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Translational Neuroscience of Speech and Language Disorders pp 21–46Cite as

Treatment and Intervention Approaches for the Improvement of Language Abilities in Neurodegenerative Diseases

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Part of the book series: Contemporary Clinical Neuroscience ((CCNE))

Abstract

This chapter discusses the current state of treatment and intervention approaches to language impairments resulting from neurodegenerative conditions such as Alzheimer’s disease (AD), mild cognitive impairment (MCI), and primary progressive aphasia (PPA). Traditionally, language therapy has focused on improving performance after stroke, while linguistic difficulties resulting from various neurodegenerative conditions have largely been left untreated. Despite the progressive nature of these conditions, current research has shown that language impairments associated with them are responsive to therapy, indicating the potential for neuroplasticity even in neurodegeneration. In this chapter, we present and discuss behavioral intervention methods targeting the word as well as the sentence level of impairment in the aforementioned conditions, as well as neuromodulatory techniques (repetitive transcranial magnetic stimulation, transcranial direct current stimulation) and their application in the domain of language impairments. Efficacy of treatment varies depending on the condition but also on the technique: therapy gains seem to be higher when it comes to AD as compared to MCI and when it comes to agrammatic (PPA-G) or logopenic PPA (PPA-L) as compared to semantic PPA (PPA-S). Moreover, neuromodulatory techniques may have longer-lasting effects relative to behavioral treatment, while combined interventions (behavioral and neuromodulatory) have produced more promising results, maximizing the efficacy of the intervention.

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Notes

  1. 1.

    Low-frequency (1–4 Hz) rTMS has inhibitory effects, while high-frequency stimulation (>5 Hz) causes excitatory effects; similarly, cathodal tDCS induces neural hyperpolarization reducing the responsiveness of the neurons leading to inhibition of performance, while anodal induces neural depolarization, increasing neurons’ excitability (Pini et al., 2019).

  2. 2.

    The process of creating a lexical item from a verbal basis. For instance, teach > teacher, play > playing, understand > understandable.

Abbreviations

(r)TMS:

(Repetitive) transcranial magnetic stimulation

AD:

Alzheimer’s disease

CCT:

Computerized cognitive training

DLPFC:

Dorsolateral prefrontal cortex

EF:

Executive functions

FTD:

Frontotemporal dementia

LH:

Left hemisphere

MCI:

Mild cognitive impairment

PPA:

Primary progressive aphasia

PPA-G:

Agrammatic PPA

PPA-L:

Logopenic PPA

PPA-S:

Semantic PPA

RH:

Right hemisphere

tDCS:

Transcranial direct current stimulation

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Further Reading

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Acknowledgments

We would like to thank Georgios Argyropoulos and Ioannis Papakyritsis for thoroughly reading the manuscript. Writing of the chapter was partly supported by grant J6-1806 from ARRS (Slovenian Research Agency) awarded to Christina Manouilidou.

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Authors and Affiliations

  1. Department of Comparative and General Linguistics, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia

    Christina Manouilidou

  2. Department of Philology, School of Philosophy, University of Ioannina, Ioannina, Greece

    Michaela Nerantzini

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Correspondence to Christina Manouilidou .

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  1. Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital University of Oxford, Oxford, UK

    Georgios P. D. Argyropoulos

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Manouilidou, C., Nerantzini, M. (2020). Treatment and Intervention Approaches for the Improvement of Language Abilities in Neurodegenerative Diseases. In: Argyropoulos, G.P.D. (eds) Translational Neuroscience of Speech and Language Disorders. Contemporary Clinical Neuroscience. Springer, Cham. https://doi.org/10.1007/978-3-030-35687-3_3

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