Dementia Care Research and Psychosocial Factors

Area of Science:

• Neuromodulation
• Neuroscience
• Speech-Language Pathology

Background:

• Transcranial direct current stimulation (tDCS) shows promise for primary progressive aphasia (PPA) but faces accessibility barriers.
• Existing research on tDCS for PPA primarily focuses on naming deficits, with limited investigation into nonfluent/agrammatic PPA (nfvPPA).
• A novel trial protocol was developed to deliver remotely supervised tDCS (RS-tDCS) alongside tele-rehabilitation for all PPA variants.

Purpose of the Study:

• To pilot a trial protocol for remotely supervised tDCS (RS-tDCS) combined with speech-language tele-rehabilitation for primary progressive aphasia (PPA).
• To assess the feasibility and acceptability of RS-tDCS for individuals with PPA, particularly those in remote areas or with limited mobility.
• To explore the efficacy of RS-tDCS as an adjunct to speech-language treatments for different variants of PPA (logopenic, semantic, and nonfluent/agrammatic).

Main Methods:

• A sham-controlled, double-blind crossover design was used with nine participants.
• Participants received either lexical retrieval treatment (LRT) or video-implemented script training for aphasia (VISTA) combined with active or sham RS-tDCS.
• Electrode placement varied based on PPA variant, targeting specific brain regions (e.g., left inferior frontal gyrus, temporoparietal cortex).

Main Results:

• The RS-tDCS trial protocol was feasible and acceptable for all participants.
• Primary outcome measures indicated a robust response to treatment for most participants.
• Effectiveness of active versus sham stimulation varied individually, suggesting personalized responses.

Conclusions:

• Remotely delivered tDCS (RS-tDCS) is a promising, accessible method for neuromodulation in individuals with PPA.
• The feasibility and acceptability of RS-tDCS support its potential for wider clinical application.
• Further research is necessary to elucidate individual response patterns to active and sham stimulation.