Frontiers in Psychology (Apr 2015)
Remediation of Anomia in lvPPA and svPPA
Abstract
Anomia treatment efficacy has been examined in cases with different subtypes of primary progressive aphasia (PPA), and it has been evaluated in groups of participants with the semantic variant (svPPA), but efficacy has not been examined in groups with different subtypes of PPA. Method Participants. Four individuals with the logopenic variant (lvPPA) and four individuals with svPPA participated. Procedure. At baseline, participants attempted to name two sets of pictured nouns. One set (Exemplar 1) was utilized during treatment. The second set (Exemplar 2) was never trained and was used to assess stimulus generalization. For each participant, nouns that were consistently named incorrectly were divided among three conditions: Orthographic treatment (OTC), Phonological treatment (PTC), and Untrained (UC). The nouns were matched across conditions for frequency, semantic category, and number of syllables, phonemes, and letters. In the OTC, participants viewed a picture and the corresponding word, read the word out loud, and transcribed the word. In the PTC, participants viewed the picture and a string of symbols. The auditory word was then presented, and participants repeated it. There were two treatment sessions per week during the first month. During the subsequent five months, subjects participated in monthly treatment sessions, in addition to thrice-weekly practice sessions. A post-treatment evaluation began one month after treatment ended. Results lvPPA. From baseline to post-treatment, there was a significant or marginally significant increase in naming accuracy for both exemplars, within every condition [Exemplar 1: UC: t(3) = 2.78, p = .07; PTC: t(3) = 5.75, p = .01; OTC: t(3) = 3.62, p = .04; Exemplar 2: UC: t(3) = 7.82, p = .004; PTC: t(3) = 3.59, p = .04; OTC: t(3) = 3.78, p = .03]. Compared to UC, accuracy at post-treatment was marginally greater for Exemplar 1 in the PTC, t(3) = 3.03, p = .06. There were no other significant or marginally significant differences between UC and the treatment conditions. svPPA. From baseline to post-treatment, there was a significant or marginally significant increase in accuracy for both exemplars within both treatment conditions, but not in UC [Exemplar 1: UC: t(3) = 1.00, p = .39; PTC: t(3) = 3.62, p = .04; OTC: t(3) = 3.68, p = .04; Exemplar 2: UC: both means and SD’s equal zero; PTC: t(3) = 6.57, p = .01; OTC: t(3) = 3.00, p = .06]. Compared to UC, accuracy at post-treatment was marginally or significantly greater in the treatment conditions [Exemplar 1: PTC: t(3) = 3.25, p = .05; OTC: t(3) = 3.42, p = .04; Exemplar 2: PTC: t(3) = 6.57, p = .01; OTC: t(3) = 3.00, p = .06]. Conclusions The lvPPA group demonstrated stimulus generalization and a larger treatment effect in PTC. Naming also improved in UC, which may be due to variability in phonological access and/or a testing effect. The svPPA group demonstrated stimulus generalization and similar treatment effects in PTC and OTC. There was no improvement in UC, which suggests that degraded semantic representations remain inaccessible without treatment.
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