Rehabilitation in semantic dementia: Study of the effectiveness of lexical reacquisition in three patients

Senaha, Mirna Lie Hosogi; Brucki, Sonia Maria Dozzi; Nitrini, Ricardo

doi:10.1590/S1980-57642010DN40400009

Abstract

Although language rehabilitation in patients with primary progressive aphasia (PPA) is recommended, rehabilitation studies in this clinical syndrome are scarce. Specifically, in relation to semantic dementia (SD), few studies have shown the possibility of lexical relearning. Objective: To analyze the effectiveness of rehabilitation for lexical reacquisition in SD. Methods: Three SD patients were submitted to training for lexical reacquisition based on principles of errorless learning. Comparisons between naming performance of treated items (pre and post-training) and non-treated items of the Boston Naming Test (BNT) were made. Results: All patients improved their performance in naming treated words after intervention. However, decline in performance in naming of non-treated items was observed. Case 1 named zero items at baseline while her performance post-training was 29.4% correct responses without cueing, and 90.7% correct with and without cueing. Case 2 named 6.9% of items correctly at baseline and his performance in post-training was 52.9% without cueing and 87.3%, with and without cueing. Case 3 named zero items at baseline and his performance in post-training was 100% correct responses without cueing. Considering the performance in naming the non-treated items of the BNT, the percentages of correct responses in the first evaluation and in the re-evaluation, respectively were: 16.7% and 8.3% (case 1; 14 month-interval); 26.7% and 11.6% (case 2; 18 month-interval) and 11.6% and 8.3% (case 3; 6 month-interval). Conclusions: The reacquisition of lost vocabulary may be possible in SD despite progressive semantic deterioration.

Key words:
semantic dementia, semantic memory, primary progressive aphasia, rehabilitation; lexical reacquisition

Resumo

Apesar de recomendada reabilitação da linguagem na afasia progressiva primária (APP), há poucos estudos sobre reabilitação nesta síndrome. Especificamente, quanto à demência semântica (DS), os poucos estudos têm mostrado possibilidade de reaprendizado lexical. Objetivo: Analisar a eficácia da reabilitação para reaquisição lexical na DS. Métodos: Três pacientes com DS foram submetidos à reabilitação para reaquisição lexical baseada nos princípios do aprendizado sem erro. Comparações entre desempenhos na nomeação de itens treinados (pré e pós-tratamento) e de itens não-treinados do Teste de Nomeação de Boston (TNB) foram realizadas. Resultados: Os pacientes obtiveram melhor desempenho na nomeação das palavras treinadas após intervenção. Por outro lado, houve declínio no desempenho dos itens não-treinados. O caso 1 não nomeou nenhum item na linha de base (pré-tratamento) e seu desempenho após o tratamento foi de 29,4% de acertos sem pistas e 90,7% com e sem pistas. O caso 2 nomeou corretamente 6,9% na linha de base e sua performance, pós-treinamento, foi de 52,9% sem pistas e 87,3%, com e sem pistas. O caso 3 não nomeou nenhum item na linha de base e após o treinamento nomeou 100% dos itens sem pista. Considerando a nomeação dos itens lexicais não-treinados do TNB, as porcentagens de acertos na primeira e segunda avaliações foram respectivamente: 16,7% e 8,3% (caso 1; 14 meses de intervalo); 26,7% e 11,6% (caso 2; 18 meses de intervalo) e 11,6% e 8,3% (caso 3; 6 meses de intervalo). Conclusões: A reaquisição do vocabulário perdido pode ser possível na DS apesar da progressiva deterioração semântica.

Palavras-chave:
demência semântica; memória semântica; afasia progressiva primária; reabilitação; reaquisição lexical

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References

Mesulam MM. Slowly progressive aphasia without generalized dementia. Ann Neurol 1982;11:592-598.
Snowden JS, Goulding PJ, Neary D. Semantic dementia: a form of circumscribed cerebral atrophy. Behav Neurol 1989;2:167-182.
Hodges JR, Patterson K, Oxburry S, Funnell E. Semantic dementia. Progressive fluent aphasia with temporal lobe atrophy. Brain 1992;1151783-1806.
Neary D, Snowden JS, Gustafson L, et al. Frontotemporal lobar degeneration. A consensus on clinical diagnostic criteria. Neurology 1998;51:1546-1554.
Adlam ALR, Patterson K, Rogers TT, et al. Semantic dementia and fluent primary progressive aphasia: two sides of the same coin? Brain 2006;129:3066-3080.
Rogaslki E, Mesulam MM. Clinical Trajectories and biological Features of primary progressive aphasia (PPA). Curr Alzheimer Res 2009;6:331-336.
Mesulam M, Weintraub S. Primary progressive aphasia and kindred disorders. Handb Clin Neurol 2008;89:573-587.
Gorno-Tempini ML, Dronkers NF, et al. Cognition and anatomy in three variants of primary progressive aphasia. Ann Neurol 2004;55:335-346.
Henry, ML, Beeson, PM, Rapcsak, SZ. Treatment for anomia in semantic dementia. Semin Sppech Lang 2008;29:60-70.
Mesulam MM. Primary progressive aphasia a 25-year retrospective. Alzheimer Dis Assoc Disord 2007;21:S8-S11.
Mesulam MM. Primary progressive aphasia: a language-based dementia. N Engl J Med 2003;349:1535-1542.
Mesulam MM. Primary progressive aphasia. Ann Neurol 2001;49:425-432.
Murray LM. Longitudinal treatment of primary progressive aphasia: a case study. Aphasiology 1998;12:651-672.
Weintraub S, Rubin NP, Mesulam MM. Primary progressive aphasia: longitudinal course, neuropsychological profile, and language features. Arch Neurol 1990;47:1329-1335
Snowden JS, Neary D. Relearning of verbal labels in semantic dementia. Neuropsychologia 2002;40:1715-1728.
Graham KS, Patterson K, Pratt KH, Hodges JR. Relearning and subsequent forgetting of semantic category exemplars in a cast of semantic dementia. Neuropsychology 1999;13:359-380.
Graham KS, Patterson K, Pratt KH, Hodges JR. Can repeated exposure to "forgotten" vocabulary help alleviate word-finding difficulties in semantic dementia? An illustrative case study. Neuropsychol Rehabil 2001;11:429-454.
Jokel R, Rochon E, Leonard C. Treating anomia in semantic dementia: improvement, maintenance, or both? Neuropsychol Rehabil 2006;16:241-256.
Frattali C. An errorless learning approach to treating dysnomia in frontotemporal dementia. J Med Speech Lang Pathol 2004;12:11-24.
Jokel R, Rochon E, Anderson ND. Errorless learning of computer-generated words in a patient with semantic dementia. Neuropsychol Rehabil 2010;20:16-41.
Newhart M, Davis C, Kannan V, Heidler-Gary J, Cloutman L, Hillis AE. Therapy for naming deficits in two variants of primary progressive aphasia. Aphasiology 2009;23:823-834.
Heredia CG, Sage K, Lambon-Ralph MA, Berthier ML. Relearning and retention of verbal labels in a case of semantic dementia. Aphasiology 2009;23:192-209.
Robinson S, Druks J, Hodges JR, Garrard P. The treatment of object naming, definition and object use in semantic dementia: the effectiveness of errorless learning. Aphasiology 2009;23:749-775.
Bier N, Macoir J, Gagnon L, Van der Linden M, Louveaux S, Desrosiers J. Known, lost, and recovered: Efficacy of formal-semantic therapy and spaced retrieval method in a case of semantic dementia. Aphasiology 2009;23:210-235.
Senaha MLH, Caramelli P, Porto CS, Nitrini R. Semantic dementia Brazilian study of nineteen cases. Dement Neuropsychol 2007;1:366-373.
Senaha MLH, Caramelli P, Porto CS, Nitrini R. Verbal and non-verbal semantic impairment: from fluent primary progressive aphasia to semantic dementia. Dement Neuropsychol 2007;1:203-211
Clare L, Van Paasschen J, Evans SJ, Parkinson C, Woods RT, Linden DEJ. Goal-oriented cognitive rehabilitation for an individual with Mild Cognitive Impairment: Behavioural and neuroimaging outcomes. Neurocase 2009;15:318-331.
Clare L, Jones RSP. Errorless learning in the rehabilitation of memory impairment: a critical review. Neuropsychol Review 2008;18:1-23.
Clare L, Wilson BA, Carter G, Roth I, Hodges JR. Relearning of face-name associations in early Alzheimer's disease. Neuropsychology 2002;16:538-547.
Nespoulous JL, Lecours AR, Lafond D, Parente MAMP. Protocole Montréal-Tolouse MT-86 d'examen linguistique de l'aphasie-version Beta. Laboratoire Théophile-Alajouanine, Montréal; 1986.
Goodglass H, Kaplan E. The Assessment of Aphasia and Related Disorders. 2nd ed., Philadelphia, PA: Lea & Febiger; 1983.
Parente MAMP, Hosogi ML, Delgado AP, Lecours AR. Protocolo de Leitura para o projeto H.F.S.P.;São Paulo; 1992.
Kaplan E, Goodglass H, Weintraub S. The Boston Naming Test. Philadelphia: Lea & Febiger; 1983.

Publication Dates

Publication in this collection
Oct-Dec 2010

History

Received
10 Mar 2010
Accepted
11 Aug 2010

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] Mesulam MM. Slowly progressive aphasia without generalized dementia. Ann Neurol 1982;11:592-598.

[2] Snowden JS, Goulding PJ, Neary D. Semantic dementia: a form of circumscribed cerebral atrophy. Behav Neurol 1989;2:167-182.

[3] Hodges JR, Patterson K, Oxburry S, Funnell E. Semantic dementia. Progressive fluent aphasia with temporal lobe atrophy. Brain 1992;1151783-1806.

[4] Neary D, Snowden JS, Gustafson L, et al. Frontotemporal lobar degeneration. A consensus on clinical diagnostic criteria. Neurology 1998;51:1546-1554.

[5] Adlam ALR, Patterson K, Rogers TT, et al. Semantic dementia and fluent primary progressive aphasia: two sides of the same coin? Brain 2006;129:3066-3080.

[6] Rogaslki E, Mesulam MM. Clinical Trajectories and biological Features of primary progressive aphasia (PPA). Curr Alzheimer Res 2009;6:331-336.

[7] Mesulam M, Weintraub S. Primary progressive aphasia and kindred disorders. Handb Clin Neurol 2008;89:573-587.

[8] Gorno-Tempini ML, Dronkers NF, et al. Cognition and anatomy in three variants of primary progressive aphasia. Ann Neurol 2004;55:335-346.

[9] Henry, ML, Beeson, PM, Rapcsak, SZ. Treatment for anomia in semantic dementia. Semin Sppech Lang 2008;29:60-70.

[10] Mesulam MM. Primary progressive aphasia a 25-year retrospective. Alzheimer Dis Assoc Disord 2007;21:S8-S11.

[11] Mesulam MM. Primary progressive aphasia: a language-based dementia. N Engl J Med 2003;349:1535-1542.

[12] Mesulam MM. Primary progressive aphasia. Ann Neurol 2001;49:425-432.

[13] Murray LM. Longitudinal treatment of primary progressive aphasia: a case study. Aphasiology 1998;12:651-672.

[14] Weintraub S, Rubin NP, Mesulam MM. Primary progressive aphasia: longitudinal course, neuropsychological profile, and language features. Arch Neurol 1990;47:1329-1335

[15] Snowden JS, Neary D. Relearning of verbal labels in semantic dementia. Neuropsychologia 2002;40:1715-1728.

[16] Graham KS, Patterson K, Pratt KH, Hodges JR. Relearning and subsequent forgetting of semantic category exemplars in a cast of semantic dementia. Neuropsychology 1999;13:359-380.

[17] Graham KS, Patterson K, Pratt KH, Hodges JR. Can repeated exposure to "forgotten" vocabulary help alleviate word-finding difficulties in semantic dementia? An illustrative case study. Neuropsychol Rehabil 2001;11:429-454.

[18] Jokel R, Rochon E, Leonard C. Treating anomia in semantic dementia: improvement, maintenance, or both? Neuropsychol Rehabil 2006;16:241-256.

[19] Frattali C. An errorless learning approach to treating dysnomia in frontotemporal dementia. J Med Speech Lang Pathol 2004;12:11-24.

[20] Jokel R, Rochon E, Anderson ND. Errorless learning of computer-generated words in a patient with semantic dementia. Neuropsychol Rehabil 2010;20:16-41.

[21] Newhart M, Davis C, Kannan V, Heidler-Gary J, Cloutman L, Hillis AE. Therapy for naming deficits in two variants of primary progressive aphasia. Aphasiology 2009;23:823-834.

[22] Heredia CG, Sage K, Lambon-Ralph MA, Berthier ML. Relearning and retention of verbal labels in a case of semantic dementia. Aphasiology 2009;23:192-209.

[23] Robinson S, Druks J, Hodges JR, Garrard P. The treatment of object naming, definition and object use in semantic dementia: the effectiveness of errorless learning. Aphasiology 2009;23:749-775.

[24] Bier N, Macoir J, Gagnon L, Van der Linden M, Louveaux S, Desrosiers J. Known, lost, and recovered: Efficacy of formal-semantic therapy and spaced retrieval method in a case of semantic dementia. Aphasiology 2009;23:210-235.

[25] Senaha MLH, Caramelli P, Porto CS, Nitrini R. Semantic dementia Brazilian study of nineteen cases. Dement Neuropsychol 2007;1:366-373.

[26] Senaha MLH, Caramelli P, Porto CS, Nitrini R. Verbal and non-verbal semantic impairment: from fluent primary progressive aphasia to semantic dementia. Dement Neuropsychol 2007;1:203-211

[27] Clare L, Van Paasschen J, Evans SJ, Parkinson C, Woods RT, Linden DEJ. Goal-oriented cognitive rehabilitation for an individual with Mild Cognitive Impairment: Behavioural and neuroimaging outcomes. Neurocase 2009;15:318-331.

[28] Clare L, Jones RSP. Errorless learning in the rehabilitation of memory impairment: a critical review. Neuropsychol Review 2008;18:1-23.

[29] Clare L, Wilson BA, Carter G, Roth I, Hodges JR. Relearning of face-name associations in early Alzheimer's disease. Neuropsychology 2002;16:538-547.

[30] Nespoulous JL, Lecours AR, Lafond D, Parente MAMP. Protocole Montréal-Tolouse MT-86 d'examen linguistique de l'aphasie-version Beta. Laboratoire Théophile-Alajouanine, Montréal; 1986.

[31] Goodglass H, Kaplan E. The Assessment of Aphasia and Related Disorders. 2nd ed., Philadelphia, PA: Lea & Febiger; 1983.

[32] Parente MAMP, Hosogi ML, Delgado AP, Lecours AR. Protocolo de Leitura para o projeto H.F.S.P.;São Paulo; 1992.

[33] Kaplan E, Goodglass H, Weintraub S. The Boston Naming Test. Philadelphia: Lea & Febiger; 1983.

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