.e., amnestic AD) for therapeutic treatment trials, and that all variants of AD should be included to capture the true clinical spectrum of AD. The high degree of clinical overlap in these AD patients should also be considered for appropriate tailoring of patient management strategies ( Volkmer et al, 2022 ).…”

Section: Clinical Overlap Across Atypical Ad Variantsmentioning

confidence: 99%

Atypical clinical variants of Alzheimer’s disease: are they really atypical?

Whitwell

2024

Front. Neurosci.

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Alzheimer’s disease (AD) is a neuropathological disorder defined by the deposition of the proteins, tau and β-amyloid. Alzheimer’s disease is commonly thought of as a disease of the elderly that is associated with episodic memory loss. However, the very first patient described with AD was in her 50’s with impairments in multiple cognitive domains. It is now clear that AD can present with multiple different non-amnestic clinical variants which have been labeled as atypical variants of AD. Instead of these variants of AD being considered “atypical,” I propose that they provide an excellent disease model of AD and reflect the true clinical heterogeneity of AD. The atypical variants of AD usually have a relatively young age at onset, and they show striking cortical tau deposition on molecular PET imaging which relates strongly with patterns of neurodegeneration and clinical outcomes. In contrast, elderly patients with AD show less tau deposition on PET, and neuroimaging and clinical outcomes are confounded by other age-related pathologies, including TDP-43 and vascular pathology. There is also considerable clinical and anatomical heterogeneity across atypical and young-onset amnestic variants of AD which reflects the fact that AD is a disease that causes impairments in multiple cognitive domains. Future studies should focus on careful characterization of cognitive impairment in AD and consider the full clinical spectrum of AD, including atypical AD, in the design of research studies investigating disease mechanisms in AD and clinical treatment trials, particularly with therapeutics targeting tau.

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Better conversations: a language and communication intervention for aphasia in posterior cortical atrophy

Cited by 8 publications

References 47 publications

Diagnosis and Management of Posterior Cortical Atrophy

Diagnosis and Management of Posterior Cortical Atrophy

COS-PPA: protocol to develop a core outcome set for primary progressive aphasia

Atypical clinical variants of Alzheimer’s disease: are they really atypical?

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