Treatment for Speech and Language in Primary Progressive Aphasia

NCT04881617 | Active Not Recruiting

• 1 other identifier: R01DC016291
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 2

Brief Summary

Primary progressive aphasia (PPA) is a progressive neurological disorder that causes a gradual decline in communication ability as a result of selective neurodegeneration of speech and language networks in the brain. PPA is a devastating condition affecting adults as young as their 40's or 50's, depriving them of the ability to communicate and function in society. There has been significant progress in discovering the neurobiological mechanisms that underlie PPA and in identifying its clinical phenotypes. With these advances, we are poised to investigate behavioral treatments that are grounded in modern cognitive and neuroanatomical concepts. Research documenting the efficacy of speech-language treatment for PPA is emerging, but limited. Systematic research is needed to establish best clinical practices in this unique patient population for whom pharmacological treatment remains elusive. The long-term objectives of this project are to provide evidence-based treatment methods addressing the speech and language deficits in PPA and to determine the neural predictors of responsiveness to intervention. The study has three main goals that build on the findings of our previous work: 1) to examine the utility of treatments designed to facilitate significant, generalized and lasting improvement of speech-language function in PPA, 2) to determine whether treatment alters the trajectory of decline in PPA by comparing performance on primary outcome measures in treated versus untreated participants after a one-year interval, and 3) to identify imaging predictors (gray matter, white matter, and functional connectivity measures) of responsiveness to behavioral intervention in individuals with PPA. In order to accomplish these aims, we will enroll 60 individuals with PPA, who will undergo a comprehensive multidisciplinary evaluation and neuroimaging. Subsequently, participants will be enrolled in treatment designed to promote lasting and generalized improvement of communicative function in core speech-language domains. Participants will be followed for up to one-year post-treatment in order to determine long-term effects of rehabilitation, and their performance will be compared with a historical cohort of untreated PPA patients. This ambitious study and the necessary recruitment will be possible due to an ongoing collaboration with the UCSF Memory and Aging Center, a leading institution in the field of PPA research. The study will broaden the evidence base supporting the efficacy of speech-language intervention in PPA and will provide novel evidence regarding neural predictors of treatment outcomes, with the potential to inform clinical decision-making and improve clinical care for individuals with this debilitating disorder.

Conditions

Primary Progressive Aphasia; Semantic Dementia; Semantic Memory Disorder; Logopenic Progressive Aphasia; Nonfluent Aphasia, Progressive; Aphasia; Aphasia, Progressive

Outcome Measures

Primary Outcomes (2)

• Change in spoken naming of target items

  Change in percent correctly named trained/untrained pictures

  change from pre-treatment to post-treatment (approximately 8-12 weeks after treatment onset) and follow-ups at 3 months post-treatment, 6 months post-treatment, and 12 months post-treatment

• Change in script production accuracy

  Change in percent correct intelligible, scripted words for trained/untrained scripts

  change from pre-treatment to post-treatment (approximately 6 weeks after treatment onset) and follow-ups at 3 months post-treatment, 6 months post-treatment, and 12 months post-treatment

Secondary Outcomes (3)

• Change on Western Aphasia Battery, Revised

  change from pre-treatment to post-treatment (approximately 6-12 weeks after treatment onset) and follow-ups at 3 months post-treatment, 6 months post-treatment, and 12 months post-treatment

• Change on Boston Naming Test

  change from pre-treatment to post-treatment (approximately 6-12 weeks after treatment onset) and follow-ups at 3 months post-treatment, 6 months post-treatment, and 12 months post-treatment

• Change on Northwestern Assessment of Verbs and Sentences

  change from pre-treatment to post-treatment (approximately 6-12 weeks after treatment onset) and follow-ups at 3 months post-treatment, 6 months post-treatment, and 12 months post-treatment

Other Outcomes (1)

• Post-treatment Communication Survey

  post-treatment (approximately 6-12 weeks after treatment onset)

Study Arms (2)

Lexical Retrieval Treatment

EXPERIMENTAL

Behavioral: Lexical Retrieval Training (LRT)

Script Training

EXPERIMENTAL

Behavioral: Video-Implemented Script Training for Aphasia (VISTA)

Interventions

Lexical Retrieval Training (LRT) BEHAVIORAL

In person or via teletherapy: Participants work on producing spoken and written names of personally relevant target items using a self-cueing hierarchy. Treatment focuses on the use of strategies that capitalize on spared cognitive-linguistic abilities to support word retrieval. The participant completes two (one hour each) sessions per week with a clinician plus daily home practice exercises.

Lexical Retrieval Treatment

Video-Implemented Script Training for Aphasia (VISTA) BEHAVIORAL

In person or via teletherapy: Participants work on producing personally relevant scripts of 4-6 sentences in length. Length and complexity of scripts are individually tailored. The participant completes 30 minutes per day of home practice, during which they speak in unison with a video/audio model of a healthy speaker clearly articulating the scripts. Biweekly (one hour each) sessions with a clinician target clear and accurate script production, script memorization, and conversational usage of scripts.

Script Training

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Meets diagnostic criteria for Primary Progressive Aphasia (PPA; Gorno-Tempini et al., 2011)
• Score of 15 or higher on the Mini-Mental State Examination

You may not qualify if:

• Other neurological or psychiatric diagnosis that may contribute to cognitive-linguistic deficits
• Significant, uncorrected visual or hearing impairment that would interfere with participation
• Score of less than 15 on the Mini-Mental State Examination
• Prominent initial non-speech-language impairment (cognitive, behavioral, motoric)

Sponsors & Collaborators

• University of Texas at Austin: lead
• National Institute on Deafness and Other Communication Disorders (NIDCD): collaborator
• University of California, San Francisco: collaborator

Study Sites (2)

University of California San Francisco

San Francisco, California, 94158, United States

Location

University of Texas

Austin, Texas, 78712, United States

Location

Related Publications (3)

• Henry ML, Hubbard HI, Grasso SM, Mandelli ML, Wilson SM, Sathishkumar MT, Fridriksson J, Daigle W, Boxer AL, Miller BL, Gorno-Tempini ML. Retraining speech production and fluency in non-fluent/agrammatic primary progressive aphasia. Brain. 2018 Jun 1;141(6):1799-1814. doi: 10.1093/brain/awy101.

  PMID: 29718131 BACKGROUND

• Henry ML, Hubbard HI, Grasso SM, Dial HR, Beeson PM, Miller BL, Gorno-Tempini ML. Treatment for Word Retrieval in Semantic and Logopenic Variants of Primary Progressive Aphasia: Immediate and Long-Term Outcomes. J Speech Lang Hear Res. 2019 Aug 15;62(8):2723-2749. doi: 10.1044/2018_JSLHR-L-18-0144. Epub 2019 Aug 7.

  PMID: 31390290 BACKGROUND

• Dial HR, Hinshelwood HA, Grasso SM, Hubbard HI, Gorno-Tempini ML, Henry ML. Investigating the utility of teletherapy in individuals with primary progressive aphasia. Clin Interv Aging. 2019 Feb 25;14:453-471. doi: 10.2147/CIA.S178878. eCollection 2019.

  PMID: 30880927 BACKGROUND

Related Links

• University of Texas Aphasia Research and Treatment Lab
• UCSF Language Neurobiology Lab

MeSH Terms

Conditions

Aphasia, Primary Progressive; Frontotemporal Dementia; Memory Disorders; Primary Progressive Nonfluent Aphasia; Aphasia

Condition Hierarchy (Ancestors)

Dementia; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Speech Disorders; Language Disorders; Communication Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Neurocognitive Disorders; Mental Disorders; Frontotemporal Lobar Degeneration; TDP-43 Proteinopathies; Neurodegenerative Diseases; Proteostasis Deficiencies; Metabolic Diseases; Nutritional and Metabolic Diseases

Study Officials

• Maya L Henry, PhD

  University of Texas at Austin

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 30, 2021
• First Posted: May 11, 2021
• Study Start: July 1, 2017
• Primary Completion: August 30, 2025
• Study Completion: December 30, 2025
• Last Updated: November 13, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

US (2)