Week 11

Question 1

how many variants of PPA

Answer 1

3

Question 2

what are the variants of PPA

Answer 2

1) Nonfluent/agrammatic - nfvPPA
2) Fluent (semantic) - svPPA
3) Logopenic - lvPPA

Question 3

What is PCA (Posterior Cortical Atrophy)

Answer 3

dementia that begins from visual symptoms

Question 4

PPA variant can be diagnosed only after the following are established:

(4 required + 3 must nots)

Answer 4

1) insidious onset, gradual progression
2) language impairment is most salient feature
3) language difficulty is cause of impaired ADLs
4) aphasia is the most prominent feature at onset

But must not:
- must not be better explained by neurodegen, psych, medical disorders
- must not have initial impairments in episodic & visual memory, or visuo-perceptual impairments
- must not have prominent initial behavioural disturbances

Question 5

which two variants of PPA are types of fronto-temporal dementia?

Answer 5

fluent and non-fluent variants

Question 6

where is the nonfluent/agrammatic variant lesion?

Answer 6

unilateral, inferior frontal part of dominant hemisphere

Question 7

cause of nonfluent/agrammatic variant?

Answer 7

sporadic, familial, or hereditary

Question 8

characteristics of nonfluent/agrammatic variant?

Answer 8

at least one: agrammatism or AOS
at least two: impaired complex syntax, spared comprehension of single words, spared object knowledge

Question 9

t or f: nonfluent/agrammatic variant is similar to Wernicke’s

Answer 9

false; similar to Broca’s

Question 10

t or f: people with nonfluent/agrammatic variant have spared semantic knowledge

Answer 10

true

Question 11

explain the cause for errors in the semantic (fluent) variant? (think processing models)

Answer 11

phonology needs to meet semantics but it cannot meet the semantic network; there is an access problem

Question 12

where is the semantic (fluent) variant lesion?

Answer 12

anterior temporal lobe bilaterally
right hemisphere houses understanding & recognition
left hemisphere usually has worse damage

Question 13

characteristics of semantic (fluent) variant?

Answer 13

both: impaired confrontation naming and comprehension of single words
at least 3: impaired object knowledge, surface dyslexia or dysgraphia, spared repetition, spared syntax and motor speech

Question 14

describe the loss of semantic features in the semantic (fluent) variant in a picture drawing task

Answer 14

animals might be missing characteristic components (4 legs, wings, beak)

Question 15

what is the most salient feature of logopenic variant?

Answer 15

anomia

Question 16

where is the logopenic variant lesion?

Answer 16

(L) unilateral posterior temporal region, inferior parietal lobule

Question 17

the lesion of the logopenic variant is similar to that of ________

Answer 17

Alzheimer’s disease

Question 18

characteristics of logopenic variant?

Answer 18

both: impaired single word retrieval (naming & convo), impaired repetition of sentences
at least 3: phonological errors on naming and in convo, spared single-word comprehension and obj knowledge, spared motor speech, absence of agrammatism

Question 19

how to differ logopenic variant from nonfluent/agrammatic variant?

Answer 19

motor speech
spared in logopenic
impaired in nonfluent/agrammatic

Question 20

what is the hardest linguistic component for each variant?

Answer 20

logopenic: working memory
nonfluent/agrammatic: phonology & syntax
semantic (fluent): semantics

Question 21

what is the mini linguistics state examination (MLSE)?

Answer 21

an ax tool that focuses acutely on language domains to help clinicians assess and classify primary progressive aphasia

Question 22

PPA that has progressed is called _____

Answer 22

PPA+

Question 23

compare early stages nonfluent/agrammatic PPA to late stages

Answer 23

early: grammar or motor speech deficit
late: problems with executive function, swallowing, motor function, other diseases

Question 24

compare early stages semantic (fluent) PPA to late stages

Answer 24

early: single word comprehension deficit
late: change in behaviour/personality & deficits in recognizing faces and objects

Question 25

compare early stages logopenic PPA to late stages

Answer 25

early: word-finding and oral repetition difficulties late: problems with WM and/or general memory, possible DAT

Question 26

language intervention approaches for PPA

Answer 26

lexical retrieval (phonemic/semantic feature analysis, spaced retreival, errorless learning) work on syntax (mapping therapy) --> for nonfluent PPA

Question 27

speech intervention approaches for PPA

Answer 27

Apraxia therapy/fluency: script training --> nfPPA

Question 28

group intervention approaches for PPA

Answer 28

Baycrest hybrid model: individual tx + group + caregiver support + counselling + education Aphasia Institute: supported conversation

Question 29

adjuvant therapies

Answer 29

using additional treatments alongside SLP tx to improve outcomes for PPA e.g., tDCS (transcranial direct current stimulation) + lexical retrieval

Question 30

computerized approaches for PPA

Answer 30

Internet-based programs (wordfinding.ca) Apps (TACTUS, Constant Therapy. Etc)

Question 31

t or f: people w PPA can relearn?

Answer 31

true

Question 32

Reginas research on picture naming tx for PPA showed (3):

Answer 32

1) improvement after tx 2) effects maintained 6 months later 3) slower forgetting of treated words

Question 33

factors affecting success in therapy:

Answer 33

1) Personal familiarity with items 2) Organizing words in semantic categories is more helpful than alphabetical 3) Partially spared semantic knowledge facilitates re-learning

Question 34

how does errorless learning work on computer software?

Answer 34

have client name object only if they are 100% certain with the response. if uncertain, they are prompted to listen to a description, then read the written word

Question 35

t or f: repeating words improves the synergy of repeating that word

Answer 35

true

Question 36

t or f: patients w dementia aren't good candidates for computer training programs

Answer 36

false

Question 37

t or f: computer approaches showed improvement up to 3 months post training

Answer 37

true

Question 38

t or f: errorless re-learning of words helped with all naming retention immediately post-tx

Answer 38

false; only with treated words

Question 39

errorful v errorless learning

Answer 39

Errorful learning involves making and correcting mistakes, while errorless learning aims to prevent mistakes from the start in errorless learning, the client should only name the item if 100% sure

Question 40

effortless v effortful learning

Answer 40

effortless: passive effortful: active

Question 41

effortful errorful learning cues

Answer 41

asking open-ended questions, asking them to repeat the obj name

Question 42

effortful errorless learning cues

Answer 42

asking y/n questions where the answer is always yes, asking them to repeat the obj name

Question 43

effortless errorful learning cues

Answer 43

describing what the object is *not*, asking them to repeat the obj name (not a giraffe, does not start with l)

Question 44

effortless errorless learning cues

Answer 44

describing the object, asking them to repeat the obj name

Question 45

rank the most helpful to least helpful types of learning

Answer 45

errorless active, errorless passive, errorful active, errorful passive

Question 46

t or f: semantic judgement tasks can increase brain activation post-treatment

Answer 46

true; other areas of the brain are compensating for the lost skill

Question 47

t or f: types of effortful/effortless errorful/errorless learning cues have a positive effect on word comprehension

Answer 47

false; no effect

Question 48

why is language tx beneficial in PPA?

Answer 48

- post-tx improvement - focused activity (active) - could relearn words for daily functioning - could generalize to different items/contexts - could maintain gains with practice - neuroplasticity - to prolong the ability to use words/speak as long as possible - to improve QoL

Question 49

Goals of PPA group intervention

Answer 49

1) education on PPA 2) communication opportunities for people with PPA 3) teach communication strategies 4) discuss ideas, practicing strategies, sharing experiences

Question 50

Structure of group intervention for PPA

Answer 50

10 weeks 2 hour sessions: - first hour: work together on language while spouses mingle with SLP, SW - second hour: spouses join group members for educational sessions or communication strategy sessions