Alrasheed Abdulrahim Saleh, Alshamrani Reem Ali, Al Ameer Abdullah Ali, Alkahtani Reham Mohammed, AlMohish Noor Mohammad, AlQarni Mustafa Ahmed, Alabdali Majed Mohammad
Department of Neurosurgery, College of Medicine, King Faisal University, AlAhsa 31982, Saudi Arabia.
College of Medicine, Taif University, Taif 21944, Saudi Arabia.
J Clin Med. 2025 Apr 29;14(9):3063. doi: 10.3390/jcm14093063.
: Primary progressive aphasia (PPA) is a neurodegenerative disorder that worsens over time without appropriate treatment. Although referral to a speech and language pathologist is essential for diagnosing language deficits and developing effective treatment plans, there is no scientific consensus regarding the most effective treatment. Thus, our study aims to assess the efficacy and safety of various therapeutic interventions for PPA. : Google Scholar, PubMed, Web of Science, and the Cochrane Library databases were systematically searched to identify articles assessing different therapeutic interventions for PPA. To ensure comprehensive coverage, the search strategy employed specific medical subject headings. The primary outcome measure was language gain; the secondary outcome assessed overall therapeutic effects. Data on study characteristics, patient demographics, PPA subtypes, therapeutic modalities, and treatment patterns were collected. : Fifty-seven studies with 655 patients were included. For naming and word finding, errorless learning therapy, lexical retrieval cascade (LRC), semantic feature training, smartphone-based cognitive therapy, picture-naming therapy, and repetitive transcranial magnetic stimulation (rTMS) maintained effects for up to six months. Repetitive rTMS, video-implemented script training for aphasia (VISTA), and structured oral reading therapy improved speech fluency. Sole transcranial treatments enhanced auditory verbal comprehension, whereas transcranial direct current stimulation (tDCS) combined with language or cognitive therapy improved repetition abilities. Phonological and orthographic treatments improved reading accuracy across PPA subtypes. tDCS combined with speech therapy enhanced mini-mental state examination (MMSE) scores and cognitive function. Several therapies, including smartphone-based cognitive therapy and VISTA therapy, demonstrated sustained language improvements over six months. : Various therapeutic interventions offer potential benefits for individuals with PPA. However, due to the heterogeneity in study designs, administration methods, small sample sizes, and lack of standardized measurement methods, drawing a firm conclusion is difficult. Further studies are warranted to establish evidence-based treatment protocols.
原发性进行性失语（PPA）是一种神经退行性疾病，若不进行适当治疗，病情会随时间恶化。尽管转诊至言语治疗师对于诊断语言缺陷和制定有效的治疗方案至关重要，但对于最有效的治疗方法尚无科学共识。因此，我们的研究旨在评估针对PPA的各种治疗干预措施的疗效和安全性。
系统检索了谷歌学术、PubMed、科学网和考科蓝图书馆数据库，以识别评估针对PPA的不同治疗干预措施的文章。为确保全面覆盖，检索策略采用了特定的医学主题词。主要结局指标是语言能力提升；次要结局评估总体治疗效果。收集了关于研究特征、患者人口统计学、PPA亚型、治疗方式和治疗模式的数据。
纳入了57项研究，共655名患者。对于命名和找词，无错误学习疗法、词汇检索级联（LRC）、语义特征训练、基于智能手机的认知疗法、图片命名疗法和重复经颅磁刺激（rTMS）的效果可持续长达六个月。重复rTMS、失语症视频实施脚本训练（VISTA）和结构化口语阅读疗法改善了言语流畅性。单纯的经颅治疗增强了听觉言语理解，而经颅直流电刺激（tDCS）与语言或认知疗法相结合提高了复述能力。语音和正字法治疗提高了PPA各亚型的阅读准确性。tDCS与言语治疗相结合提高了简易精神状态检查表（MMSE）评分和认知功能。包括基于智能手机的认知疗法和VISTA疗法在内的几种疗法在六个月内持续改善了语言能力。
各种治疗干预措施对PPA患者具有潜在益处。然而，由于研究设计、给药方法、样本量小以及缺乏标准化测量方法的异质性，难以得出确凿结论。有必要进行进一步研究以建立基于证据的治疗方案。
