INS NYC 2024 Program

Poster	Poster Session 04 Program Schedule 02/15/2024 12:00 pm - 01:15 pm Room: Majestic Complex (Posters 61-120) Poster Session 04: Neuroimaging \| Neurostimulation/Neuromodulation \| Teleneuropsychology/Technology Final Abstract #72 Home-Based Transcranial Direct Current Stimulation (tDCS) Paired with Personalized Word Retrieval Intervention Improves Naming in Primary Progressive Aphasia (PPA) Eric McConathey, Department of Neurology, NYU Grossman School of Medicine, New York City, United States Amy Vogel-Eyny, Rusk Rehabilitation, NYU Langone Health, New York City, United States Allan George, Department of Neurology, NYU Grossman School of Medicine, New York City, United States Elizabeth Galletta, Rusk Rehabilitation, NYU Langone Health, New York City, United States Giuseppina Pilloni, Department of Neurology, NYU Grossman School of Medicine, New York City, United States Leigh Charvet, Department of Neurology, NYU Grossman School of Medicine, New York City, United States Category: Neurostimulation/Neuromodulation Keyword 1: aphasia Keyword 2: neuromodulation Keyword 3: neurostimulation Objective: Primary progressive aphasia (PPA) is a neurocognitive disorder defined by initial and progressive deterioration of language function¹. While PPA remains without cure, speech and language therapy (SLT) is a common management approach to support communication abilities. Transcranial direct current stimulation (tDCS), a noninvasive brain stimulation technique, can be paired with rehabilitative training (e.g., cognitive, motor, speech and language) to augment its outcomes. Initial studies of tDCS paired with SLT in PPA have shown promise with montages directing electrical current to the left inferior frontal gyrus (L-IFG)². Using our home-based remotely supervised (RS)-tDCS protocol³, we tested a 20-session intervention of L-IFG tDCS paired with personalized word retrieval training in an open-label cohort of patients with PPA. Participants and Methods: We recruited participants nationally and enrolled n=10 individuals (M_age = 70, SD_age= 6.90; 60% male) with confirmed logopenic variant (lvPPA; n=2), semantic variant (svPPA; n=2), or unspecified (n=6) with prominent word-finding difficulties to complete a home-based intervention administered using video visits (Zoom). The stimulation was delivered by a 1x1 tDCS mini-CT (Soterix Medical Inc., USA) at 2.0 mA for 30 minutes with the anode placed over the left IFG (F7) and the cathode over the left occipital area (O1). Participants completed a remotely administered battery of cognitive and language tests at baseline and intervention end. The intervention consisted of 20x 45-minute sessions (5x week) of personalized word retrieval training paired with tDCS for the initial 30 minutes. For word training, 60 familiar targets (objects and actions) were selected from a larger stimulus set⁴, and assigned to trained and untrained sets (30 in each). Items were then trained using a cueing hierarchy outlined by Henry and colleagues⁵. Results: All n=10 participants completed the Quick Aphasia Battery (QAB), Boston Naming Test-Short Form (BNT-Short), Controlled Oral Word Association Test (COWAT; FAS), and Semantic fluency (Animals). The successful completion of the protocol for all 10 participants confirms the feasibility of the home-based tDCS and word training intervention. At intervention end, the group was able to correctly name significantly more trained items (M = 25.10, SD = 4.33) vs. untrained items (M = 20.20, SD = 7.45; t (9) = 4.03, p = .003). From baseline (M = 6.20, SD = 5.55) to intervention end (M = 7.80, SD = 5.18), the group significantly improved in naming (BNT-Short); t (9) = -2.95, p = .016. No measure showed clinically significant⁶ decline over the course of the intervention at either the group or individual level, indicating stability or improvement across all participants. Conclusions: A remotely delivered 20-session intervention using F7-O1 tDCS+personalized word retrieval SLT was feasible for people living with PPA. Language outcomes were notable for maintained expressive language at the group and individual level. Word retrieval was significantly better for trained items and confrontation naming. Home-based tDCS with telerehabilitation has potential as a prophylactic approach to offsetting lexical retrieval decline in PPA. This study can inform the design of future sham-controlled randomized clinical trials using our (RS)-tDCS protocol for home-based intervention.

Poster

02/15/2024
12:00 pm - 01:15 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 04: Neuroimaging | Neurostimulation/Neuromodulation | Teleneuropsychology/Technology

Final Abstract #72

Home-Based Transcranial Direct Current Stimulation (tDCS) Paired with Personalized Word Retrieval Intervention Improves Naming in Primary Progressive Aphasia (PPA)

Eric McConathey, Department of Neurology, NYU Grossman School of Medicine, New York City, United States
Amy Vogel-Eyny, Rusk Rehabilitation, NYU Langone Health, New York City, United States
Allan George, Department of Neurology, NYU Grossman School of Medicine, New York City, United States
Elizabeth Galletta, Rusk Rehabilitation, NYU Langone Health, New York City, United States
Giuseppina Pilloni, Department of Neurology, NYU Grossman School of Medicine, New York City, United States
Leigh Charvet, Department of Neurology, NYU Grossman School of Medicine, New York City, United States

Category: Neurostimulation/Neuromodulation

Keyword 1: aphasia
Keyword 2: neuromodulation
Keyword 3: neurostimulation

Objective:

Primary progressive aphasia (PPA) is a neurocognitive disorder defined by initial and progressive deterioration of language function¹. While PPA remains without cure, speech and language therapy (SLT) is a common management approach to support communication abilities. Transcranial direct current stimulation (tDCS), a noninvasive brain stimulation technique, can be paired with rehabilitative training (e.g., cognitive, motor, speech and language) to augment its outcomes. Initial studies of tDCS paired with SLT in PPA have shown promise with montages directing electrical current to the left inferior frontal gyrus (L-IFG)². Using our home-based remotely supervised (RS)-tDCS protocol³, we tested a 20-session intervention of L-IFG tDCS paired with personalized word retrieval training in an open-label cohort of patients with PPA.

Participants and Methods:

We recruited participants nationally and enrolled n=10 individuals (M_age = 70, SD_age= 6.90; 60% male) with confirmed logopenic variant (lvPPA; n=2), semantic variant (svPPA; n=2), or unspecified (n=6) with prominent word-finding difficulties to complete a home-based intervention administered using video visits (Zoom). The stimulation was delivered by a 1x1 tDCS mini-CT (Soterix Medical Inc., USA) at 2.0 mA for 30 minutes with the anode placed over the left IFG (F7) and the cathode over the left occipital area (O1). Participants completed a remotely administered battery of cognitive and language tests at baseline and intervention end. The intervention consisted of 20x 45-minute sessions (5x week) of personalized word retrieval training paired with tDCS for the initial 30 minutes. For word training, 60 familiar targets (objects and actions) were selected from a larger stimulus set⁴, and assigned to trained and untrained sets (30 in each). Items were then trained using a cueing hierarchy outlined by Henry and colleagues⁵.

Results:

All n=10 participants completed the Quick Aphasia Battery (QAB), Boston Naming Test-Short Form (BNT-Short), Controlled Oral Word Association Test (COWAT; FAS), and Semantic fluency (Animals). The successful completion of the protocol for all 10 participants confirms the feasibility of the home-based tDCS and word training intervention. At intervention end, the group was able to correctly name significantly more trained items (M = 25.10, SD = 4.33) vs. untrained items (M = 20.20, SD = 7.45; t (9) = 4.03, p = .003). From baseline (M = 6.20, SD = 5.55) to intervention end (M = 7.80, SD = 5.18), the group significantly improved in naming (BNT-Short); t (9) = -2.95, p = .016. No measure showed clinically significant⁶ decline over the course of the intervention at either the group or individual level, indicating stability or improvement across all participants.

Conclusions:

A remotely delivered 20-session intervention using F7-O1 tDCS+personalized word retrieval SLT was feasible for people living with PPA. Language outcomes were notable for maintained expressive language at the group and individual level. Word retrieval was significantly better for trained items and confrontation naming. Home-based tDCS with telerehabilitation has potential as a prophylactic approach to offsetting lexical retrieval decline in PPA. This study can inform the design of future sham-controlled randomized clinical trials using our (RS)-tDCS protocol for home-based intervention.