The Effect of Language Interventions and Non-Invasive Brain Stimulation on Naming Deficits and Other Cognitive Skills in Patients with Alzheimer's Disease: A Scoping Review

Document Type : Scoping Review

Authors
Leila Ghasisin 1
Seyed Amin Modarres Zadeh 2
Neda Farhadi 3
1 Assistant Professor, Department of Speech Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
2 PhD, Department of Speech Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
3 MSc, Department of Speech Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
10.48305/jrrs.2026.46168.1136
Abstract
Introduction: Alzheimer's disease (AD) is a progressive clinical syndrome characterized by the deterioration of higher mental functions, including memory, language, executive function, and attention. Among language impairments, naming deficits (anomia) are particularly prominent. While various studies have investigated treatments for these deficits, identifying the most effective intervention remains challenging. This study aims to review and compare the efficacy of therapeutic methods for naming deficits in patients with AD to assist researchers and clinicians in selecting optimal approaches.
Materials and Methods: A comprehensive search was conducted across international databases (Cochrane Library, ISI Web of Science, Scopus, ProQuest, PubMed, and ScienceDirect) and Persian databases [Scientific Information Database (SID), Magiran, IranDoc, and the Ministry of Health research registry]. The review included all studies involving adults, irrespective of gender or ethnicity, published in English or Persian from January 2010 to December 2022. Study designs ranged from clinical trials to case reports, and the level of evidence for each study was assessed.
Results: Following the screening of identified records based on inclusion and exclusion criteria, 10 studies were selected for review. Data were extracted using a structured checklist. Interventions were stratified into four categories: language-based, instrumental, cognitive, and combined instrumental-language therapies.
Conclusion: Although the existing literature is limited, current findings indicate that lexical-semantic stimulation ‒ a language-based therapy ‒ provides the highest level of evidence for the treatment of naming deficits in AD.

Keywords

Subjects

1.     Hosseinzadeh A, Baneshi M, Sedighi B, Kermanchi J, Haghdoost A. Indirect Estimation of Dementia Prevalence and Its Geographical Variation Using the Claim Data in Iran. Iranian Journal of Epidemiology. 2022; 18(1): 1-11.
2.     Calzà L, Gagliardi G, Favretti RR, Tamburini F. Linguistic features and automatic classifiers for identifying mild cognitive impairment and dementia. Computer Speech & Language. 2021; 65: 101113.
3.     Gollan TH, Garcia DL, Stasenko A, Murillo M, Kim C, Galasko D, et al. The MINT Sprint 2.0: A picture naming test for detection of naming impairments in Alzheimer's disease and in preclinical AD. Alzheimer's & Dementia. 2024; 20(1): 112-23.
4.     Epperly T, Dunay MA, Boice JL. Alzheimer disease: pharmacologic and nonpharmacologic therapies for cognitive and functional symptoms. American family physician. 2017; 95(12): 771-8.
5.     Silagi ML, Bertolucci PHF, Ortiz KZ. Naming ability in patients with mild to moderate Alzheimer’s disease: what changes occur with the evolution of the disease? Clinics. 2015; 70: 423-8.
6.     Noroozian M. The elderly population in iran: an ever growing concern in the health system. Iranian journal of psychiatry and behavioral sciences. 2012; 6(2): 1.
7.     Hakimeh Z, Sadat SS, Pour AR, Tavirani MR. Epidemiology and etiology of Alzheimer's disease. Koomesh. 2015;16(2).
8.     Pasand Mojdeh H, Alipour F, Borhani Haghighi M. Alzheimer's disease: Background, current and future aspects. The Neuroscience Journal of Shefaye Khatam. 2016; 4(3): 70-80.
9.     Lecy EE, Min H-K, Apgar CJ, Maltais DD, Lundt ES, Albertson SM, et al. Patterns of Early Neocortical Amyloid-β Accumulation: A PET Population-Based Study. Journal of Nuclear Medicine. 2024; 65(7): 1122-8.
10.  Szatloczki G, Hoffmann I, Vincze V, Kalman J, Pakaski M. Speaking in Alzheimer’s disease, is that an early sign? Importance of changes in language abilities in Alzheimer’s disease. Frontiers in aging neuroscience. 2015; 7: 195.
11.  Ortiz KZ, Lira JOD, Minett TSC, Bertolucci PHF. Language impairments in Alzheimer’s disease: What changes can be found between mild and moderate stages of the disease? Clinics. 2024; 79: 100412.
12.  Lin C-Y, Chen T-B, Lin K-N, Yeh Y-C, Chen W-T, Wang K-S, et al. Confrontation naming errors in Alzheimer's disease. Dementia and geriatric cognitive disorders. 2014; 37(1-2): 86-94.
13.  Brandt J, Bakker A, Maroof DA. Auditory confrontation naming in Alzheimer's disease. The Clinical Neuropsychologist. 2010; 24(8): 1326-38.
14.  Johnson CJ, Paivio A, Clark JM. Cognitive components of picture naming. Psychological bulletin. 1996; 120(1): 113.
15.  Levelt WJ, Schriefers H, Vorberg D, Meyer AS, Pechmann T, Havinga J. The time course of lexical access in speech production: A study of picture naming. Psychological review. 1991; 98(1): 122.
16.  Moayedfar S, Purmohammad M, Shafa N, Shafa N, Ghasisin L. Analysis of naming processing stages in patients with mild Alzheimer. Applied Neuropsychology: Adult. 2021.
17.  Domoto-Reilly K, Sapolsky D, Brickhouse M, Dickerson BC, Initiative AsDN. Naming impairment in Alzheimer's disease is associated with left anterior temporal lobe atrophy. Neuroimage. 2012; 63(1): 348-55.
18.  Rabins PV, Rovner BW, Rummans T, Schneider LS, Tariot PN. Guideline Watch (October 2014): Practice Guideline for the Treatment of Patients With Alzheimer's Disease and Other Dementias. Focus (Am Psychiatr Publ). 2017; 15(1): 110-28.
19.  Cipriani G, Danti S, Picchi L, Nuti A, Fiorino MD. Daily functioning and dementia. Dementia & neuropsychologia. 2020; 14(2): 93-102.
20.  Eaglestone G, Gkaintatzi E, Jiang H, Stoner C, Pacella R, McCrone P. Cost-effectiveness of non-pharmacological interventions for mild cognitive impairment and dementia: a systematic review of economic evaluations and a review of reviews. PharmacoEconomics-Open. 2023; 7(6): 887-914.
21.  Leung P, Orgeta V, Orrell M. The effects on carer well‐being of carer involvement in cognition‐based interventions for people with dementia: a systematic review and meta‐analysis. International Journal of Geriatric Psychiatry. 2017; 32(4): 372-85.
22.  Rabins PV, Blacker D, Rovner BW, Rummans T, Schneider LS, Tariot PN, et al. American Psychiatric Association practice guideline for the treatment of patients with Alzheimer's disease and other dementias. Second edition. Am J Psychiatry. 2007; 164(12 Suppl): 5-56.
23.  lare L. Cognitive training and cognitive rehabilitation for people with early-stage dementia. Reviews in clinical Gerontology. 2003; 13(1): 75-83.
24.  Swan K, Hopper M, Wenke R, Jackson C, Till T, Conway E. Speech-language pathologist interventions for communication in moderate–severe dementia: A systematic review. American journal of speech-language pathology. 2018; 27(2): 836-52.
25.  Bahar‐Fuchs A, Clare L, Woods B. Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer's disease and vascular dementia. Cochrane database of systematic reviews. 2013; (6).
26.  Trebbastoni A, Imbriano L, Podda L, Rendace L, Sacchetti ML, Campanelli A, et al. Cognitive training in patients with Alzheimer's disease: findings of a 12-month randomized controlled trial. Current Alzheimer Research. 2018; 15(5): 452-61.
27.  Nousia A, Siokas V, Aretouli E, Messinis L, Aloizou A-M, Martzoukou M, et al. Beneficial effect of multidomain cognitive training on the neuropsychological performance of patients with early-stage Alzheimer’s disease. Neural plasticity. 2018; 2018.
28.  Nousia A, Martzoukou M, Siokas V, Aretouli E, Aloizou A-M, Folia V, et al. Beneficial effect of computer-based multidomain cognitive training in patients with mild cognitive impairment. Applied Neuropsychology: Adult. 2021; 28(6): 717-26.
29.  Coslett HB. Noninvasive brain stimulation in aphasia therapy: lessons from TMS and tDCS.  Neurobiology of language: Elsevier; 2016. p. 1035-54.
30.  Smirni D, Oliveri M, Misuraca E, Catania A, Vernuccio L, Picciolo V, et al. Verbal fluency in mild Alzheimer’s disease: transcranial direct current stimulation over the dorsolateral prefrontal cortex. Journal of Alzheimer's Disease. 2021; 81(3): 1273-83.
31.  Smirni D, Oliveri M, Misuraca E, Catania A, Vernuccio L, Picciolo V, et al. Verbal fluency in mild Alzheimer’s disease: Transcranial direct current stimulation over the dorsolateral prefrontal cortex. Journal of Alzheimer’s Disease. 2021; 81(3): 1273-83.
32.  Mojarrad A, Sadri Damirchi E, Sheykholeslami A, Rezaii Sharif A, Abbasi V. Comparing the Effects of Transcranial Direct Current Stimulation and Cognitive Rehabilitation on Language Skills and Attention in Elderly With Mild Alzheimer's Disease. Iranian Journal of Ageing. 2024; 19(3): 452-69.
33.  Rozisky JR, Antunes LdC, Brietzke AP, de Sousa AC, Caumo W. Transcranial direct current stimulation and neuroplasticity. Transcranial Direct Current Stimulation (tDCS): emerging used, Safety and Neurobiological effects New York, NY: Nova Science Publishers Inc. 2016: 1-26.
34.  Zhao Y, Ficek B, Webster K, Frangakis C, Caffo B, Hillis AE, et al. White matter integrity predicts electrical stimulation (tDCS) and language therapy effects in primary progressive aphasia. Neurorehabilitation and neural repair. 2021; 35(1): 44-57.
35.  Ferrucci R, Ruggiero F, Mameli F, Bocci T, Priori A. Transcranial direct current stimulation (tDCS).  Language Electrified: Principles, Methods, and Future Perspectives of Investigation: Springer; 2023. p. 339-65.
36.  Wang T, Guo Z, Du Y, Xiong M, Yang Z, Ren L, et al. Effects of noninvasive brain stimulation (NIBS) on cognitive impairment in mild cognitive impairment and Alzheimer disease: a meta-analysis. Alzheimer Disease & Associated Disorders. 2021; 35(3): 278-88.
37.  Naeser MA, Martin PI, Ho M, Treglia E, Kaplan E, Bashir S, et al. Transcranial magnetic stimulation and aphasia rehabilitation. Archives of Physical Medicine and Rehabilitation. 2012; 93(1): S26-S34.
38.  Chail A, Saini RK, Bhat P, Srivastava K, Chauhan V. Transcranial magnetic stimulation: a review of its evolution and current applications. Industrial psychiatry journal. 2018; 27(2): 172.
39.  Weiler M, Stieger KC, Long JM, Rapp PR. Transcranial magnetic stimulation in Alzheimer’s disease: are we ready? Eneuro. 2020; 7(1).
40.  Peterson MH, Barnason S, Donnelly B, Hill K, Miley H, Riggs L, et al. Choosing the best evidence to guide clinical practice: application of AACN levels of evidence. Critical care nurse. 2014; 34(2): 58-68.
41.  Aromataris E, Munn Z. JBI manual for evidence synthesis: Joanna Briggs Institute; 2020.
42.  Tate R, McDonald S, Perdices M, Togher L, Schultz R, Savage S. Rating the methodological quality of single-subject designs and n-of-1 trials: Introducing the Single-Case Experimental Design (SCED) Scale. Neuropsychological rehabilitation. 2008; 18(4): 385-401.
43.  Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. bmj. 2021; 372.
44.  Jelcic N, Cagnin A, Meneghello F, Turolla A, Ermani M, Dam M. Effects of lexical–semantic treatment on memory in early Alzheimer disease: An observer-blinded randomized controlled trial. Neurorehabilitation and neural repair. 2012; 26(8): 949-56.
45.  Potemkowski A, Wąsik M, Ratajczak M. The effect of a training programme stimulating language functions on Alzheimer-type dementia and maintenance of language skills. Aktualności Neurologiczne. 2017; 17(4): 227-44.
46.  Noonan KA, Pryer LR, Jones RW, Burns AS, Lambon Ralph MA. A direct comparison of errorless and errorful therapy for object name relearning in Alzheimer's disease. Neuropsychological Rehabilitation. 2012; 22(2): 215-34.
47.  Flanagan KJ, Copland DA, van Hees S, Byrne GJ, Angwin AJ. Semantic feature training for the treatment of anomia in Alzheimer disease: A preliminary investigation. Cognitive and Behavioral Neurology. 2016; 29(1): 32-43.
48.  Im JJ, Jeong H, Bikson M, Woods AJ, Unal G, Oh JK, et al. Effects of 6-month at-home transcranial direct current stimulation on cognition and cerebral glucose metabolism in Alzheimer's disease. Brain stimulation. 2019; 12(5): 1222-8.
49.  Tsantali E, Economidis D, Rigopoulou S. Testing the benefits of cognitive training vs. cognitive stimulation in mild Alzheimer's disease: a randomised controlled trial. Brain Impairment. 2017; 18(2): 188-96.
50.  Tsantali E, Economidis D. Implications of a longitudinal cognitive intervention program in mild Alzheimer’s disease. Archives of psychiatric nursing. 2014; 28(2): 128-34.
51.  Woodward M. Aspects of communication in Alzheimer's disease: clinical features and treatment options. International psychogeriatrics. 2013; 25(6): 877-85.
52.  Savarimuthu A, Ponniah RJ. A Slip between the brain and the lip: Working memory and cognitive-communication disorders. Journal of Psycholinguistic Research. 2023; 52(4): 1237-48.
53.  Morello ANdC, Lima TM, Brandão L. Language and communication non-pharmacological interventions in patients with Alzheimer's disease: a systematic review. Communication intervention in Alzheimer. Dementia & neuropsychologia. 2017; 11: 227-41.
54.  Kazemi Y, Stringer H, Klee T. Study of child language development and disorders in Iran: A systematic review of the literature. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2015; 20(1): 66.
55.  Montagut N, Borrego-Écija S, Castellví M, Rico I, Reñé R, Balasa M, et al. Errorless learning therapy in semantic variant of primary progressive aphasia. Journal of Alzheimer's Disease. 2021; 79(1): 415-22.
56.  Irazoki E, Contreras-Somoza LM, Toribio-Guzmán JM, Jenaro-Río C, Van der Roest H, Franco-Martín MA. Technologies for cognitive training and cognitive rehabilitation for people with mild cognitive impairment and dementia. A systematic review. Frontiers in psychology. 2020; 11: 648.
57.  Auvichayapat N, Auvichayapat P. Transcranial Direct Current Stimulation in Treatment of Child Neuropsychiatric Disorders: Ethical Considerations. Frontiers in Human Neuroscience. 2022; 16: 842013.