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.
Who can participate
Inclusion Criteria:
* Meets diagnostic criteria for primary progressive aphasia (PPA)
* Meets diagnostic criteria for logopenic variant PPA
* Attains score of 20 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 20 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
Interventions
Lexical Retrieval Cascade Treatment
BEHAVIORAL
Remotely Supervised Transcranial Direct Current Stimulation- Active
DEVICE
Remotely Supervised Transcranial Direct Current Stimulation - Sham