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Primary progressive aphasia (PPA) is a neurological disorder characterized by a gradual decline in the ability to communicate. Currently, there are no available cures or medications that can halt its advancement, making speech-language therapy the primary method to assist those affected in preserving their communication skills.
Researchers at the University of Arizona have introduced an innovative treatment strategy that combines conventional speech therapy with a noninvasive brain stimulation method known as transcranial direct current stimulation (tDCS). This approach applies a mild electrical current through electrodes placed on the scalp.
A recently published study in the Journal of Speech, Language, and Hearing Research presents findings that suggest this combined treatment is more effective in managing PPA compared to using speech therapy alone.
“Primary progressive aphasia has only gained recognition as a medical condition over the past few decades, making it a relatively new area of study in healthcare,” noted Katlyn Nickels, the study’s lead researcher and a postdoctoral scholar in the Department of Speech, Language and Hearing Sciences at the University of Arizona.
According to Aneta Kielar, the senior author and an associate professor in the same department, language production involves more than just recalling word meanings; it also requires retrieving the phonetic aspects of words. An issue in linking words to their sounds can impede a person’s ability to correctly articulate or write those words, severely affecting their communication and work capabilities. The research particularly focused on logopenic PPA, a subtype marked by difficulties in word retrieval and repeating phrases.
The researchers employed neuroimaging techniques to identify brain regions that needed stimulation, since PPA is associated with brain atrophy or neuronal loss.
“Our goal was to target the language-responsive areas of the brain while avoiding regions that had already experienced atrophy,” Kielar explained.
A total of twelve participants, all experiencing challenges with written language, underwent two treatment phases: during one phase, they received speech therapy alongside active tDCS, and during the other, they received the same speech therapy paired with a placebo version of tDCS. The order of these phases was randomized with a two-month gap in between.
Results indicated that although participants showed improvement after both treatments, the enhancements were significantly greater and more durable when they received active tDCS alongside speech therapy, compared to the placebo treatment.
Kielar highlighted the impact of the treatment by stating, “Participants who previously exhibited numerous spelling errors and struggled to construct complete sentences were able to formulate grammatically correct sentences with fewer mistakes and enhanced meaning post-treatment.”
The researchers associate the benefits of brain stimulation with neuroplasticity, which refers to the brain’s ability to reorganize and adapt, thus enhancing the effectiveness of speech therapies.
“Essentially, brain stimulation can facilitate the formation of new synapses, which are vital for learning and maintaining new skills,” Kielar elaborated.
Looking ahead, the research team plans to investigate genetic, cognitive, and neural factors that may influence recovery from PPA, with the overarching aim of translating their findings into clinical practice.
Nickels noted that tDCS is cost-effective, safe, and simple to administer, minimizing barriers to its incorporation into clinical settings. “There is often a misconception that with a neurodegenerative diagnosis, there are no further options for patients. Our research indicates that even with a progressive brain condition, it is possible to aid in recovering lost abilities and potentially slow the progression of the disease,” she remarked.
This research was funded by several grants awarded to senior author Aneta Kielar, including those from the Arizona Alzheimer’s Consortium, Arizona Department of Health Services, and The University of Arizona Health Sciences. The study received additional support from the Arizona Department of Health Services and the state of Arizona.
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