Heterogeneity of repetition abilities in logopenic variant primary progressive aphasia

ABSTRACT. The differential diagnosis of primary progressive aphasia (PPA) is challenging due to overlapping clinical manifestations of the different variants of the disease. This is particularly true for the logopenic variant of PPA (lvPPA), in which such overlap was reported with regard to impairments in repetition abilities. In this study, four individuals with lvPPA underwent standard neuropsychological and language assessments. The influence of psycholinguistic variables on their performance of in word, nonword and sentence repetition tasks was also specifically explored. Some level of heterogeneity was found in cognitive functions and in language. The four participants showed impairment in sentence repetition in which their performance was negatively affected by semantic reversibility and syntactic complexity. This study supports the heterogeneity of lvPPA with respect to the cognitive and linguistic status of participants. It also shows that sentence repetition is influenced not only by length, but also by semantic reversibility and syntactic complexity, two psycholinguistic variables known to place additional demands on phonological working memory.

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Répéter s'il vous plait: Working memory intensive sentence repetition deficits as a sensitive neuropsychological marker of primary progressive aphasia

Alzheimer s & Dementia ◽

10.1002/alz.042842 ◽

2020 ◽

Vol 16 (S6) ◽

Author(s):

Seckin Arslan ◽

Alexandra Plonka ◽

Magali Payne Cogordan ◽

Valeria Manera ◽

Auriane Gros ◽

...

Keyword(s):

Working Memory ◽

Primary Progressive Aphasia ◽

Progressive Aphasia ◽

Primary Progressive ◽

Sentence Repetition

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Contribution of the Cognitive Approach to Language Assessment to the Differential Diagnosis of Primary Progressive Aphasia

Brain Sciences ◽

10.3390/brainsci11060815 ◽

2021 ◽

Vol 11 (6) ◽

pp. 815

Author(s):

Joël Macoir ◽

Annie Légaré ◽

Monica Lavoie

Keyword(s):

Differential Diagnosis ◽

Language Impairment ◽

Primary Progressive Aphasia ◽

Behavioral Management ◽

Language Abilities ◽

Cognitive Approach ◽

Progressive Aphasia ◽

Primary Progressive ◽

Assessment Approach ◽

Cognitive Neuropsychological

Diagnosis of primary progressive aphasia (PPA) is essentially based on the identification of progressive impairment of language abilities while other cognitive functions are preserved. The three variants of PPA are characterized by core and supportive clinical features related to the presence or absence of language impairment in different linguistic domains. In this article, we review the cognitive neuropsychological approach to the assessment of PPA and its contribution to the differential diagnosis of the three variants. The main advantage of this assessment approach is that it goes beyond the mere description and classification of clinical syndromes and identifies impaired and preserved cognitive and linguistic components and processes. The article is structured according to the main language domains: spoken production, language comprehension, and written language. Each section includes a brief description of the cognitive processes involved in the assessment tasks, followed by a discussion of typical characteristics for each PPA variant and common pitfalls in the interpretation of the results. In addition, the clinical benefit of the cognitive neuropsychological approach for the behavioral management of PPA is briefly sketched out in the conclusion.

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Differential diagnosis dilemma: A case of possible primary progressive aphasia versus aphasic dementia

Archives of Clinical Neuropsychology ◽

10.1093/arclin/14.1.121 ◽

1999 ◽

Vol 14 (1) ◽

pp. 121-121

Author(s):

M. T. Barisa ◽

J. Schumacher

Keyword(s):

Differential Diagnosis ◽

Primary Progressive Aphasia ◽

Progressive Aphasia ◽

Primary Progressive

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A Case of a Monolingual Spanish-Speaking Latina with Semantic Variant Primary Progressive Aphasia (svPPA)

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz029.57 ◽

2019 ◽

Vol 34 (7) ◽

pp. 1290-1290

Author(s):

L Perez

Keyword(s):

Working Memory ◽

Language Production ◽

Primary Progressive Aphasia ◽

Motor Speech ◽

Problem Solving Skills ◽

Progressive Aphasia ◽

Primary Progressive ◽

Spanish Speaking ◽

Word Finding ◽

Semantic Variant

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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Semantic and lexical features of words dissimilarly affected by non-fluent, logopenic, and semantic primary progressive aphasia

Journal of the International Neuropsychological Society ◽

10.1017/s1355617719000948 ◽

2019 ◽

Vol 25 (10) ◽

pp. 1011-1022 ◽

Cited By ~ 2

Author(s):

Jet M. J. Vonk ◽

Roel Jonkers ◽

H. Isabel Hubbard ◽

Maria Luisa Gorno-Tempini ◽

Adam M. Brickman ◽

...

Keyword(s):

Semantic Processing ◽

Mental Lexicon ◽

Primary Progressive Aphasia ◽

Word Form ◽

Lexical Frequency ◽

Progressive Aphasia ◽

Primary Progressive ◽

Lexical Semantic ◽

Psycholinguistic Variables

AbstractObjective:To determine the effect of three psycholinguistic variables—lexical frequency, age of acquisition (AoA), and neighborhood density (ND)—on lexical-semantic processing in individuals with non-fluent (nfvPPA), logopenic (lvPPA), and semantic primary progressive aphasia (svPPA). Identifying the scope and independence of these features can provide valuable information about the organization of words in our mind and brain.Method:We administered a lexical decision task—with words carefully selected to permit distinguishing lexical frequency, AoA, and orthographic ND effects—to 41 individuals with PPA (13 nfvPPA, 14 lvPPA, 14 svPPA) and 25 controls.Results:Of the psycholinguistic variables studied, lexical frequency had the largest influence on lexical-semantic processing, but AoA and ND also played an independent role. The results reflect a brain-language relationship with different proportional effects of frequency, AoA, and ND in the PPA variants, in a pattern that is consistent with the organization of the mental lexicon. Individuals with nfvPPA and lvPPA experienced an ND effect consistent with the role of inferior frontal and temporoparietal regions in lexical analysis and word form processing. By contrast, individuals with svPPA experienced an AoA effect consistent with the role of the anterior temporal lobe in semantic processing.Conclusions:The findings are in line with a hierarchical mental lexicon structure with a conceptual (semantic) and a lexeme (word-form) level, such that a selective deficit at one of these levels of the mental lexicon manifests differently in lexical-semantic processing performance, consistent with the affected language-specific brain region in each PPA variant.

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Neural substrates of verbal repetition deficits in primary progressive aphasia

Brain Communications ◽

10.1093/braincomms/fcab015 ◽

2021 ◽

Author(s):

Hilary E Miller ◽

Claire Cordella ◽

Jessica A Collins ◽

Rania Ezzo ◽

Megan Quimby ◽

...

Keyword(s):

Working Memory ◽

Cortical Thickness ◽

Digit Span ◽

Primary Progressive Aphasia ◽

Supramarginal Gyrus ◽

Phonological Working Memory ◽

Progressive Aphasia ◽

Primary Progressive ◽

Left Posterior ◽

Verbal Repetition

Abstract In this cross-sectional study, we examined the relationship between cortical thickness and performance on several verbal repetition tasks in a cohort of patients with primary progressive aphasia in order to test predictions generated by theoretical accounts of phonological working memory that predict phonological content buffers in left posterior inferior frontal sulcus and supramarginal gyrus. Cortical surfaces were reconstructed from magnetic resonance imaging scans from 42 participants diagnosed with primary progressive aphasia. Cortical thickness was measured in a set of anatomical regions spanning the entire cerebral cortex. Correlation analyses were performed between cortical thickness and average score across three phonological working memory related tasks: the Repetition subtest from the Western Aphasia Battery, a forward digit span task, and a backward digit span task. Significant correlations were found between average working memory score across tasks and cortical thickness in left supramarginal gyrus and left posterior inferior frontal sulcus, in support of prior theoretical accounts of phonological working memory. Exploratory whole-brain correlation analyses performed for each of the three behavioral tasks individually revealed a distinct set of positively-correlated regions for each task. Comparison of cortical thickness measures from different primary progressive aphasia subtypes to cortical thickness in age-matched controls further revealed unique patterns of atrophy in the different subtypes.

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Primary Progressive Aphasia: Use of Graphical Markers for an Early and Differential Diagnosis

Brain Sciences ◽

10.3390/brainsci11091198 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1198

Author(s):

Alexandra Plonka ◽

Aurélie Mouton ◽

Joël Macoir ◽

Thi-Mai Tran ◽

Alexandre Derremaux ◽

...

Keyword(s):

Differential Diagnosis ◽

Healthy Subjects ◽

Language Disorder ◽

Primary Progressive Aphasia ◽

Clinical Settings ◽

Healthy Controls ◽

Progressive Aphasia ◽

Primary Progressive ◽

Digital Tablet

Primary progressive aphasia (PPA) brings together neurodegenerative pathologies whose main characteristic is to start with a progressive language disorder. PPA diagnosis is often delayed in non-specialised clinical settings. With the technologies’ development, new writing parameters can be extracted, such as the writing pressure on a touch pad. Despite some studies having highlighted differences between patients with typical Alzheimer’s disease (AD) and healthy controls, writing parameters in PPAs are understudied. The objective was to verify if the writing pressure in different linguistic and non-linguistic tasks can differentiate patients with PPA from patients with AD and healthy subjects. Patients with PPA (n = 32), patients with AD (n = 22) and healthy controls (n = 26) were included in this study. They performed a set of handwriting tasks on an iPad® digital tablet, including linguistic, cognitive non-linguistic, and non-cognitive non-linguistic tasks. Average and maximum writing pressures were extracted for each task. We found significant differences in writing pressure, between healthy controls and patients with PPA, and between patients with PPA and AD. However, the classification of performances was dependent on the nature of the tasks. These results suggest that measuring writing pressure in graphical tasks may improve the early diagnosis of PPA, and the differential diagnosis between PPA and AD.

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Neuroimaging in the Differential Diagnosis of Primary Progressive Aphasia – Illustrative Case Series in the Light of New Diagnostic Criteria

Polish Journal of Radiology ◽

10.12659/pjr.890320 ◽

2014 ◽

Vol 79 ◽

pp. 251-258 ◽

Cited By ~ 2

Author(s):

Jarosław Sławek

Keyword(s):

Differential Diagnosis ◽

Diagnostic Criteria ◽

Case Series ◽

Primary Progressive Aphasia ◽

Illustrative Case ◽

Progressive Aphasia ◽

Primary Progressive

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First Symptoms of Primary Progressive Aphasia and Alzheimer's Disease in Brazilian Individuals

Frontiers in Neurology ◽

10.3389/fneur.2021.628406 ◽

2021 ◽

Vol 12 ◽

Author(s):

Talita Gallas dos Reis ◽

Thais Helena Machado ◽

Paulo Caramelli ◽

Francisco Scornavacca ◽

Liana Lisboa Fernandez ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Differential Diagnosis ◽

Latin American ◽

Primary Progressive Aphasia ◽

Motor Speech ◽

Progressive Aphasia ◽

Primary Progressive ◽

Initial Symptoms ◽

Semantic Variant

Background: Primary Progressive Aphasia (PPA) is characterized by progressive language impairment due to focal degeneration of brain areas related to linguistic processing. The detection and differential diagnosis of PPA can be difficult with clinical features that may overlap with features of other neurological conditions, such as Alzheimer's disease (AD). The scientific production on PPA in Latin American patients is still scarce. This study investigated the first symptoms in a Brazilian sample of patients with PPA in comparison with AD patients.Method: We compared the first symptoms reported by caregivers of people with PPA (n = 20; semantic variant n = 8, non-fluent variant n = 7, logopenic variant n = 3, and unclassified cases n = 2) and AD (n = 16). Data were collected through the application of a structured questionnaire that was presented in an interview format to the caregiver who knew the patient best.Results: Anomia, paraphasias and motor speech difficulties were the first symptoms capable of differentiating patients with PPA from those with AD, while memory was exclusive of AD. Among the PPA variants, anomia was the initial symptom associated with the semantic variant, while motor speech difficulties were associated with the non-fluent variant. The results are discussed considering the unique cultural and sociodemographic characteristics of this studied population.Conclusion: This study demonstrated that some of the initial symptoms of PPA patients may be unique to clinical variants of PPA and of AD, and their investigation may be useful for the early and differential diagnosis of this population.

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