Primary Progressive Aphasia
Conditions
Brief summary
Primary progressive aphasia (PPA) is a clinical syndrome characterized by the neurodegeneration of language brain systems. Three main clinical variants are currently recorgnized (nonfluent, semantic, and logopenic PPA). Nowadays, there are no effective treatments for this disorder. Transcranial Magnetic Stimulation (TMS) is a technique based on the principle of electromagnetic induction of an electric field in the brain. It has been used as a non-invasive therapy in different disorders, such as depression, bipolar disorder, Parkinson's disease, and in the rehabilitation of post-stroke aphasia. Recent studies have shown how repetitive TMS improved language characteristics in Alzheimer's disease, and there are initial data in patients with PPA. This research project investigates the effect of repetitive TMS in patients with PPA. Investigators will perform a personalized TMS treatment for each patient (brain region, type of stimulation/inhibition, etc.), according to the specific characteristics of each patient and with the final aim to generate a computational model.
Interventions
DEVICETranscranial Magnetic Stimulation
Stimulation or inhibition using TMS will be delivered guided by a neuronavigator system in different brain regions.
Sponsors
Universidad Complutense de Madrid
Hospital San Carlos, Madrid
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
45 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Must be clinically diagnosed of PPA according to current diagnostic criteria (Gorno-Tempini et al. 2011) with PET-FDG confirmation. * Clinical Dementia Rating 0-1.
Exclusion criteria
* Contraindications for TMS or MRI * History of epilepsy * Pregnancy * Other language disorder previous to the diagnosis of PPA * Neuroimaging not suggestive of PPA
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in repetition | 2 months (at baseline and at the end of the treatment) | Non-words and sentence repetition task |
| Changes in spontaneous speech (main primary endpoint) | 2 months (at baseline and at the end of the treatment) | Picture and story description task |
| Changes in oral naming | 2 months | Object naming test |
| Changes in reading | 2 months | Story and words reading test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in brain metabolism | 2 months (at baseline and at the end of the treatment) | Brain metabolism measured using 18F-FDG-PET |
| Changes in clinical impression of change | 2 months (at baseline and at the end of the treatment) | Patient's clinical impression of change (from 0 to 10) |
| Changes in brain cortical electrical activity | 2 months (at baseline and at the end of the treatment) | Changes in the brain cortical electrical activity measured using quantitative electroencephalography (EEG) |
| Changes in global cognition | 2 months (at baseline and at the end of the study) | Addenbrooke's Cognitive Examination III |
Countries
Spain
Outcome results
None listed