Rocío Acosta Esperón's Lab Notebook

Date

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Fall 2024

Priorities, Tasks, & Assignments 

Type in “/ action item” to create a to-do list or “/ numbered list” to start listing. To add a due date, add due by // date.

Notes, Progress, or Issues 

Type “/ success panel” to highlight a point or type in notes; ensure you take detailed notes so that it’s clear what you have worked on. This is not meant to be a brief summary, this is meant to be a place to document what you worked on in detail so you can return to it easily and pick-up where you left off, it also is meant to aid your supervisors in providing feedback and assistance and to know what you have worked on! Clearly provide names of files you have worked on, stating “Redcap” is not sufficient for example, because we have several Redcaps and projects within Redcap. Screen captures can also be added here.

Important Links to Projects

Type “ / link “ to insert a link.

Jan 5, 2026

• List of papers can be found here: Duplicate of Welcome to the MADR Lab: URA/Student Version | Relevant ArticlesPreview

• Take notes here:

Paper: Barcelona Scale for buccophonatory apraxia: Quantitatice assessment tool

• Purpose: Develop a quantitative (time- based) scale to assess buccophonatory apraxia. Test its usufulness in nfvPPA and other neurodegenerative diseases.

• Relevance:

• Verbal and nonverbal apraxia frequently co-occur, especially in nfvPPA.

• Most existing tools are qualitative, subjective, and limited for follow-up.

• There is a need for an objective measure to compare patients and track progression.

• The Barcelona Scale is administered in Spanish or Catalan by a speech therapist.

• Total score = time in seconds (higher = worse performance).

• Two subscales:

• Nonverbal apraxia: oral/facial movements (13 items).

• Verbal apraxia: phonation, diadochokinesis, word repetition, sentence reading (14 items).

• *If a task cannot be completed → 50-second penalty.

• Main findings

• All patient groups scored worse than controls.

• nfvPPA showed the highest scores, indicating the greatest apraxic impairment.

• Clear differences among PPA variants:

• nfvPPA = worst performance

• svPPA = best performance

• Strong correlation between verbal and nonverbal apraxia.

• Provides an objective alternative to subjective speech ratings.

• Particularly useful for diagnosis and monitoring in nfvPPA

• High scores in other groups suggest the scale may reflect general speech-motor difficulty, not only pure apraxia.

• Small size samples

• No inter-rater reliability testing.

• No longitudinal data

• The Barcelona Scale is a quialitative tool

• Most clinically useful in nfvPPA.

• Promising for tracking severity and progression, but needs farther validation.

Paper: Treatment for Anomia in Bilingual Speakers with Progressive Aphasia  

Purpose:  

• Examine whether lexical retrieval treatment is effective for bilingual speakers with progressive anomia. Also to evaluate within-language gains, maintenance, and cross-linguistic transfer. And to test whether cognates promote stronger cross-language effects than noncognates.  

This study matters because: 

• Most anomia treatment focuses on monolingual speakers. 

• Bilingual speakers with PPA are underrepresented despite high clinical need. 

• Evidence is needed to guide dual-language intervention and reduce health disparities.  

Cross-linguistic transfer 

• Cognates showed strong translation effects: 

• Bidirectional transfer (dominant ↔ nondominant). 

• Noncognates showed weaker and less consistent transfer. 

• Cognate advantages diminished gradually during follow-up. 

Interpretation 

• Dual-language intervention is effective and feasible in bilingual PPA. 

• Cognates benefit from shared semantic and phonological representations. 

• Treatment can strengthen cross-language activation, even in neurodegenerative disease. 

 Main findings 

• All participants improved on trained items in both languages.  

• Gains observed in: 

• Dominant language  

• Nondominant language  

• Majority maintained gains up to 6-12 months, despite overall cognitive decline.  

• Lexical retrieval therapy is effective for bilingual speakers with progressive anomia. 

• Treating both languages is justified. 

• lvPPA and svPPA both benefited from treatment. 

• lvPPA showed more evidence of noncognate transfer than svPPA. 

• Differences likely reflect underlying mechanisms of anomia (phonological vs semantic). 

• Using cognates can provide "two-for-one" benefits, especially when clinicians are monolingual.

Notes: Bilingual Primary Progressive Aphasia: A Scoping Review of Assessment and Treatment Practices  

Purpose:  

• To map and synthesize existing research on the assessment and treatment of bilingual individuals with primary progressive aphasia (PPA) and identify patterns, gaps, and clinical implications in the current literature.

This study matter because:

• PPA research is largely based on monolingual speakers

• Bilingual individuals with PPA are underrepresented, despite growing multilingual populations

• Clinicians lack clear guidelines for assessment intervention in bilingual PPA

Assessment and intervention findings:

• Language impairment severity often differs across languages within the same individual.

• Performance is influenced by:

  • Language dominance

  • Age of acquisition

  • Frequency of language

• Most assessments were adapted monolingual tools, not designed for bilingual PPA

• Naming and lexical retrieval therapies were most common

• Cognates were more likely to show cross-language generalization

• Treatment generally led to:

  • Within-language improvement for trained items

  • Variable cross-linguistic transfer

Cross-linguistic effects:

• Transfer was

  • More consistent from dominant to nondominant language

  • Less predictable in later disease stages

• Results varied depending on PPA variant and underlaying impairment

Clinical implications

• Bilingual assessments should consider both languages, not only the dominant one.

• Treating both languages is feasible and can be beneficial

• Cognates may offer efficient intervention targets

• Individual language history is crucial for clinical decision-making

Notes: Investigating the utility of teletherapy in individuals with Primary Progressive Aphasia. 

Purpose:  

• Evaluate the feasibility and effectiveness of telerehabilitation for individuals with PPA.  

• Examine whether language treatment delivered remotely can lead to meaningful improvements. 

This study matters because:  

• Individuals with PPA often have limited access to specialized speech-language therapy  

• Neurodegenerative progression makes early and continuous intervention important. 

• Teletherapy may reduce geographic, mobility and time barriers 

Intervention design 

• Speech-language therapy delivered remotely using videoconferencing. 

• Focus on lexical retrieval and functional communication tasks. 

• Treatment individualized based on participant needs. 

• Sessions conducted over several weeks. 

Outcome measures: 

• Naming accuracy for trained items  

• Generalization to untrained items or functional communication tasks  

• Participant and caregiver satisfaction and feasibility measures.  

Interpretation:  

• TT is a feasible and effective delivery method for language intervention in PPA. 

• Remote treatment can support continued engagement and maintenance of communication abilities  

LRT (Lexical Retrieval Treatment):

• A naming-based intervention targeting word-finding difficulties.

• Uses a cueing hierarchy that may include:

  • semantic cues (meaning, category, function),

  • phonological cues (initial sound, syllables),

  • orthographic cues (written word or letters).

• Emphasizes self-cueing strategies to promote independent word retrieval.

• In PPA, LRT is used to:

  • strengthen access to specific vocabulary,

  • slow decline for trained items,

  • and support functional communication.

• Well suited for teletherapy due to its structured format and clear outcome measures.

VISTA (Video- Implemented Script Training for Aphasia):

• A script-based intervention adapted for delivery via videoconferencing

• Focuses on practicing personally relevant functional scripts (introductions, phone calls, daily routines).

• Scripts are:

  • practiced repeatedly during sessions,

  • supported with clinician modeling and cueing,

  • and reinforced through video recordings for home practice.

• VISTA aims to improve speech fluency, automaticity, and confidence in everyday communication.

• Particularly suitable for telerehabilitation because scripts can be practiced consistently outside sessions.

 Main findings:

• Participants showed improvement in trained language tasks following treatment  

• Some evidence of generalization beyond trained items  

• Gains were observed despite the progressive nature of PPA. 

• Teletherapy was well tolerated by participants  

• High levels of participant and caregiver satisfaction  

• There were minimal technical difficulties reported.  

• Teletherapy is a feasible and effective delivery method for language intervention for PPA. 

• May be particularly useful for individuals with mobility or geographic constraints. 

• Supports inclusion of remote therapy in standard care models.  

• Teletherapy is a viable option for delivering speech-language therapy in PPA  

• Even in progressive conditions, meaningful short-term gains are possible through remote intervention.  

Notes: Classification of Primary Progressive Aphasia and its variants

Purpose:

• Propose a consensus classification for PPA

• Define the core and supportive features of the three PPA variants.

This study matters because:

• Establishes the standard diagnostic framework used in PPA research and clinical practice

• Provides clear criteria for distinguishing variants

• Integrates language, cognition, and neurodegeneration.

• Variants are distinguished by patterns of language breakdown, not by single symptoms.

PPA variants proposed:

• Nonfluent/agrammatic variant (nfvPPA)

• Semantic variant (svPPA)

• Logopenic variant (lvPPA)

Nonfluent/agrammatic variant (nfvPPA)

• Core features:

  • Agrammatism and/or apraxia of speech.

• Language characteristics:

  • Effortful, halting speech.

  • Simplified grammatical structure.

• Related language behaviors:

  • Speech production difficulties can affect tasks requiring complex phonological or motor planning.

Semantic variant (svPPA)

• Core features:

  • Impaired single-word comprehension.

  • Loss of semantic knowledge.

• Language characteristics:

  • Fluent but empty speech.

  • Anomia and semantic paraphasias.

• Related language behaviors:

  • Difficulty with words that require semantic support (e.g., irregular word reading).

Logopenic variant (lvPPA)

• Core features:

  • Impaired word retrieval.

  • Poor sentence repetition.

• Language characteristics:

  • Frequent pauses due to word-finding difficulty.

  • Relatively preserved grammar and motor speech.

• Related language behaviors:

  • Difficulties increase with length and phonological load.

How language tasks help differentiate variants:

• Performance patterns across tasks reflect breakdowns in:

  • Semantic processing (svPPA)

  • Motor speech and grammatical processing (nfvPPA)

  • Phonological working memory (lvPPA)

• No single task is diagnostic, profiles across tasks are critical.

Clinical implications:

• Diagnosis should be based on language profiles, not isolated deficits.

• Variant classification guides:

  • Prognosis

  • Management and intervention planning

  • Research stratification

Notes: Retraining speech production and fluency in non-fluent/agrammatic primary progressive aphasia

Purpose:

• Investigate whether Video-Implemented Script Training for Aphasia (VISTA) improves:

  • speech production accuracy

  • intelligibility

  • grammar

  • in people with nfvPPA. 

Why this study matters:

• nfvPPA involves progressive decline in grammar and motor speech.

• Few studies have looked at the behavioral rehabilitation for the core deficits in this group.

Intervention:

• VISTA:

  • Participants practiced personally revelant scripts

  • Repetition with clinicians + speech entrainment (practice with audiovisual models).

Clinical implications:

• Script-based training can be a viable rehabilitation strategy for nfvPPA.

• Supports use of structured repetition and speech entrainment to target fluency and comprehensibility.

Key results:

• Trained scripts:

  • Significant improvement in production accuracy and intelligibility post-treatment.

  • Reduction in grammatical errors for trained topics.

• Untrained scripts:

  • Some increase in comprehensibility at post-treatment.

• Follow-up (up to 1 year)

  • Gains for trained scripts maintained long-term despite disease progression.

  • Standardized test scores remained stable or showed expected decline.

Notes: Treatment for Word Retrieval in Semantic and Logopenic Variants of Primary Progressive Aphasia: Immediate and Long-Term Outcomes

Jan 5, 2026

• Take notes and write any questions here:

• @Rocio Acosta Esperon --I’ve linked a screening folder to a current patient (Camille completed this screening--the recent ones I have done have been in English). There are two parts to the screening, as well as the screening PPT presentation that is completed after a screening. – @Diana Cruz

Jan 23, 2026

Meeting with Dr. Grasso:

1. Read this paper and take some notes/write questions for next meeting: https://pubmed.ncbi.nlm.nih.gov/30186225/

2. Create a section in your lab notebook for writing the codes of each patient you review for fidelity or the screenings and write your clinical impressions of the patient in Spanish or English so we can review that in the next meeting. Be sure to include which variant they have and what symptoms you observed that fit the variant.

3. Observe MaCa all the way through therapy and testing

   1. Let’s discuss with Camille and Ana P, if Rocio can assist with testing with MaCa

4. Lower priorty: Read chapter on Multiple Baseline design to understand how we design the interventions at the single-subject level (across participants)

5. Revisar plan para los próximos 5 viernes que tengo clase con el Tec

Feb 5, 2026

1. Read this paper and take notes about the main findings and write any questions: https://pmc.ncbi.nlm.nih.gov/articles/PMC6261353/

2. Watch pre-treatment videos of one semantic and one logopenic and take notes about profile (language and cognitive domains you observe)

3. Read this about bvFTD so you have context about Martin https://memory.ucsf.edu/dementia/ftd/behavioral-variant-frontotemporal-dementia

4. Lower priorty: Read chapter on Multiple Baseline design to understand how we design the interventions at the single-subject level (across participants)

5. Rocio will return home at lunch on Fridays and arrive at 8am M-Thursday on weeks when she has her Friday class

Feb 19, 2026

1. Watch pre-treatment videos of one logopenic and one nonfluent and take notes about profile (language and cognitive domains you observe)

2. Read this paper and take notes about main findings and write any questions:

   1. Distinction between semantic and logopenic and features we expect to see in each variant:

      1. https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0038-1660782

      2. Read also the chapter Dr. Grasso provided (book)

3. Lower priority: Read chapter on Multiple Baseline design to understand how we design the interventions at the single-subject level (across participants)

4. Norms for MMSE forthcoming by Feb 27, 2026 brief lab meeting presentation

5. Rocio will likely keep her Friday schedule through end of externship to help with nephews

6. Next time: potential collaborators: https://www.mdpi.com/2076-3425/15/3/245

Date

Type //date to populate

Fall 2024

Priorities, Tasks, & Assignments 

Type in “/ action item” to create a to-do list or “/ numbered list” to start listing. To add a due date, add due by // date.

Notes, Progress, or Issues 

Type “/ success panel” to highlight a point or type in notes; ensure you take detailed notes so that it’s clear what you have worked on. This is not meant to be a brief summary, this is meant to be a place to document what you worked on in detail so you can return to it easily and pick-up where you left off, it also is meant to aid your supervisors in providing feedback and assistance and to know what you have worked on! Clearly provide names of files you have worked on, stating “Redcap” is not sufficient for example, because we have several Redcaps and projects within Redcap. Screen captures can also be added here.

Important Links to Projects

Type “ / link “ to insert a link.

Jan 5, 2026

• Take notes and write any questions here:

During my session with Ana Pau, she explained and guided me through the different platforms to give me an overall idea of what I should mainly review and understand in each one. In Wiki, she showed me where to find the necessary information. In REDCap, she provided general guidance on how the platform works, how the assessments are displayed, and how to open them. In Box, she explained the structure and highlighted important files and materials to keep in mind.

She also gave me an overview of the lab, the projects currently being worked on, and what we will be working on. We discussed the assessments, and we agreed that I will review them first and then we will practice together.

I met with Ana Pau again, and she explained and showed me how to create patient folders in Box, schedule patients in Google Calendar, set up the necessary Zoom settings, and properly name the meetings and documents. We also discussed the inclusion and exclusion criteria, and she explained the usual order of assessments during the screenings with a briefly explanation of each assessment.

Jan 5, 2026

Jan 5, 2026

• Take notes about any questions here:

Jan 6, 2026