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Dementia & Neuropsychologia

Print version ISSN 1980-5764

Dement. neuropsychol. vol.7 no.1 São Paulo Jan./Mar. 2013

http://dx.doi.org/10.1590/S1980-57642013DN70100018 

ORIGINAL ARTICLES

Nonpharmacological interventions for cognitive impairments following primary progressive aphasia: A systematic review of the literature

Intervenções não-farmacológicas para distúrbios cognitivos na Afasia Progressiva Primária: uma revisão sistemática da literatura

Maria Teresa Carthery-Goulart1 

Amanda da Costa da Silveira2 

Thais Helena Machado3 

Leticia Lessa Mansur4 

Maria Alice de Mattos Pimenta Parente2 

Mirna Lie Hosogi Senaha5 

Sonia Maria Dozzi Brucki5 

Ricardo Nitrini5 

1Núcleo de Cognição e Sistemas Complexos e Centro de Matemática, Computação e Cognição da Universidade Federal do ABC, Santo André SP, Brazil. Grupo de Neurologia Cognitiva e do Comportamento, Departamento de Neurologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo SP, Brazil.

2Núcleo de Cognição e Sistemas Complexos e Centro de Matemática, Computação e Cognição da Universidade Federal do ABC, Santo André SP, Brazil.

3Grupo de Neurologia Cognitiva e do Comportamento da Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte MG, Brazil.

4Curso de Fonoaudiologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo SP, Brazil.

5Grupo de Neurologia Cognitiva e do Comportamento, Departamento de Neurologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo SP, Brazil.

ABSTRACT

This study provided a systematic review on nonpharmacological interventions applied to patients diagnosed with Primary Progressive Aphasia (PPA) and its variants: Semantic (SPPA), Nonfluent (NFPPA) and Logopenic (LPPA) to establish evidence-based recommendations for the clinical practice of cognitive rehabilitation for these patients.

Methods:

A PubMed and LILACS literature search with no time restriction was conducted with the keywords PPA (and its variants) AND rehabilitation OR training OR intervention OR therapy OR treatment OR effectiveness. To develop its evidence-based recommendations, a research committee identified questions to be addressed and determined the level of evidence for each study according to published criteria (Cicerone et al., 2000). Overall evidence for treatments was summarized and recommendations were derived.

Results:

Our search retrieved articles published from 1995 to 2013: 21 for SPPA, 8 for NFPPA, 3 for LPPA and 8 for PPA with no specification. Thirty-five studies were rated as Class III, consisting of studies with results obtained from one or more single-cases and that used appropriate single-subject methods with adequate quantification and analysis of results. The level of evidence of three functional interventions could not be established. One study was rated as Class II and consisted of a nonrandomized case-control investigation.

Conclusion:

Positive results were reported in all reviewed studies. However, in order to be recommended, some investigation regarding the intervention efficacy was required. Results of the present review allows for recommendation of some nonpharmacological interventions for cognitive deficits following PPA as Practice Options. Suggestions for further studies on PPA interventions and future research are discussed.

Key words: primary progressive aphasia; treatment; speech and language therapy; intervention; cognitive rehabilitation

RESUMO

Este estudo ofereceu uma revisão sistemática de intervenções não-farmacológicas aplicadas a pacientes com Afasia Progressiva Primária (APP) e suas variantes: Semântica (APPS), Não-fluente (APPNF) e Logopênica (APPL) com o objetivo de estabelecer recomendações baseadas em evidências para a prática clínica de reabilitação cognitiva para estes pacientes.

Métodos:

Conduziu-se busca por literatura, sem restrição de período, no PubMed e LILACS com as palavras-chave PPA (e variantes) AND rehabilitation OR training OR intervention OR therapy OR treatment OR effectiveness. Para desenvolver recomendações baseadas em evidências um comitê de pesquisadores identificou as questões relevantes para investigação e determinou o nível de evidência para cada estudo de acordo com critérios publicados (Cicerone et al., 2000). A evidência total para os tratamentos foi sumarizada e recomendações redigidas.

Resultados:

Foram encontrados artigos publicados de 1995 a 2013: 21 para APPS, 8 para APPNF, 3 para APPL e 8 para APP sem especificações. Trinta e cinco estudos foram classificados como Classe III, consistindo de resultados obtidos com um ou mais indivíduos e utilizando metodologia apropriada para estudo de casos. O nível de evidência de três intervenções funcionais não pôde ser estabelecido. Um estudo foi classificado como Classe II e consistiu de pesquisa caso-controle não-randomizada.

Conclusão:

Resultados positivos foram reportados em todos os trabalhos analisados mas, para serem recomendados, os tratamentos requerem investigação em relação a sua eficácia. Resultados da presente revisão permitiram recomendação de algumas intervenções como Opções Práticas. Ademais, apresentamos sugestões para futuros estudos de intervenção em APP.

Palavras-chave: afasia progressiva primária; terapia fonoaudiológica; tratamento; intervenção; reabilitação cognitiva

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

REFERENCES

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

Mesulam MM. Primary progressive aphasia. Ann Neurol2001;49: 425-432. [ Links ]

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

Gorno-Tempini ML, Dronkers NF, Rankin KP, et al. Cognition and anatomy in three variants of primary progressive aphasia. Ann Neurol2004; 55:335-346. [ Links ]

Gorno-Tempini ML, Hillis AE, Weintraub S. Classification of primary progressive aphasia and its variants. Neurology2011;76:1006-1014. [ Links ]

Croot K, Nickels L, Laurence F, Manning M. Impairment- and activity/participation-directed interventions in progressive language impairment: Clinical and theoretical issues. Aphasiology 2009;23:125-160. [ Links ]

American Speech-Language-Hearing Association - ASHA Scope of practice in Speech-Language pathology 2007; Available from http://www.asha.org/policy/SP2007-00283.htmLinks ]

Cicerone KD, Dahlberg C, Kalmar K, et al. Evidence-based Cognitive rehabilitation: Recommendations for Clinical Practice. Arch Phys Med Rehabil 2000;81:1596-1615. [ Links ]

World Health Organization- WHO. International Classification of Functioning, Disability and Health - ICF, 2001; Available from http://www.who.int/classifications/icf/en/ Links ]

McNeil MR, Small SL, Masterson RJ, Fossett TRD. Behavorial and pharmacological treatment of lexical-semantic deficits in a single patient with primary progressive aphasia. Am J Speech Lang Pathol 1995;4: 76-87. [ Links ]

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

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

Snowden JS, Neary D. Relearning of verbal labels in semantic dementia. Neuropsychology2002;40:1715-1728. [ Links ]

Bozeat S, Patterson K, Hodges J. Relearning object use in semantic dementia. Neuropsychol Rehabil2004;14:351-363. [ Links ]

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

Jokel R, Rochon E, Leonard C. Therapy for anomia in semantic dementia. Brain Cogn 2002;49:241-244. [ Links ]

Jokel R, Rochon E, Leonard C. Treating anomia in semantic dementia: improvement, maintenance, or both? Neuropsychol Rehabil2006;16: 241-256. [ Links ]

Bier N, Macoir J, Gagnon L, Linden MV, Louveaux S, Desrosiers J. Known, lost, and recovered: Efficacy of formal-semantic therapy and spaced retrieval method in a case of semantic dementia. Aphasiology2009;23:210-235. [ Links ]

Dewar BK, Patterson K, Wilson BA, Graham KS. Re-acquisition of person knowledge in semantic memory disorders. Neuropsychol Rehabil2008;19:383-421. [ Links ]

Heredia CG, Sage K, Ralph M, Berthier M. Relearning and retention of verbal labels in a case of semantic dementia. Aphasiology2009;23: 192-209. [ Links ]

Newhart M , Davis C , Kannan V, Heidler-Gary J, Cloutman L, Hillis AE. Therapy for naming deficits in two variants of primary progressive aphasia. Aphasiology2009;23:823-834. [ Links ]

Robinson S, Druks J, Hodges J, Garrard P. The treatment of object naming, definition, and object use in semantic dementia: The effectiveness of errorless learning. Aphasiology2008;23:749-775. [ Links ]

Dressel K, Huber W, Frings L, et al. Model-oriented naming therapy in semantic dementia: A single-case fMRI study. Aphasiology2010;24: 1537-1558. [ Links ]

Jokel R, Rochon E, Anderson ND. Errorless learning of computer-generated words in a patient with semantic dementia. Neuropsychol Rehabil2010;20:16-41. [ Links ]

Montagut N, Sánchez-Valle R, Castellví M, Rami L, Molinuevo JL. Reaprendizaje de vocabulario. Análisis comparativo entre un caso de demencia semántica y enfermedad de Alzheimer con afectación predominante del lenguaje. Rev Neurol 2010;50:152-156. [ Links ]

Senaha MLH, Brucki SMD, Nitrini R. Rehabilitation in semantic dementia: study of the effectiveness of lexical reacquisition in three patients. Dement Neuropsychol 2010;4:306-312. [ Links ]

Mayberry EJ, Sage K, Ehsan S, Ralph MAL. Relearning in semantic dementia reflects contributions from both medial temporal lobe episodic and degraded neocortical semantic systems: Evidence in support of the complementary learning systems theory. Neuropsychol 2011;49: 3591-3598. [ Links ]

Jokel R, Anderson ND. Quest for the best: Effects of errorless and active encoding on word re-learning in semantic dementia. Neuropsychol Rehabil2012;22:187-214. [ Links ]

Savage SA, Ballard KJ, Piguet O, Hodges JR. Bringing words back to mind - Improving word production in semantic dementia. Cortex 2012; http://dx.doi.org/10.1016/j.cortex.2012.09.014Links ]

Wong SBC, Anand R, Chapman SB, et al. When nouns and verbs degrade: Facilitating communication in semantic dementia. Aphasiology2009;23:286-301. [ Links ]

Bier N, Macoir J, Joubert S, et al. Cooking "Shrimp à la Créole": A pilot study of an ecological rehabilitation in semantic dementia. Neuropsychol Rehabil2011;21:455-483. [ Links ]

Schneider SL, Thompson CK, Luring B. Effects of verbal plus gestural matrix training on sentence production in a patient with primary progressive afasia. Aphasiology1996;10:297-317. [ Links ]

Louis M, Espesser R, Rey V, et al. Intensive training of phonological skills in progressive aphasia: a model of brain plasticity in neurodegenerative disease. Brain Cogn2001;:197-201. [ Links ]

Jokel R, Cupit J, Rochon E, Leonard C. Re-learning lost vocabulary in nonfluent progressive aphasia with MossTalk Words(r). Aphasiology2009;23:175-191. [ Links ]

Marcotte K, Ansaldo AI. The neural correlates of semantic feature analysis in chronic aphasia: discordant patterns according to the etiology. Semin Speech Lang 2010;31:52-63. [ Links ]

Henry ML, Meese MV, Truong S, et al. Treatment for apraxia of speech in nonfluent variant primary progressive aphasia. Behav Neurol 2013;26: 77-88. [ Links ]

Murray LL. Longitudinal treatment of primary progressive aphaisa: a case study. Aphasiology1998;12:651-672. [ Links ]

Rogers MA, Alarcon NB. Dissolution of spoken language in primary progressive aphasia. Aphasiology1998;12:635-650. [ Links ]

Pattee C, Von Berg S, Ghezzi P. Effects on alternative communication on the communicative effectiveness of an individual with a progressive language disorder. Int J Rehabil Res 2006;29:151-153. [ Links ]

Beeson PM, King RM, Bonakdarpour B, et al. Positive effects of language treatment for the logopenic variant of primary progressive aphasia. J Mol Neurosci 2011;45:724-736. [ Links ]

Tsapkini K, Hillis AE. Spelling intervention in post-stroke aphasia and primary progressive aphasia. Behav Neurol2013;26:55-66. [ Links ]

Finocchiaro C, Maimone M, Brighina F, et al. A case study of primary progressive aphasia: improvement on verbs after rTMS treatment. Neurocase 2006;12:317-321. [ Links ]

Henry ML, Beeson PM, Rapcsak SZ. Treatment for lexical retrieval in progressive aphasia. Aphasiology2008;22:826-838. [ Links ]

Rapp B, Glucroft B. The benefits and protective effects of behavioural treatment for dysgraphia in a case of primary progressive afasia. Aphasiology2009;23:236-265. [ Links ]

Snowden JS, Kindell J, Thompson JC, et al. Progressive aphasia presenting with deep dyslexia and dysgraphia. Cortex2012;48:1234-1239. [ Links ]

Cress CJ, King JM. AAC strategies for people with primary progressive aphasia without dementia: two case study. AAC Augment Alternat Commun 1999;15:248-259. [ Links ]

Cartwright J, Elliott KAE. Promoting strategic television viewing in the context of progressive language impairment. Aphasiology2009;23: 266-285. [ Links ]

Farrajota L, Maruta C, Maroco J, et al. Speech therapy in primary progressive aphasia: a pilot study. Dement Geriatr Cogn Disord Extra 2012; 2:321-331. [ Links ]

Carthery-Goulart MT, Knibb JA, et al. Semantic dementia versus nonfluent progressive aphasia. Alz Dis Assoc Disord 2012;26:36-43. [ Links ]

Ladavass E, Paolucci S, Umiltà C. Reasons for holding a Consensus Conference on neuropsychological rehabilitation in adult patients. Eur J Phys Rehabil Med 2011;47:91-99. [ Links ]

Basso A, Cattaneo S, Girelli L, et al. Treatment efficacy of language and calculation disorders and speech apraxia: a review of the literature. Eur J Phys Rehabil Med2011; 47:101-121. [ Links ]

Received: November 07, 2012; Accepted: January 12, 2013

Maria Teresa Carthery-Goulart. Universidade Federal do ABC - Rua Santa Adelia, 166 / Bloco A / Torre II / sala 516 - 09210-170 Santo André SP - Brazil. E-mail: carthery@uol.com.br

Disclosure: The authors report no conflicts of interest.

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