Intensive training of phonological skills in progressive aphasia: A model of brain plasticity in neurodegenerative disease

Three patients with a typical syndrome of nonfluent primary progressive aph asia (Mesulam's syndrome) were trained daily with a remediation protocol in cluding auditory exercises specifically designed to involve several aspects of phonological processing, a domain known to be specifically affected in this condition. The speech content of the exercises was based on the tempor al theory of phonological processes according to which increasing the durat ion of formant transition should facilitate phoneme discrimination and phon emic awareness. Significantly improved performance on the trained tasks was demonstrated in the three patients. Improvement further generalized to oth er tasks such as nonword repetition and reading. We conclude that such resu lts (1) argue for using intensive focused therapy of language impairment in neurodegenerative disorders, (2) may constitute a good model of brain plas ticity in neurodegenerative disorders in general, and (3) support theories of phonological processing emphasizing temporal features of the auditory si gnal. (C) 2001 Academic Press.