1
BACKGROUND: Difficulties in word retrieval are early, prominent and debilitating symptoms for people with progressive aphasia (Mesulam, 2001). • word retrieval impairments can be improved with treatment in non-progressive aphasia but limited research with progressive aphasia • such research as there is suggests that word retrieval can be improved in progressive aphasia (Nickels & Croot, 2009). • BUT most research has investigated only the effects of treatment on picture naming, when, to have an impact on an individual’s quality of life, what is required is improved word retrieval in connected speech and conversation. AIM: to evaluate the effects of a standard treatment for word retrieval disorders in stroke aphasia with people with progressive aphasia. We will examine whether 1. A treatment that improves word retrieval in stroke aphasia can improve word retrieval in progressive aphasia. 2. The treatment will not only improve word retrieval in picture naming (the treated task), but also in connected speech. RESULTS Naming DESIGN Stimuli: Individually chosen words related to two personally relevant topics, generated through informal conversation with participant and a common conversational partner. Outcome measures: Three pretreatment baseline measures of... • Naming: Photographs collated of stimulus items for naming, and presented with definitions to assist recognition as required. • Word retrieval in connected speech: elicited using a semi- structured interview focusing on each topic, prompted by e.g. “Tell me about important people in your life” or “What kind of things do you enjoy doing?” Treatment: Half of the items in one topic were treated • Different depictions of the treated items • Repetition and reading in the presence of the picture. • Presented in PowerPoint. • 1x day for 10 days over 2 weeks CONCLUSIONS A relatively ‘quick and painless’ treatment (repetition and/or reading in the presence of a picture x 10) can improve word retrieval of functionally relevant vocabulary in most people with progressive aphasia, but there remains little evidence of carryover into connected speech. Food for thought: Is there a lack of generalisation to connected speech or are we just failing to measure it? What is the relevant measure of treatment success in a progressive disorder? (It may not be BETTER performance) Can retrieval of functionally relevant vocabulary be improved in progressive aphasia? Lyndsey Nickels 1 , Cathleen Taylor 2 , Karen Croot 3,1 , Stefanie Abel 1,4 , Leanne Ruggero 3 , Sharon Savage 5 and John R Hodges 5 1. Macquarie University, Sydney; 2. War Memorial Hospital, Waverley, Sydney; 3. University of Sydney; 4. University Hospital, Aachen; 5. University of New South Wales & Neuroscience Research Australia ...library PARTICIPANTS PPA as primary clinical diagnosis & word retrieval deficit on screening (Graded Naming Test GNT, McKenna & Warrington, 1983) sex age yrs p.o. Diagnosis GNT (n=30) BRM M 80 4 Nonfluent progressive aphasia 18 COH F 54 5 Logopenic progressive aphasia 5 ANP F 71 1 Nonfluent progressive aphasia 24 ALT M 68 1.5 Mixed presentation (FTD) 2 SOP F 72 2-3 Nonfluent progressive aphasia 2 TEG F 59 4 Logopenic progressive aphasia 4 STATISTICS: Wilcoxon Tests comparing rate of change: • pre- to post :1-sample, 1-tailed; • trained vs. untrained : 2-sample, 1-tailed) 5/6 show sig. better naming of different pictures of trained items 5/6 show sig. more positive change for trained than untrained. 1 shows some generalisation within topic (but not across topics). Connected Speech (target words in semi structured interview) Little generalisation to semi-structured interview (SOP? ANP?) Treated Untreated Pre1 Pre2 Post Pre1 Pre2 Post BRM 0 0 0 0 0 1 COH 0 0 0 2 2 2 ANP 7 10 10 10 9 10 ALT 0 2 2 4 1 1 SOP 1 2 5 2 3 2 TEG 2 2 2 3 1 2 But ANP’s untrained topic improved significantly! Pre1 =17; Pre2 =16; Post 1=35
