Beschreibung
<p>Primary progressive aphasia (PPA) is a brain disorder that leads to severe impairment of lan-guage (for example, speaking or understanding words and sentences). There is currently no cure for PPA. However, scientists have found out that language therapy, tailored to the patients’ indi-vidual needs, can have positive effects on language and communication. In addition, language therapy may benefit personal well-being and participation in everyday life. Scientists also showed that it is possible to make the brain “more receptive” to language therapy, by combining language training with weak electric currents applied to the brain’s language areas using electrodes at-tached to the scalp. This so-called non-invasive electrical brain stimulation is a very safe proce-dure.<br>Unfortunately, the combination of language therapy and electrical brain stimulation is typically only available in specialized hospitals or research institutions and needs to be administered fin a massed fashion to be effective. For many patients, mobility restrictions and other barriers limit the access to such potentially effective treatment. To remove such barriers, the German Federal Ministry for Education and Research (BMBF) has previously provided us with funding to develop a combined language and brain stimulation therapy that patients can receive in their own homes.<br>In this first project, we first wanted to learn what is most important for patients and their caregivers with regard to treatment goals. To find out, our own group and colleagues from all over the world interviewed more than 200 patients with PPA and their caregivers. Improving “word-finding” and “interpersonal communication by any means” were the top priorities for treatment in PPA. These priorities overlap strongly with the focus of a treatment program that our group had previously developed for patients with aphasia after a stroke and which was highly effective in this popula-tion. Hence, this program is therefore well suited to be used as “blueprint” for the planned therapy in patients with PPA.<br>To be able to provide the therapy in the patients’ homes, we had to find and test a secure vide-oconferencing platform, through which a therapist can provide the language therapy. We also developed a special “cap” for the brain stimulation treatment, that makes it easy for patients to handle the positioning of the electrodes on the scalp.<br>In a second step, we asked patients with PPA and their caregivers to help us to make the therapy as relevant and accessible as possible. For example, we asked them how long the therapy should be and which content they would prefer. We also went to the patients’ homes and asked them to test the different aspects of the therapy and technology, and to provide us with suggestions to make it better in several rounds of feedback. In a final step, two patients and their caregivers volunteered to test the new treatment program (daily, for two weeks). Patients and caregivers reported that they enjoyed their participation in the therapy and that they found the use of the videoconferencing platform and brain stimulation technology easy and intuitive. Importantly, word-finding and communication ability were improved in language tests after the treatment period in both patients.<br>Based on these positive results, we believe that our program is now ready to be tested in larger group of patients. This is highly relevant, because we need to know more about how well a larger and more diverse group of patients with PPA and different degrees of disease severity can use the home-based therapy program, how much they benefit from the therapy and if brain stimulation can indeed enhance the effects of speech-language teletherapy. The outcome of this study will determine, if we can proceed to the next level of a clinical study, with testing in an even larger group of patients with PPA, to formally confim the efficacy of this new therapy. If successful, this combined therapy program will provide patients with PPA with a novel, effective and accessible treatment approach that is currently not available to them.</p>