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

  • Christina ManouilidouEmail author
  • Michaela Nerantzini
Chapter
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Part of the Contemporary Clinical Neuroscience book series (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.

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

Notes

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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Further Reading

  1. Cadorio, I., Lousada, M., Martins, P., & Figueiredo, D. (2017). Generalization and maintenance of treatment gains in primary progressive aphasia (PPA): A systematic review. International Journal of Communication Disorders, 52(5), 543–560.CrossRefGoogle Scholar
  2. Fyndanis, V., Manouilidou, C., Koufou, E., Karampekios, S., & E-M. Tsapakis. (2013). Agrammatic patterns in Alzheimer’s disease: evidence from Tense, Agreement and Aspect. Aphasiology27(2), 178–200.Google Scholar
  3. Joubert, S.,  Brambati, S. M., Ansado, J., Barbeau, E. J., Felician, O., Didic, M., Lacombe, J., Goldstein, R., Chayer, C., & Kergoat, M-J. (2010). The cognitive and neural expression of semantic memory impairment in mild cognitive impairment and early Alzheimer’s disease. Neuropsychologia 48(4), 978–988.Google Scholar
  4. Manouilidou, C., Kordouli, K., Papanagiotou, A., Messinis, L., & Papathanassopoulos, P. (2014). Lexical-semantic deficits in Mild Cognitive Impairment: the case of abstract vs. concrete nouns. Stem-, Spraak-en Taalpathologie 19(S01), 92–95.Google Scholar
  5. Norise, C., & Hamilton, R. (2017). Non-invasive brain stimulation in the treatment of post-stroke and neurodegenerative aphasia: Parallels, differences, and lessons learned. Frontiers in Human Neuroscience, 10, 675.Google Scholar
  6. Patterson, K., Ralph, M. A. L., Jefferies, E., Woollams, A., Jones, R., Hodges, J. R., & Rogers, T. T. (2006). “Presemantic” cognition in semantic dementia: Six deficits in search of an explanation. Journal of Cognitive Neuroscience 18(2), 169–183.Google Scholar
  7. Tippett, D. C., Hillis, A. E., & Tsapkini, K. (2015). Treatment of primary progressive aphasia. Current Treatment Options in Neurology, 17, 362–362.PubMedPubMedCentralCrossRefGoogle Scholar

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Authors and Affiliations

  1. 1.Department of Comparative and General Linguistics, Faculty of ArtsUniversity of LjubljanaLjubljanaSlovenia
  2. 2.Department of Philology, School of PhilosophyUniversity of IoanninaIoanninaGreece

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