Remotely-supervised Neuromodulation in PPA

Summary

The goal of this clinical trial is to learn whether home-based brain stimulation combined with virtual speech-language therapy can improve communication abilities in adults with logopenic variant primary progressive aphasia (lvPPA), a language disorder most often caused by Alzheimer's disease. The main questions the study aims to answer are: * Is combining remotely supervised transcranial direct current stimulation (tDCS) with virtual speech-language therapy feasible and acceptable for people with lvPPA? * Does this combined treatment lead to improvements in communication compared to speech-language therapy with sham (placebo) stimulation? * Do individual brain characteristics help predict who benefits most from this treatment? Researchers will compare participants who receive active tDCS plus virtual speech-language therapy to participants who receive sham (placebo) tDCS plus virtual speech-language therapy to see if active brain stimulation enhances communication outcomes. Participants will: * Complete speech-language therapy sessions delivered by video visit. * Receive either active or sham tDCS that is remotely supervised and completed at home. * Complete language and cognitive testing before and after treatment. * Undergo brain imaging and other assessments to help understand treatment response.

Interventions

• Lexical Retrieval Cascade Treatment · BEHAVIORAL

  Participants work on producing spoken and written names of personally-relevant target items. Treatment focuses on the use of strategies that capitalize on spared cognitive-linguistic abilities to support word retrieval. The participant completes two (one hour each) teletherapy sessions per week with a clinician plus 30 minutes of additional independent, computer-based practice exercises 3 times per week.

• Remotely Supervised Transcranial Direct Current Stimulation- Active · DEVICE

  tDCS is a type of non-invasive brain stimulation. 2.0 milliamp (mA) of current will be delivered via electrodes in saline-soaked sponges placed on the left and right sides of the head. The stimulation will last 20 minutes and will occur 5 times weekly, in the participant's home setting, while the participant engages in computer-delivered speech-language training. Sessions are monitored by study personnel.

• Remotely Supervised Transcranial Direct Current Stimulation - Sham · DEVICE

  tDCS is a type of non-invasive brain stimulation. 2.0 milliamp (mA) of current will be delivered via electrodes in saline-soaked sponges placed on the left and right sides of the head. In sham stimulation, current will be delivered for a brief period of time and then turned off. Sham stimulation will last 20 minutes and will occur 5 times weekly, in the participant's home setting, while the participant engages in computer-delivered speech-language training. Sessions are monitored by study personnel.

Published eligibility criteria

Verbatim from the registry. Only the site can decide how these apply to a specific patient.

Inclusion Criteria:

* Meets diagnostic criteria for primary progressive aphasia (PPA)
* Meets diagnostic criteria for logopenic variant PPA
* Attains score of 15 or higher on the Mini-Mental State Examination
* Has adequate hearing and vision (with hearing or vision aids, if needed)
* Is able to travel to research site and undergo MRI brain scan
* Has access to high speed internet and basic experience using a computer and the internet
* Is a fluent speaker of English
* Has a study partner who can co-enroll in the study, attend pre-treatment training at the research site, and be present for teleconference meetings, as needed

Exclusion Criteria:

* Speech and language deficits better accounted for by another neurological disorder
* Does not meet diagnostic criteria for logopenic variant PPA
* Scores less than 15 on the Mini-Mental State Examination
* Does not have a study partner who can co-enroll in the study
* Has contraindications for tDCS or MRI scan (History of seizures, head injury, craniotomy, skull surgery or fracture; History of severe or frequent migraines; Metallic implant in head or any metal in head; Pacemaker or cardioverter-defibrillator or any other stimulator; Chronic skin problems; Pregnancy)
* Has a history of stroke, epilepsy, or significant brain injury

Sites (2)

• UCSF Memory and Aging Cener, San Francisco, California · RECRUITING
• University of Texas, Austin, Texas · RECRUITING