Dementia Care Research and Psychosocial Factors

Area of Science:

• Neuroscience
• Neurology
• Clinical Medicine

Background:

• Primary progressive aphasia (PPA) is a neurodegenerative disorder causing progressive language decline with no current effective treatments.
• Non-invasive brain stimulation techniques like transcranial magnetic stimulation (TMS) show potential for symptom improvement, but long-term efficacy in PPA remains unestablished.

Purpose of the Study:

• To evaluate the 6-month efficacy of TMS combined with language therapy in patients with PPA.
• To assess the impact on regional brain metabolism and various language and functional outcomes.

Main Methods:

• A 6-month, double-blinded, randomized clinical trial involving 63 PPA patients.
• Intermittent theta-burst stimulation (iTBS) over the left dorsolateral prefrontal cortex (DLPFC) followed by Lexical Retrieval Cascade Treatment.
• Primary outcome: change in FDG-PET SUV; Secondary outcomes: language tests, functional independence, and neuropsychiatric symptoms.

Main Results:

• Active TMS group demonstrated significant benefits in the primary outcome (reduced decline in regional brain metabolism) compared to the sham group at 6 months.
• Secondary outcomes showed improvements in language abilities, functional independence, and neuropsychiatric symptoms with active TMS.
• High adherence (92%) was observed, with no significant difference in spontaneous speech rate improvement.

Conclusions:

• Six months of iTBS combined with language therapy is associated with reduced decline in brain metabolism in PPA patients.
• The combined treatment improved language performance, functional independence, and neuropsychiatric symptoms.
• This approach presents a potential therapeutic strategy for managing PPA.