Treatment for Apraxia of Speech in Nonfluent Variant Primary Progressive Aphasia

M. L. Henry,M. V. Meese,M. L. Gorno-Tempini,S. Truong,B. L. Miller,M. C. Babiak

doi:10.1155/2013/824302

Abstract

There is a growing body of literature examining the utility of behavioral treatment in primary progressive aphasia (PPA). There are, however, no studies exploring treatment approaches to improve speech production in individuals with apraxia of speech (AOS) associated with the nonfluent variant of PPA. The purpose of this study was to examine a novel approach to treatment of AOS in nonfluent PPA. We implemented a treatment method using structured oral reading as a tool for improving production of multisyllabic words in an individual with mild AOS and nonfluent variant PPA. Our participant showed a reduction in speech errors during reading of novel text that was maintained at one year post-treatment. Generalization of improved speech production was observed on repetition of words and sentences and the participant showed stability of speech production over time in connected speech. Results suggest that oral reading treatment may offer an efficient and effective means of addressing multisyllabic word production in AOS associated with nonfluent PPA, with lasting and generalized treatment effects.

Highlights

Primary progressive aphasia (PPA) is a degenerative neurological condition in which speech and language functions are disrupted, while other cognitive abilities remain relatively spared
In order to assess whether our oral reading treatment could improve production of multisyllabic words during oral reading of difficult, untrained text and to examine the long-term effects of treatment, we administered the GORT-4 at post-treatment and follow-up assessments
When examining all word types together, very similar results were observed (post-treatment (Z = −1.75, p = 0.04), three months post treatment (Z = −2.02, p = 0.02), six months post-treatment treatment (Z = −1.6, p = 0.05), one year posttreatment treatment (Z = −2.02, p = 0.02)). These results confirm that oral reading treatment significantly improved production of multisyllabic words during text reading and that this pattern held when examining all word types combined

Summary

Introduction

Primary progressive aphasia (PPA) is a degenerative neurological condition in which speech and language functions are disrupted, while other cognitive abilities remain relatively spared. Three clinical variants of PPA are widely accepted. These include a semantic variant, with verbal and nonverbal semantic deficits, a logopenic variant, with anomia and phonological working memory problems, and a nonfluent/agrammatic variant, with agrammatism and/or apraxia of speech [1,2]. PPA has been linked to several types of neuropathology, including tau or ubiquitin/TDP-43 positive frontotemporal lobar degeneration and Alzheimer’s Disease [3,4]. While the prevalence of PPA is not known, frontotemporal dementia, which may manifest in PPA, is recognized as a common cause of dementia affecting individuals under the age of 65 [5,6]

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