Dementia is among the most daunting public health crises facing industrialized nations. Many countries, including the United States,1 have recently adopted comprehensive national dementia strategies.2 The US National Dementia Strategy (section 2B) has identified early diagnosis and links to community treatment services as pillars of its management plan. The availability of evidence-based outpatient treatment for progressive language impairments remains exceedingly sparse. In 2014, we began to address this void via a longitudinal intervention targeting maintenance of a core vocabulary consisting of 100 words over two years. This caregiver-friendly treatment is showing great promise for promoting the retention of key vocabulary in frontotemporal degeneration and Alzheimer's Disease. A secondary aim involved evaluating prediction of later language forgetting. We have learned much during this initial project period, and its renewal has the potential to tell us much more. Our current proposal consists of three aims, all of which directly align both with the US National Dementia Strategy and the mission of our funding institute (i.e., the National Institute on Deafness and Other Communication Disorders).3 In Specific Aim 1 (SA1), we will evaluate the long-term effectiveness of a regimen of noninvasive brain stimulation (transcranial direct current stimulation) delivered over the anterior temporal lobes as an adjuvant to our ongoing semantic behavioral treatment. We will do so using a crossover design where two groups of patients with semantic variant Primary Progressive Aphasia complete sham and active stimulation conditions paired with behavioral treatment (order counterbalanced). We will subsequently follow this patient cohort over two years to evaluate the durability of treatment gains. In SA2, we will evaluate predictors of emerging cognitive-linguistic impairment in a vastly underserved population (i.e., older African American adults). We will identify older adults who are at increased risk for conversion to mild cognitive impairment as indexed by global cognitive and language measures. We will then follow and characterize this prospective cohort using sensitive behavioral (gaze patterns during visual confrontation naming) and neuropsychological markers. Finally, in SA3 we will evaluate representation, processing, and shifts in abstract word meaning as functions of age, pathology, and individual differences (e.g., vocabulary size, years of education) using machine learning. This renewal reflects the continuation of a productive and rigorous line of research that will yield complementary data about human semantic memory, best practices in promoting language maintenance, and variability of age-associated language change.

Public Health Relevance

We will investigate the effectiveness of pairing non-invasive brain stimulation with an ongoing behavioral treatment targeting maintenance of a small functional vocabulary in patients with progressive naming disorders. In a secondary sequence of aims, we will evaluate processing of abstract words (e.g., love, truth) and prediction of evolving language impairment in a prospective cohort of lower-income, predominantly minority older adults with the aim of improving early detection of cognitive-linguistic decline.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Research Project (R01)
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Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Cooper, Judith
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Temple University
Public Health & Prev Medicine
Schools of Public Health
United States
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Binney, Richard J; Zuckerman, Bonnie M; Waller, Hilary N et al. (2018) Cathodal tDCS of the bilateral anterior temporal lobes facilitates semantically-driven verbal fluency. Neuropsychologia 111:62-71
Rycroft, Sarah Seligman; Giovannetti, Tania; Shipley, Thomas F et al. (2018) Windows to functional decline: Naturalistic eye movements in older and younger adults. Psychol Aging 33:1215-1222
Binney, Richard J; Ashaie, Sameer A; Zuckerman, Bonnie M et al. (2018) Frontotemporal stimulation modulates semantically-guided visual search during confrontation naming: A combined tDCS and eye tracking investigation. Brain Lang 180-182:14-23
Primativo, Silvia; Reilly, Jamie; Crutch, Sebastian J (2017) Abstract Conceptual Feature Ratings Predict Gaze Within Written Word Arrays: Evidence From a Visual Wor(l)d Paradigm. Cogn Sci 41:659-685
Troche, Joshua; Crutch, Sebastian J; Reilly, Jamie (2017) Defining a Conceptual Topography of Word Concreteness: Clustering Properties of Emotion, Sensation, and Magnitude among 750 English Words. Front Psychol 8:1787
Binney, Richard J; Zuckerman, Bonnie; Reilly, Jamie (2016) A Neuropsychological Perspective on Abstract Word Representation: From Theory to Treatment of Acquired Language Disorders. Curr Neurol Neurosci Rep 16:79
Cousins, Katheryn A Q; York, Collin; Bauer, Laura et al. (2016) Cognitive and anatomic double dissociation in the representation of concrete and abstract words in semantic variant and behavioral variant frontotemporal degeneration. Neuropsychologia 84:244-51
Reilly, Jamie; Peelle, Jonathan E; Garcia, Amanda et al. (2016) Linking somatic and symbolic representation in semantic memory: the dynamic multilevel reactivation framework. Psychon Bull Rev 23:1002-14
Reilly, Jamie; Garcia, Amanda; Binney, Richard J (2016) Does the sound of a barking dog activate its corresponding visual form? An fMRI investigation of modality-specific semantic access. Brain Lang 159:45-59
Reilly, Jamie (2016) How to constrain and maintain a lexicon for the treatment of progressive semantic naming deficits: Principles of item selection for formal semantic therapy. Neuropsychol Rehabil 26:126-56

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