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Positive Effects of Language Treatment for the Logopenic Variant of Primary Progressive Aphasia

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Abstract

Despite considerable recent progress in understanding the underlying neurobiology of primary progressive aphasia (PPA) syndromes, relatively little attention has been directed toward the examination of behavioral interventions that may lessen the pervasive communication problems associated with PPA. In this study, we report on an individual with a behavioral profile and cortical atrophy pattern consistent with the logopenic variant of PPA. At roughly two-and-a-half years post onset, his marked lexical retrieval impairment prompted administration of a semantically based intervention to improve word retrieval. The treatment was designed to improve self-directed efforts to engage the participant’s relatively preserved semantic system in order to facilitate word retrieval. His positive response to an intensive (2-week) dose of behavioral treatment was associated with improved lexical retrieval of items within trained categories, and generalized improvement for naming of untrained items that lasted over a 6-month follow-up interval. These findings support the potential value of intensive training to achieve self-directed strategic compensation for lexical retrieval difficulties in logopenic PPA. Additional insight was gained regarding the neural regions that supported improved performance by the administration of a functional magnetic resonance imaging protocol before and after treatment. In the context of a picture-naming task, post-treatment fMRI showed increased activation of left dorsolateral prefrontal regions that have been implicated in functional imaging studies of generative naming in healthy individuals. The increased activation in these frontal regions that were not significantly atrophic in our patient (as determined by voxel-based morphometry) is consistent with the notion that neural plasticity can support compensation for specific language loss, even in the context of progressive neuronal degeneration.

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Acknowledgments

This work was supported by grants R01 DC007646 (PMB), R01 DC008286 (SZR), and F31DC009145 (MLH) from the National Institute on Deafness and Other Communication Disorders. The authors thank Sarah Andersen and Kindle Rising for their assistance with this paper.

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Authors and Affiliations

  1. Department of Speech, Language, and Hearing Sciences, The University of Arizona, 1131 E. Second Street, Tucson, AZ, 85721-0071, USA

    Pélagie M. Beeson, Rachel M. King, Borna Bonakdarpour, Hyesuk Cho & Steven Z. Rapcsak

  2. Department of Neurology, University of Arizona, Tucson, AZ, USA

    Pélagie M. Beeson, Borna Bonakdarpour & Steven Z. Rapcsak

  3. Memory and Aging Center, University of California, San Francisco, CA, USA

    Maya L. Henry

  4. Neurology Section, Southern Arizona VA Health Care System, Tucson, AZ, USA

    Steven Z. Rapcsak

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  1. Pélagie M. Beeson
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  2. Rachel M. King
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  4. Maya L. Henry
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  5. Hyesuk Cho
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  6. Steven Z. Rapcsak
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Correspondence to Pélagie M. Beeson.

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Beeson, P.M., King, R.M., Bonakdarpour, B. et al. Positive Effects of Language Treatment for the Logopenic Variant of Primary Progressive Aphasia. J Mol Neurosci 45, 724–736 (2011). https://doi.org/10.1007/s12031-011-9579-2

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