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

21 Participants Needed

Trial Summary

What is the purpose of this trial?

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 in their 50's, depriving them of the ability to communicate and function in society. As a result of improved diagnostic precision, PPA is now identified with greater accuracy and frequency and, increasingly, patients and their families seek options for behavioral treatments to ameliorate the devastating effects on their communication, prolong speech language skills, and maximize quality of life. Speech-language treatment outcomes from our group and others are encouraging, confirming that behavioral intervention may lead to improvements in trained behaviors and, for some interventions, lasting and generalized benefit. Most speech-language interventions for individuals with PPA that have been explored in the literature are restitutive, or impairment-based in nature, and have not addressed the full range of severity and phenotypic variability in this population. The investigators will evaluate the utility of a novel, multicomponent intervention that incorporates elements of restitutive (e.g., word finding strategic training, script training), compensatory (e.g., multimodal communication, communication book), and care partner-focused treatment to meet the needs of individuals varying in clinical presentation and severity.

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.

What data supports the effectiveness of the Multicomponent Language Treatment for Primary Progressive Aphasia?

Research shows that communication partner training and video script training can help people with primary progressive aphasia improve their communication skills. Studies found that these treatments can increase confidence, improve language use, and maintain communication abilities over time, even as the condition progresses. ^{1 2 3 4 5}

Is Multicomponent Language Treatment for Primary Progressive Aphasia safe for humans?

The studies reviewed did not report any safety concerns for the Multicomponent Language Treatment or its variations, suggesting it is generally safe for humans. ^{1 2 4 6 7}

How is the Multicomponent Language Treatment for Primary Progressive Aphasia different from other treatments?

The Multicomponent Language Treatment for Primary Progressive Aphasia is unique because it combines multiple approaches, including communication partner training, lexical retrieval training, and video-implemented script training, to address the complex language challenges in PPA. This comprehensive approach aims to improve communication by involving both the person with PPA and their communication partners, which is not typically the focus of other treatments. ^{1 2 3 8 9}

Research Team

Maya L Henry, PhD

Principal Investigator

University of Texas - Austin

Eligibility Criteria

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

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

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

Timeline

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

Treatment Details

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.

Participant Groups

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: 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+

Findings from Research

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 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 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]

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]

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]

References

1. England 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. [2023]

2. England 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. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Group Communication Treatment for Individuals with PPA and Their Partners. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Script Training Using Telepractice with Two Adults with Chronic Non-Fluent Aphasia. [2020]

5. England pubmed.ncbi.nlm.nih.gov

Retraining speech production and fluency in non-fluent/agrammatic primary progressive aphasia. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Embedding Aphasia-Modified Cognitive Behavioral Therapy in Script Training for Primary Progressive Aphasia: A Single-Case Pilot Study. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Script training and generalization for people with aphasia. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

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

9. United States pubmed.ncbi.nlm.nih.gov

Primary Progressive Aphasia Education and Support Groups: A Clinical Evaluation. [2020]