The Effect of Word Retrieval Therapy in Primary Progressive Aphasia: A Single-Case Study

Abstract

Background: Anomia is a common symptom that can be detrimental to the everyday communication of patients with primary progressive aphasia (PPA). Studies on the anomia treatment in PPA demonstrate that re-learning is possible, but the maintenance and generalization of improvements are limited. The treatment of word retrieval in PPA has typically centered on the retrieval of single lexical items. Little is known about the effects of word-finding treatments in discourse tasks on lexical retrieval. Objectives: The purpose of this study was to introduce a combined semantic/phonological cueing treatment in the context of narrative discourse as a novel method for the treatment of word retrieval difficulty in a PPA patient and compare its effects with the effect of cueing treatment in the context of single words. Methods: One individual with PPA (FK) participated in this single-subject interventional study. FK was a 56-year-old woman with a one-year history of word finding difficulties following Frontotemporal dementia. She received 16 sessions of naming treatment over an eight-week period. The participant completed three baselines prior to treatment. The treatment used a semantic and phonological cueing hierarchy (four weeks, two times a week), followed by a cueing in a story-retelling context (four weeks, two times a week). The main outcome was the naming ability assessment score administered 10 times in order to examine the effectiveness of the therapy through statistical analysis. Results: The participant showed a significant improvement in the word retrieval ability in all stimuli and each set separately related to the therapies phases (P < 0.001). Nevertheless, no significant differences were observed between the therapies (P = 0.26). Following the integrated therapy, FK showed a slightly significant improvement in untreated words. Conclusions: Generally, without considering the type of therapy during this study, in spite of the progressive nature of the disease, word retrieval ability of the patient improved via both treatment programs. Furthermore, the generalization of untreated items and maintenance of treated items also were occurred to some extents. However, there was no evidence of integrated discourse context in cueing hierarchy protocol to make it elaborated and cause a greater effect in people with PPA. As the first known study to trial this issue in the context of PPA, its findings may warrant further investigations.