Remotely-supervised Neuromodulation in PPA

Investigating the Benefits of Remotely-Supervised Neuromodulation In Primary Progressive Aphasia

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.

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