A Preliminary Look Into the Clinical Evolution of Motor Speech Characteristics in Primary Progressive Apraxia of Speech in Québec French

2021 ◽  
pp. 1-18
Author(s):  
Liziane Bouvier ◽  
Laura Monetta ◽  
Paolo Vitali ◽  
Robert Laforce ◽  
Vincent Martel-Sauvageau
Keyword(s):  
Multiple Testing ◽  
Case Series ◽  
Cognitive Screening ◽  
Apraxia Of Speech ◽  
Motor Speech ◽  
Primary Progressive ◽  
Speech Characteristics ◽  
Quebec French ◽  
Language Assessments ◽  
Almost All

Purpose This study aimed to track changes in acoustical and perceptual features of motor speech in patients with phonetic and prosodic primary progressive apraxia of speech (PPAOS) in Québec French over an 18-month period. Method A prospective multiple-case series with multiple testing periods, including four participants with a diagnosis of PPAOS, was conducted. Participants were 0.5–4 years postonset of disease at baseline. They underwent comprehensive motor speech and language assessments and cognitive screening every 6 months for up to 18 months. Acoustical and perceptual analyses of motor speech were conducted. Results Results showed a considerable impairment in motor speech abilities for patients with PPAOS at all time points and a significant decrease in performance for almost all articulatory and prosodic measures over time. Passage reading and diadochokinesis seemed particularly promising for the tracking of changes in PPAOS motor speech characteristics and PPAOS classification. Quantifying length of speech runs made it possible to distinguish phonetic from prosodic PPAOS. Finally, the patients who evolved to phonetic PPAOS developed aphasia, and the two with prosodic PPAOS showed greater motor symptoms such as unequivocal dysarthria. Conclusion This study extends the growing literature on PPAOS and its subtypes by describing specific changes in articulatory and prosodic abilities over a period of at least 6 months, which are important for the diagnosis and management of PPAOS.

scholarly journals Lack of Frank Agrammatism in the Nonfluent Agrammatic Variant of Primary Progressive Aphasia

2016 ◽  
Vol 6 (3) ◽  
pp. 407-423 ◽  
Author(s):  
Naida L. Graham ◽  
Carol Leonard ◽  
David F. Tang-Wai ◽  
Sandra Black ◽  
Tiffany W. Chow ◽  
...  
Keyword(s):  
Primary Progressive Aphasia ◽  
Diagnostic Feature ◽  
Apraxia Of Speech ◽  
Volumetric Mri ◽  
Motor Speech ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Grammatical Morphemes ◽  
Grammatical Errors ◽  
Diagnosis Method

Background/Aims: Frank agrammatism, defined as the omission and/or substitution of grammatical morphemes with associated grammatical errors, is variably reported in patients with nonfluent variant primary progressive aphasia (nfPPA). This study addressed whether frank agrammatism is typical in agrammatic nfPPA patients when this feature is not required for diagnosis. Method: We assessed grammatical production in 9 patients who satisfied current diagnostic criteria. Although the focus was agrammatism, motor speech skills were also evaluated to determine whether dysfluency arose primarily from apraxia of speech (AOS), instead of, or in addition to, agrammatism. Volumetric MRI analyses provided impartial imaging-supported diagnosis. Results: The majority of cases exhibited neither frank agrammatism nor AOS. Conclusion: There are nfPPA patients with imaging-supported diagnosis and preserved motor speech skills who do not exhibit frank agrammatism, and this may persist beyond the earliest stages of the illness. Because absence of frank agrammatism is a subsidiary diagnostic feature in the logopenic variant of PPA, this result has implications for differentiation of the nonfluent and logopenic variants, and indicates that PPA patients with nonfluent speech in the absence of frank agrammatism or AOS do not necessarily have the logopenic variant.

scholarly journals Western Aphasia Battery–Revised Profiles in Primary Progressive Aphasia and Primary Progressive Apraxia of Speech

2020 ◽  
Vol 29 (1S) ◽  
pp. 498-510 ◽  
Author(s):  
Heather M. Clark ◽  
Rene L. Utianski ◽  
Joseph R. Duffy ◽  
Edythe A. Strand ◽  
Hugo Botha ◽  
...  
Keyword(s):  
Primary Progressive Aphasia ◽  
Relative Performance ◽  
Apraxia Of Speech ◽  
Motor Speech ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
R Classification ◽  
The Mean ◽  
Fluent Aphasia ◽  
Speech And Language Disorders

Purpose The primary aim was to examine the utility of the Western Aphasia Battery–Revised (WAB-R; Kertesz, 2007 ) for classifying variants of primary progressive aphasia (PPA). Traditional WAB-R metrics of Aphasia Quotient (AQ), subtest scores, WAB-R classification, and several novel metrics were examined. A secondary aim was to examine these same WAB-R metrics in individuals with primary progressive apraxia of speech (PPAOS). Method A retrospective analysis of WAB-R records from 169 participants enrolled in a study of neurodegenerative speech and language disorders was conducted. PPA/PPAOS classification was determined by consensus review of speech, language, and cognitive profiles. Scores on each of the WAB-R subtests were obtained to derive AQ, WAB-R aphasia profile, and 3 ratios reflecting relative performance on subtests. Results Mean AQ was significantly higher in the PPAOS group compared to all PPA variants except primary fluent aphasia. AQ above the normal cutoff was observed for 20% of participants with PPA. Significant main effects of group were noted for each of the subtests. Follow-up comparisons most frequently discriminated PPAOS, primary agrammatic aphasia (PAA), and logopenic progressive aphasia. Primary fluent aphasia and semantic dementia (SD) subtest scores were less distinctive, with the exception of Naming for SD, which was significantly lower than for PAA and PPAOS. When the WAB-R AQ detected aphasia, a classification of anomic aphasia was most frequently observed; this pattern held true for each of the PPA variants. The mean Information Content:Naming ratio was highest for SD, and the mean Comprehension:Fluency ratio was highest for PAA. Conclusions In the current study, AQ underestimated the presence of PPA and WAB-R classification did not distinguish among PPA classification determined by consensus. Performance on individual subtests and relative performance across subtests demonstrated inconsistent alignment with PPA classification. We conclude the WAB-R in isolation is inadequate to detect or characterize PPA. We instead suggest utilizing the WAB-R as 1 component of a comprehensive language and motor speech assessment when PPA is suspected.

scholarly journals Neural Changes Induced by a Speech Motor Treatment in Childhood Apraxia of Speech: A Case Series

2021 ◽  
pp. 088307382110158
Author(s):  
Simona Fiori ◽  
Kerstin Pannek ◽  
Irina Podda ◽  
Paola Cipriani ◽  
V. Lorenzoni ◽  
...  
Keyword(s):  
Fractional Anisotropy ◽  
Brain Mri ◽  
Case Series ◽  
Mean Diffusivity ◽  
Treated Group ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Motor Speech ◽  
Corticobulbar Tract ◽  
Speech Motor

We report a case series of children with childhood apraxia of speech, by describing behavioral and white matter microstructural changes following 2 different treatment approaches. Five children with childhood apraxia of speech were assigned to a motor speech treatment (PROMPT) and 5 to a language, nonspeech oral motor treatment. Speech assessment and brain MRI were performed pre- and post-treatment. The ventral (tongue/larynx) and dorsal (lips) corticobulbar tracts were reconstructed in each subject. Mean fractional anisotropy and mean diffusivity were extracted. The hand corticospinal tract was assessed as a control pathway. In both groups speech improvements paralleled changes in the left ventral corticobulbar tract fractional anisotropy. The PROMPT treated group also showed fractional anisotropy increase and mean diffusivity decrease in the left dorsal corticobulbar tract. No changes were detected in the hand tract. Our results may provide preliminary support to the possible neurobiologic effect of a multimodal speech motor treatment in childhood apraxia of speech.

Progressive apraxia of speech in Quebec French speakers: A case series

2021 ◽  
Author(s):  
Liziane Bouvier ◽  
Laura Monetta ◽  
Robert Jr Laforce ◽  
Paolo Vitali ◽  
Christian Bocti ◽  
...  
Keyword(s):  
Case Series ◽  
Apraxia Of Speech ◽  
Quebec French

scholarly journals Coming to Terms with a Conundrum: A Case of Primary Progressive Apraxia of Speech due to Corticobasal Degeneration?

2021 ◽  
pp. 483-489
Author(s):  
Aristotelis Karantzoulis ◽  
Emanuela Susani ◽  
Carlo Ferrarese ◽  
Ildebrando Appollonio ◽  
Lucio Tremolizzo
Keyword(s):  
Natural History ◽  
Single Case ◽  
Corticobasal Degeneration ◽  
Clinical Syndrome ◽  
Apraxia Of Speech ◽  
Motor Speech ◽  
Primary Progressive ◽  
Prominent Symptom ◽  
Cerebrospinal Fluid Biomarkers ◽  
Extrapyramidal Signs

Primary progressive apraxia of speech (PPAOS) is a progressive disorder impairing the motor speech act leaving linguistic function unattained. Although apraxia of speech frequently co-occurs with other neurodegenerative conditions, PPAOS defines a clinical syndrome where apraxia of speech is the sole or prominent symptom for much of the disease’s natural history. Mounting evidence is beginning to fully define this disease as the epiphenomenon of 4-repeat (4R) tau pathology although other pathologic signatures have been reported. Indeed, PPAOS patients generally present a parkinsonian syndrome late into their natural history mostly qualifying for either corticobasal syndrome (CBS) or progressive supranuclear palsy (PSP). This is starting to be reflected in diagnostic criteria for PSP, namely, in the PSP speech and language (SL) subcategory; however, this inclusion is not reflected for CBS. Here, we present a single case of a patient with PPAOS and her clinical follow-up lasting 6 years, from the time she sought our attention to her death which occurred 8 years into the disease. PPAOS was the only and prominent symptom for most of the illness with extrapyramidal signs overtly presenting in the last months of its course. Clinical evaluation, imaging, genetic, and cerebrospinal fluid biomarkers all pointed toward an underlying CBD pathology, albeit the eventual anatomopathological confirmation was not performed. Had her clinical course been more suggestive of PSP, she would have qualified for criteria as PSP-SL. Our case therefore suggests the hypothetic need to discuss the broadening of the existing CBS criteria to encompass isolated PPAOS.

Neurologic Substrates of Motor Speech Disorders

2013 ◽  
Vol 23 (3) ◽  
pp. 98-104 ◽  
Author(s):  
Edythe A. Strand
Keyword(s):  
Differential Diagnosis ◽  
Signs And Symptoms ◽  
Speech Disorders ◽  
Apraxia Of Speech ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Clinical Observations ◽  
Speech Characteristics ◽  
Communicative Disorders ◽  
Language Behavior

A good clinical understanding of the neurologic substrates of neurologic communicative disorders is important both to diagnosis and treatment. This article briefly reviews neurologic substrates for motor speech disorders (MSD) and how clinicians may identify neurologic signs and symptoms to facilitate differential diagnosis of apraxia of speech (AOS) and the various types of dysarthria. Students and clinicians have numerous resources regarding general neuroanatomy and neurophysiology (e.g. Benarroch, 2006; Kandel, Schwartz, and Jessel, 1991; Nolte, 2002; Snell, 1997) as well as neuroanatomic correlates of speech-language behavior and disorders (Bhatnagar, 2012; Duffy, 2013). Articles on aspects of neuroimaging (Brown, Petersen and Schlaggar, 2003; Shuster, 2003) and neurologic substrates for MSDs (Farinella-Bocian, Strand, and Benarroch, 2007) are also available in previous editions of Perspectives. This article begins with an overview of the differing MSDs. A brief overview of neurologic systems is provided, followed by a more detailed description of the neurologic substrates for MSDs. Examples of clinical observations of speech and non-speech characteristics that can aid the clinician in understanding the underlying neural deficit are provided.

Motor Speech Phenotypes of Frontotemporal Dementia, Primary Progressive Aphasia, and Progressive Apraxia of Speech

2017 ◽  
Vol 60 (4) ◽  
pp. 897-911 ◽  
Author(s):  
Matthew L. Poole ◽  
Amy Brodtmann ◽  
David Darby ◽  
Adam P. Vogel
Keyword(s):  
Frontotemporal Dementia ◽  
Meta Analysis ◽  
Primary Progressive Aphasia ◽  
Control Group ◽  
Apraxia Of Speech ◽  
Speech Impairment ◽  
Motor Speech ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Neuroimaging Data

Purpose Our purpose was to create a comprehensive review of speech impairment in frontotemporal dementia (FTD), primary progressive aphasia (PPA), and progressive apraxia of speech in order to identify the most effective measures for diagnosis and monitoring, and to elucidate associations between speech and neuroimaging. Method Speech and neuroimaging data described in studies of FTD and PPA were systematically reviewed. A meta-analysis was conducted for speech measures that were used consistently in multiple studies. Results The methods and nomenclature used to describe speech in these disorders varied between studies. Our meta-analysis identified 3 speech measures which differentiate variants or healthy control-group participants (e.g., nonfluent and logopenic variants of PPA from all other groups, behavioral-variant FTD from a control group). Deficits within the frontal-lobe speech networks are linked to motor speech profiles of the nonfluent variant of PPA and progressive apraxia of speech. Motor speech impairment is rarely reported in semantic and logopenic variants of PPA. Limited data are available on motor speech impairment in the behavioral variant of FTD. Conclusions Our review identified several measures of speech which may assist with diagnosis and classification, and consolidated the brain–behavior associations relating to speech in FTD, PPA, and progressive apraxia of speech.

High frequency repetitive transcranial magnetic stimulation for primary progressive apraxia of speech: A case series

2019 ◽  
Vol 12 (6) ◽  
pp. 1581-1582
Author(s):  
Danielle S. Shpiner ◽  
Katalina F. McInerney ◽  
Melissa Miller ◽  
Justine Allen ◽  
Jordyn Rice ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
High Frequency ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Case Series ◽  
Apraxia Of Speech ◽  
Primary Progressive

Visualizing the Knowledge Domain of Motor Speech Disorders: A Scientific Review (2000-2019)

2021 ◽  
Vol 44 (4) ◽  
pp. 563-588
Author(s):  
Huili Wang ◽  
Shurong Zhang ◽  
Xueyan Li
Keyword(s):  
Neurological Diseases ◽  
Speech Disorders ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Knowledge Domain ◽  
Motor Speech ◽  
Scientific Review ◽  
Motor Speech Disorders ◽  
Motor Delay ◽  
Speech Characteristics

Abstract This review visualizes the knowledge domain of motor speech disorders (MSDs) in linguistics between 2000 and 2019 by means of scientometric methods. With topic searches, the study collected 869 bibliographic records and 20, 411 references from Web of Science Core Collection (WoSCC) of Thomson Reuter. The clustered and visualized document co-citation network of the MSDs knowledge domain in CiteSpace identifies 15 research foci in different periods, including apraxia of speech, acoustics, children, technology, aphemia, childhood apraxia of speech, primary progressive aphasia, speech motor delay, Parkinson’s disease, amyotrophic lateral sclerosis, rhythm, foreign accent syndrome, phonation, phonological awareness, dose and speech perception. Revolving around linguistics, these foci could be divided into studies on speech characteristics of MSDs in terms of phonology and phonetics, remedies for MSDs in terms of neurolinguistics and acoustic phonetics, dysarthria secondary to neurological diseases based on pathological linguistics, subtypes of apraxia of speech, methods of MSDs based on auditory phonetics and a newly recognized subtype of MSDs. Meanwhile, the emerging trends of MSDs in linguistics are detected by the analysis of reference citation bursts, suggesting growing research in remedies for MSDs with the focus on assessments and effectiveness of treatments, speech characteristics and indexes of dysarthria secondary to neurological diseases and assistance to diagnose apraxia of speech. To sum up, the review has indicated that the acoustic measures to assess MSDs and acoustic remedies for dysarthria may not only be the past foci but also be future trends.

Clinical Assessment of Characteristics of Apraxia of Speech in Primary Progressive Aphasia

2020 ◽  
Vol 29 (1S) ◽  
pp. 485-497 ◽  
Author(s):  
E. Susan Duncan ◽  
Neila J. Donovan ◽  
Seyed Ahmad Sajjadi
Keyword(s):  
Clinical Assessment ◽  
Interrater Reliability ◽  
Stepwise Regression ◽  
Primary Progressive Aphasia ◽  
Apraxia Of Speech ◽  
Speech Language Pathologists ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Speech Characteristics

Purpose We sought to examine interrater reliability in clinical assessment of apraxia of speech (AOS) in individuals with primary progressive aphasia and to identify speech characteristics predictive of AOS diagnosis. Method Fifty-two individuals with primary progressive aphasia were recorded performing a variety of speech tasks. These recordings were viewed by 2 experienced speech-language pathologists, who independently rated them on the presence and severity of AOS as well as 14 associated speech characteristics. We calculated interrater reliability (percent agreement and Cohen's kappa) for these ratings. For each rater, we used stepwise regression to identify speech characteristics significantly predictive of AOS diagnosis. We used the overlap between raters to create a more parsimonious model, which we evaluated with multiple linear regression. Results Results yielded high agreement on the presence (90%) and severity of AOS (weighted Cohen's κ = .834) but lower agreement for specific speech characteristics (weighted Cohen's κ ranging from .036 to .582). Stepwise regression identified 2 speech characteristics predictive of AOS diagnosis for both raters (articulatory groping and increased errors with increased length/complexity). These alone accounted for ≥ 50% of the variance of AOS severity in the constrained model. Conclusions Our study adds to a growing body of research that highlights the difficulty in objective clinical characterization of AOS and perceptual characterization of speech features. It further supports the need for consensus diagnostic criteria with standardized testing tools and for the identification and validation of objective markers of AOS. Additionally, these findings underscore the need for a training protocol if diagnostic tools are to be effective when shared beyond the research teams that develop and test them and disseminated to practicing speech-language pathologists, in order to ensure consistent application.

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