Efficacy of Communication Bridge‐2 for primary progressive aphasia: A randomized controlled trial of communication intervention

INTRODUCTION: Primary progressive aphasia (PPA), a language-based neurodegenerative dementia, negatively impacts communication and quality of life. Previous non-pharmacologic interventions show promise but lack efficacy trials. Here, outcomes are provided from Communication Bridge-2 (CB2), a speech-language randomized controlled trial (RCT) for PPA. METHODS: CB2 is the first Phase 2, Stage II, parallel-group RCT delivered via video chat with global enrollment. Ninety-five dyads were randomized into one of two speech-language intervention arms. Primary outcomes included communication confidence and participation measures. Marginal linear models assessed efficacy across ≈12 months. RESULTS: Ninety-five dyads were randomized from four countries. Experimental arm superiority in communication-participation measurement of goal attainment was demonstrated (66.7% vs 49.1%, respectively, p = 0.006), and corroborated by post-study interviews. DISCUSSION: Outcomes demonstrate the feasibility and initial efficacy of a person-centered telemedicine intervention for maximizing communication participation for mild-to-moderate PPA, providing a pathway for developing and implementing clinically meaningful interventions for Alzheimer's disease and related dementias. HIGHLIGHTS: Primary progressive aphasia (PPA) negatively impacts communication participation. Communication Bridge-2 (CB2) is a telemedicine-delivered randomized controlled trial (RCT). Global recruitment of 95 PPA participant dyads into an RCT with low dropout. First international superiority trial for PPA using video chat shows efficacy. The study provides a model for rigorous non-pharmacologic trials for Alzheimer's disease/Alzheimer's disease and related dementias (AD/ADRD).