Aneta Kielar, Ph.D.
Assistant Professor
Speech, Language & Hearing

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What is Primary Progressive Aphasia and what can we do to help those affected by this syndrome

Abstract: Alzheimer’s disease can result in a progressive and debilitating loss of language function manifesting as the logopenic variant of Primary Progressive Aphasia (lvPPA). In such cases, the neuropathological changes associated with AD accumulate in the left posterior temporo-parietal regions that support language processing, disrupting the dorsal language network that critically supports phonological skills for spoken and written language. The resulting language profile is characterized by reduced and slowed speech production, word retrieval difficulties, and impaired reading and writing. Although treatment research is in its early stages, there is limited, but encouraging, evidence that behavioral treatment directed toward strengthening weakened phonological skills can improve language function. Given the deliberating and progressive nature of the impairment, there is a pressing need to develop targeted interventions that would maximize the function of residual components of critical language networks and potentially slow the language decline. In my laboratory we are working to improve language function in PPA by combining speech language therapy with fMRI-targeted transcranial direct current stimulation (tDCS) applied over preserved brain regions in the language processing network. Our work to date suggests a particularly robust outcome after active tDCS with further consolidation of learning over rest phase, and maintenance at follow-up. Our study is the first to document that improved phonological skills can results in better functional communication ability (text-level writing) relevant to the everyday lives of individuals living with PPA. Our study contributes to a growing body of evidence demonstrating that tDCS is a safe intervention that has potential to enhance benefits of speech-language treatment.