Multicomponent Language Treatment for Primary Progressive Aphasia

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Texas at Austin

Disqualifiers: Other neurological, psychiatric diagnosis, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6-12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests an online program designed to assist individuals with primary progressive aphasia (PPA), a type of dementia affecting speech and language. The goal is to determine if online speech-language therapy can enhance communication skills and benefit both patients and their care partners. The trial will evaluate three therapy methods—Multicomponent Communication Partner Training (Multi-CPT), Multicomponent Lexical Retrieval Training (Multi-LRT), and Multicomponent Video Implemented Script Training in Aphasia (Multi-VISTA)—to identify the most effective approach. Individuals diagnosed with PPA who have a partner available to join the sessions may be suitable candidates. Participants will engage in online therapy, complete tasks and surveys, and have virtual check-ins with the research team. As an unphased trial, this study provides a unique opportunity to contribute to innovative research that could improve communication strategies for PPA.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It might be best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that the treatments in this trial are generally safe for participants. Here's a simple breakdown:

1. **Multicomponent Lexical Retrieval Training (Multi-LRT)**: Similar therapies, such as those using smartphone apps, have improved language skills over six months without major safety issues. This suggests that Multi-LRT is likely safe and well-tolerated.

2. **Multicomponent Video Implemented Script Training in Aphasia (Multi-VISTA)**: Research on a modified version of this therapy has shown it to be practical and acceptable. Participants found it manageable and effective, with no significant side effects reported.

3. **Multicomponent Communication Partner Training (Multi-CPT)**: This method has been studied in people with progressive aphasia, and results show it is practical and can help improve understanding of aphasia. Studies reported no major safety concerns.

Overall, these treatments have been tested for their ability to aid communication in people with primary progressive aphasia, and they appear safe and tolerable based on existing research. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the multicomponent treatments for Primary Progressive Aphasia (PPA) because they take a comprehensive approach to tackle language deterioration. Unlike standard therapies, which often focus on a single aspect of language, these treatments integrate multiple strategies. Multi-CPT emphasizes training communication partners, enhancing the patient's daily interactions. Multi-LRT targets specific word retrieval processes, aiming to improve vocabulary access. Meanwhile, Multi-VISTA uses video-based script training, offering a practical, context-rich method to reinforce language skills. Together, these treatments provide a more holistic approach to managing PPA, potentially leading to more significant improvements in communication.

What evidence suggests that this trial's treatments could be effective for primary progressive aphasia?

This trial will compare three different treatments for primary progressive aphasia (PPA). Studies have shown that Multicomponent Lexical Retrieval Training (Multi-LRT), one of the treatments in this trial, helps people with PPA find words more easily. Participants in these studies demonstrated better naming skills and maintained these improvements over time. Another treatment option in this trial, Multicomponent Video Implemented Script Training in Aphasia (Multi-VISTA), enhances communication in people with PPA by using video scripts, which are structured speaking exercises. This method is both practical and effective, leading to better communication in practiced situations. Lastly, Multicomponent Communication Partner Training (Multi-CPT) teaches caregivers and partners how to better communicate with people who have PPA. This approach has improved understanding and communication between patients and their partners. Together, these treatments offer promising ways to help people with PPA improve their communication skills. ^{1 3 5 6 7}

Who Is on the Research Team?

Maya L Henry, PhD

Principal Investigator

University of Texas - Austin

Are You a Good Fit for This Trial?

This trial is for adults diagnosed with Primary Progressive Aphasia (PPA) who can still score at least 10 on the Mini-Mental State Examination. They must have a partner to attend sessions with them. It's not suitable for those with major visual/hearing issues, other cognitive/behavioral/motor impairments, or additional neurological/psychiatric conditions affecting language skills.

Inclusion Criteria

Has a study partner who can consistently attend sessions

Meets diagnostic criteria for Primary Progressive Aphasia (PPA; Gorno-Tempini et al., 2011)

Scores of 10 or higher on the Mini-Mental State Examination

Exclusion Criteria

I do not have major vision or hearing problems that would affect my participation.

Score of less than 10 on the Mini-Mental State Examination

I have a neurological or psychiatric condition that affects my speech or understanding.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a multicomponent intervention incorporating restitutive, compensatory, and care partner-focused treatments

6-12 weeks

Follow-up

Participants are monitored for changes in script production accuracy, spoken naming, and other communication measures

3 months

What Are the Treatments Tested in This Trial?

Interventions

• Multicomponent Communication Partner Training (Multi-CPT)
• Multicomponent Lexical Retrieval Training (Multi-LRT)
• Multicomponent Video Implemented Script Training in Aphasia (Multi-VISTA)

Trial Overview The study tests three treatments: Multi-LRT focuses on word finding strategies; Multi-VISTA uses video scripts to improve speech; and Multi-CPT involves partners in communication training. The goal is to see if these combined approaches help maintain language functions and quality of life in PPA patients.

How Is the Trial Designed?

Group I: Multicomponent Video Implemented Script Training in Aphasia (Multi-VISTA) Experimental Treatment 1 Intervention

Group II: Multicomponent Lexical Retrieval Training (Multi-LRT) Experimental Treatment 1 Intervention

Group III: Experimental: Multicomponent Communicaiton Partner Training (Multi-CPT) Experimental Treatment 1 Intervention

Who Is Running the Clinical Trial?

University of Texas at Austin

Lead Sponsor

Trials

387

Recruited

86,100+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

Published Research Related to This Trial

Lexical retrieval treatments for individuals with primary progressive aphasia (PPA) have shown immediate benefits, with some participants maintaining these gains for months or even years through long-term treatment, based on a review of studies from the 1990s to early 2018.

Five effective behavioral treatment techniques were identified, including standard naming treatment and cueing hierarchies, but there is limited evidence for generalizing these treatments to untreated words, indicating that the focus should be on maintaining a core vocabulary.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treatment for Lexical Retrieval Impairments in Primary Progressive Aphasia: A Research Update with Implications for Clinical Practice. Croot, K.[2019]

The study developed a comprehensive training program called 'Better Conversations with primary progressive aphasia' for speech and language therapists, which includes seven online modules and a manual for communication partner training, based on extensive stakeholder consultation and co-production.

Key components of the training were identified, such as the use of video feedback and understanding the timing of interventions, which were informed by focus groups with individuals affected by primary progressive aphasia and their families, ensuring the program is tailored to their needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using the Medical Research Council framework and public involvement in the development of a communication partner training intervention for people with primary progressive aphasia (PPA): Better Conversations with PPA. Volkmer, A., Spector, A., Swinburn, K., et al.[2021]

A group treatment model for individuals with primary progressive aphasia (PPA) was developed, incorporating strategies from augmentative communication and aphasia rehabilitation, and was delivered over 6 weeks to enhance communication skills.

Participants reported significant improvements in their understanding of PPA, increased use of multimodal communication, and greater confidence in daily activities, indicating that group training is an effective approach for supporting individuals with this condition.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Group Communication Treatment for Individuals with PPA and Their Partners. Mooney, A., Beale, N., Fried-Oken, M.[2019]

The pilot study of the Better Conversations with PPA (BCPPA) program involved 18 participants with primary progressive aphasia (PPA) and their communication partners, showing that the intervention was well-received and had a high treatment fidelity of 87.2%.

Results indicated that BCPPA led to positive changes in conversation behaviors and communication goals, suggesting it is a promising intervention for improving communication in individuals with PPA, paving the way for a larger randomized controlled trial.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Results from a randomised controlled pilot study of the Better Conversations with Primary Progressive Aphasia (BCPPA) communication partner training program for people with PPA and their communication partners. Volkmer, A., Walton, H., Swinburn, K., et al.[2023]

The modified script training intervention, which included both in-person and videoconferencing sessions, significantly improved accuracy, grammatical productivity, speaking rate, and articulatory fluency in two individuals with aphasia over a 3-week period for each script.

Participants also demonstrated the ability to generalize their improved skills to functional conversational tasks, indicating that the intervention was effective not only in structured settings but also in real-life communication scenarios.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Script training and generalization for people with aphasia. Goldberg, S., Haley, KL., Jacks, A.[2022]

A study involving 25 participants (12 individuals with primary progressive aphasia and 13 caregivers) showed that attending an education and support session significantly improved caregivers' knowledge about PPA and coping strategies.

Follow-up interviews revealed that caregivers felt less isolated and more supported, highlighting the importance of these sessions as a valuable part of care for individuals with PPA.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Primary Progressive Aphasia Education and Support Groups: A Clinical Evaluation. Taylor-Rubin, C., Azizi, L., Croot, K., et al.[2020]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT06649084

Primary Progressive Aphasia Multicomponent Language ... The goal of this clinical trial is to learn if a speech-language telerehabilitation helps improve communication in people with primary progressive aphasia ...

2. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1111/1460-6984.70150?af=R

Intersection of Knowledge to Practice: A Purposeful ... Communication partner training (CPT) can equip future healthcare providers with tools to more effectively communicate with patients with aphasia ...

3. withpower.com withpower.com/trial/multicomponent-language-treatment-for-primary-progressive-aphasia-4d80f

Multicomponent Language Treatment for Primary ... Research shows that communication partner training and video script training can help people with primary progressive aphasia improve their communication skills ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12552832/

Intersection of Knowledge to Practice Communication partner training (CPT) can equip future healthcare providers with tools to more effectively communicate with patients with aphasia ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S240545262400017X

A randomized controlled pilot study 13, 14, 15 Although outcome measures differ across studies, findings indicate that CPT training can result in improved understanding of aphasia, increased ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9159055/

Communication Partner Engagement: A Relevant Factor ... This study reports feasibility of the same telehealth intervention in a larger set of progressive aphasia participants and explores factors potentially ...

7. alz-journals.onlinelibrary.wiley.com alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.70088

Efficacy of Communication Bridge‐2 for primary progressive ... Outcomes demonstrate the feasibility and initial efficacy of a person-centered telemedicine intervention for maximizing communication participation.