Word-finding Pauses in Primary Progressive Aphasia (PPA): Effects of Lexical Category

Abstract Objective Often, individuals with lower educational attainment and limited proficiency in the English language get misdiagnosed and/or undertreated, which can impact their quality of life and other outcomes. The present case study intends to review and discuss the presentation of a monolingual, Spanish-speaking woman with Semantic Variant Primary Progressive Aphasia (svPPA), who was originally referred for a neuropsychological evaluation to determine the severity of her existing Alzheimer’s Disease (AD) diagnosis. Case Description Ms. X, is a 64-year-old, right-handed Hispanic woman with 6 years of education. Symptoms included forgetfulness, restlessness, and insomnia. Her family reported that she was repeating her ideas frequently during conversations and failing to recognize previously acquainted people, including her own relatives. A recent MRI of the brain showed anterior temporal lobe atrophy. Diagnostic Impressions and Outcomes Overall, she showed naming deficits (anomia), impaired verbal fluency, surface dyslexia, and significant problems with comprehension. Executive functioning, sentence repetition, working memory, and attention were generally intact. Qualitatively, her speech was apparently fluent and automatic, yet clearly empty in meaning. In Ms. X’s case, collateral reports of word-finding difficulties, tendency to repeat her thoughts incessantly, associative agnosia and prosopagnosia, and spared repetition and motor speech are strongly indicative of svPPA. Discussion svPPA primarily impacts language production and comprehension, and is characterized by severe anomia, word-finding difficulties, impaired single word comprehension, and in some cases, defective recognition of familiar faces. On testing, impairments can be observed in confrontation naming, with motor speech and repetition, working memory, episodic memory, visuospatial skills, and problem-solving skills relatively intact. Language symptoms are thought to stem from deficits of the semantic system.

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An Overview on Primary Progressive Aphasia and Its Variants

Behavioural Neurology ◽

10.1155/2006/260734 ◽

2006 ◽

Vol 17 (2) ◽

pp. 77-87 ◽

Cited By ~ 40

Author(s):

Serena Amici ◽

Maria Luisa Gorno-Tempini ◽

Jennifer M. Ogar ◽

Nina F. Dronkers ◽

Bruce L. Miller

Keyword(s):

Language Impairment ◽

Sentence Comprehension ◽

Primary Progressive Aphasia ◽

Cognitive Domains ◽

Progressive Aphasia ◽

Primary Progressive ◽

Word Finding ◽

Degenerative Disorder ◽

Language Output ◽

Progressive Nonfluent Aphasia

We present a review of the literature on Primary Progressive Aphasia (PPA) together with the analysis of neuropschychological and neuroradiologic profiles of 42 PPA patients. Mesulam originally defined PPA as a progressive degenerative disorder characterized by isolated language impairment for at least two years. The most common variants of PPA are: (1) Progressive nonfluent aphasia (PNFA), (2) semantic dementia (SD), (3) logopenic progressive aphasia (LPA). PNFA is characterized by labored speech, agrammatism in production, and/or comprehension. In some cases the syndrome begins with isolated deficits in speech. SD patients typically present with loss of word and object meaning and surface dyslexia. LPA patients have word-finding difficulties, syntactically simple but accurate language output and impaired sentence comprehension. The neuropsychological data demonstrated that SD patients show the most characteristic pattern of impairment, while PNFA and LPA overlap within many cognitive domains. The neuroimaging analysis showed left perisylvian region involvement. A comprehensive cognitive, neuroimaging and pathological approach is necessary to identify the clinical and pathogenetic features of different PPA variants.

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How the speed of word finding depends on ventral tract integrity in primary progressive aphasia

NeuroImage Clinical ◽

10.1016/j.nicl.2020.102450 ◽

2020 ◽

Vol 28 ◽

pp. 102450

Author(s):

Nikki Janssen ◽

Ardi Roelofs ◽

Margot Mangnus ◽

Joanna Sierpowska ◽

Roy P.C. Kessels ◽

...

Keyword(s):

Primary Progressive Aphasia ◽

Progressive Aphasia ◽

Primary Progressive ◽

Word Finding

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PSP-FTD Complex: A Possible Variant of PSP

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317520922383 ◽

2020 ◽

Vol 35 ◽

pp. 153331752092238

Author(s):

Sunil Pradhan ◽

Ruchika Tandon

Keyword(s):

Progressive Supranuclear Palsy ◽

Frontotemporal Dementia ◽

Frontal Lobe ◽

Primary Progressive Aphasia ◽

Semantic Dementia ◽

Progressive Aphasia ◽

Primary Progressive ◽

Variant Type ◽

Word Finding

Introduction: This study tried to find out type of lobar features found in patients with progressive supranuclear palsy (PSP) and whether they differ from those of frontotemporal dementia (FTD) as both of these are tauopathies. Methods: We studied lobar functions of 45 patients with PSP. Results: Five (11.1%) patients had no lobar feature; 11 (24.4%) had PSP-like features like apathy, frontal release signs, impaired motor Luria written sequences, and fist-edge-palm test; and 29 (64.4%) patients had FTD-like lobar features like disinhibition, poor naming, and word finding difficulty. Among features resembling FTD, behavioural variant type occurred in 31.1%, primary progressive aphasia type occurred in 58.6%, 3.4% patients had semantic dementia type features, and 6.9% were unclassified. Conclusions: Hence, patients with PSP with lobar features may fall in the middle of PSP-FTD spectrum with frontal lobe features typical of PSP (PSP-frontal like) and those with frontal lobe features resembling FTD (PSP-FTD complex) in between.

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