Anomia is one of the earliest deficits associated with primary progressive aphasia (PPA). To determine if treatment can remediate naming deficits for specific words or delay the emergence of these deficits in PPA, we are conducting a longitudinal, within-subjects treatment study. Preliminary results are reported here.
Subjects
Four participants representing three clinical subtypes of PPA included: YST and KPR (logopenic variant), XCH (semantic variant) and JSL (nonfluent/agrammatic variant).
Procedure
During baseline testing, participants were asked to name two sets of pictured nouns on three occasions. One set (exemplar 1) was presented twice and was utilized during treatment. The second set (exemplar 2) was never trained, and was used to assess generalization. One hundred twenty nouns that were consistently named correctly (prophylaxis items) or incorrectly (remediation items) were identified and divided among three conditions: reading/writing treatment, repetition treatment, and no treatment. The nouns were matched across conditions for frequency; semantic category; and number of syllables, phonemes, and letters. Due to his inconsistent naming errors, JSL's stimuli included only prophylaxis items.
In the reading/writing treatment, participants viewed a picture and the corresponding word, read the word aloud, and copied the word. A forced-choice recognition task was then presented to ensure that participants attended to both the picture and the word. In the repetition treatment, participants viewed the picture and a string of symbols. The auditory word was then presented, and participants were asked to repeat it. Next, a recognition task analogous to the one in the writing treatment was presented.
There were two treatment sessions per week during the first month. During the subsequent five months, subjects participated in monthly treatment sessions, and home practice with index cards three times per week. A follow-up evaluation began one month after the end of treatment.
Results
XCH showed significant improvement for exemplar 1 and 2 remediation items in both treatment conditions (McNemar's Test, all p's < .01). There were no significant effects for XCH's prophylaxis items, although there was a trend toward greater decline in the untrained condition.
YST's naming of remediation items improved significantly in the repetition condition for both exemplars (p's < .01). In the reading/writing condition, her naming of remediation items improved significantly for exemplar 1 (p < .05), but was only marginally significant for exemplar 2 (p = .06). KPR showed significant improvement for exemplar 2 remediation items in the reading/writing condition only (p < .01), while her improvement for exemplar 1 remediation items in this condition, and for both exemplars in the repetition condition, was marginally significant (p's = .06). There was little or no decline, and hence no observable treatment effects, for the prophylaxis items of YST, KPR, or JSL.
The findings obtained as of this writing suggest that remediation of naming deficits may be possible in people with PPA. Although significant treatment effects for the prophylaxis items have not yet been demonstrated, trends suggest that we may see such effects at later testing points.