Dear Lukas,

Thank you for your post and comments.  Below is what I obtained from Open Evidence regarding your question:

Yes — several speech-language therapy (SLT) approaches have demonstrated benefit in logopenic variant PPA (lvPPA), though gains are typically partial and most effective when initiated early. The case described already employed two evidence-based strategies (semantic feature analysis and spaced retrieval training), which align well with current literature. Below is a summary of the available options.

Impairment-Based (Restorative) Interventions

• Lexical retrieval / naming treatment: A study of 18 individuals with PPA (9 lvPPA) showed significantly improved naming of trained items immediately post-treatment, with maintenance of gains up to 1 year and generalization to untrained items up to 6 months. Notably, once-weekly clinician-directed sessions combined with daily home practice were sufficient — more frequent sessions did not confer additional benefit. This approach leverages spared cognitive-linguistic domains and develops self-cueing strategies. [1]

• Semantic feature analysis (SFA): A systematic review of 21 studies (55 participants with aphasia) found that naming of trained items improved in ~82% of participants, with a small overall treatment effect. SFA can also be combined with transcranial direct current stimulation (tDCS) over the left temporoparietal cortex, which showed advantages for trained items and a shallower rate of decline over 6 months compared with untrained items. [2-3]

• Phonological short-term memory training: A teletherapy-based study specifically in lvPPA demonstrated significant improvements in immediate and delayed repetition of trained items, though generalization to functional language tasks (picture description, naming) was limited, suggesting the intervention may remain task-specific. This approach directly targets the core phonological loop deficit in lvPPA. [4]

Compensatory and Communication-Based Strategies

• Augmentative and alternative communication (AAC): As naming deteriorates, compensatory strategies become essential. Options range from low-tech (pictographic communication boards, written prompts, laminated reference cards) to high-tech (personalized smartphone applications with prerecorded messages). Early introduction of AAC alongside restorative therapy is recommended so that patients and caregivers become familiar with these tools before they are critically needed. [5-6]

• Communication partner training: Educating caregivers and family members on how to facilitate communication — using simplified language, allowing extra response time, providing contextual cues, and reducing communication pressure — is a key component of comprehensive PPA management. [5][7]

• Script training: Particularly useful for maintaining functional communication in everyday scenarios (e.g., ordering food, greeting visitors), script training involves rehearsing personally relevant conversational scripts. [5][8]

Non-Invasive Brain Stimulation as an Adjunct

A 2024 Cochrane review and a 2025 systematic review noted that tDCS combined with language therapy may improve repetition abilities and cognitive function, while repetitive TMS (rTMS) has shown benefits for naming and speech fluency. [7-8] However, the evidence base remains limited by small sample sizes and heterogeneous study designs, and these modalities are not widely available, particularly in resource-limited settings.

Key Practical Considerations

Impairment-based approaches are most effective when initiated early in the disease course, before severe functional decline. [5] As the disease progresses, the therapeutic emphasis should shift toward compensatory strategies and caregiver support. In the case described, the patient is now at a moderate-to-severe stage (MMSE 9/30), where maximizing functional communication through AAC, environmental modifications, and caregiver-mediated cueing is likely to yield the greatest practical benefit.