Objective:

To report findings from an open-label, observational cohort study utilizing transcranial direct current stimulation (tDCS) paired with individualized word retrieval training, delivered to patients with primary progressive aphasia (PPA) at home via telehealth.

Background:

PPA is an incurable, language-based neurocognitive disorder, typically managed with speech and language therapy (SLT) to delay its progression. Pairing noninvasive brain stimulation with rehabilitation can yield strong and enduring clinical effects. tDCS, a safe and well-tolerated noninvasive brain stimulation method, has been extensively validated for home use through telehealth. We tested the effectiveness of tDCS alongside personalized word retrieval training in a cohort of PPA patients.

Design/Methods:

Individuals with PPA and notable word-finding difficulties were recruited nationally. The intervention consisted of 20 daily (5/week) sessions of 45-minutes of personalized word retrieval training with concurrent tDCS stimulation (2.0mA) over the left inferior frontal gyrus (anode F7, cathode O1) for the first 30 minutes. Objects and actions were trained using a cueing hierarchy. Sessions were conducted via telehealth. Cognitive and language tests were completed remotely at baseline and intervention end.

Results:

We enrolled n=10 patients with PPA (age: 70±6.9; 60% male) with confirmed logopenic variant (lvPPA; n=2), semantic variant (svPPA; n=2), or unspecified (n=6). The intervention was well-tolerated, with no adverse events, with all participants completing the 20 daily sessions. Following treatment, participants showed improvement in naming for trained vs. untrained items (25.1±4.3 vs. 20.2±7.5, p=.003). From baseline to intervention end, the group significantly improved in confrontation naming (6.2±5.6 vs 7.8±5.2, p=.016). Further, no measure declined over the course of the intervention at either the group or individual level, indicating stability or improvement across all participants.

Conclusions: