Spelling rehabilitation using transcranial direct current (tDCS) in primary progressive aphasia (PPA)
| Autor: | Tsapkini Kyrana, Gomez Yessinia, Frangakis Constantine, Chakravarty Tushar, Davis Cameron, Hillis Argye |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Rehabilitation Neuromodulation medicine.medical_treatment language deficits lcsh:BF1-990 medicine.disease Spelling tDCS Primary progressive aphasia Physical medicine and rehabilitation lcsh:Psychology spelling medicine Psychology PPA General Psychology Cognitive psychology |
| Zdroj: | Frontiers in Psychology, Vol 5 (2014) |
| ISSN: | 1664-1078 |
| DOI: | 10.3389/conf.fpsyg.2014.64.00086 |
| Popis: | Introduction: Spelling impairments are one of the first deficits that occur early in PPA and can usually predict the variant of PPA in which the patient may progress (Sepelyak et al., 2011). PPA is a neurodegenerative disease that affects people relatively early in life (between 55-65 years) and therefore it is important to find ways to alleviate the symptoms or impede the degree of degeneration. We present and discuss new data indicating that a neuromodulatory treatment, using transcranial direct current stimulation (tDCS) combined with a spelling intervention, shows promise for maintaining or even improving language abilities in PPA. The aim of this research is to determine whether tDCS plus language therapy is more effective than language therapy alone in treating written language deficits in PPA. Methods: Eight PPA participants underwent anodal tDCS or sham plus spelling intervention in a randomized order using a within-subject cross-over design. They were evaluated before, after, and at 2 weeks and 2 months post-intervention. Spelling intervention varied for each participant according to the main spelling deficit: 3 patients had phoneme-to-grapheme conversion (PGC) intervention, 2 had lexical intervention and 3 had advanced PGC intervention (combined with written fluency and PGC practice). Four more patients have already finished the first period of stimulations (ether sham or tDCS) and all their other sessions and evaluations will be completed in the next couple months. Analyses-Results: We analyzed the existing set of full data using both within-subject analyses (McNemar tests) and across-subjects analyses while taking into account carry-over effects. We evaluated therapy effects by the Generalized Estimating Equation approach (Liang & Zeger, 1986). All participants showed improvement in spelling after spelling intervention in trained items (with either sham or tDCS). There was, however, a significant improvement for untrained items only in the tDCS plus language therapy condition compared to sham at all follow-up intervals but mostly at 2 months post-intervention. Conclusions: We discuss these results with emphasis to the particular challenges of this method. Neuromodulation with tDCS offers promise as a means of augmenting language therapy to improve written language function, at least short-term, in PPA. The consistent finding of generalization of treatment benefits to untreated items and the superior sustainability of treatment effects with tDCS justifies further investigations. Possible explanations of brain mechanisms involved and current efforts in investigating them are also discussed. |
| Databáze: | OpenAIRE |
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