The Combination of Metabolic Posterior Cingulate Cortical Abnormalities and Structural Asymmetries Improves the Differential Diagnosis Between Primary Progressive Aphasia and Alzheimer’s Disease

2021 ◽  
pp. 1-7
Author(s):  
Micaela Mitolo ◽  
Michelangelo Stanzani-Maserati ◽  
David N. Manners ◽  
Sabina Capellari ◽  
Claudia Testa ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Differential Diagnosis ◽  
Primary Progressive Aphasia ◽  
Posterior Cingulate Cortex ◽  
Structural Imaging ◽  
Proton Mr Spectroscopy ◽  
Progressive Aphasia ◽  
Posterior Cingulate ◽  
Primary Progressive

Differential diagnosis between primary progressive aphasia (PPA) and Alzheimer’s disease (AD) could be difficult if based on clinical grounds alone. We evaluated the combination of proton MR spectroscopy of posterior cingulate cortex (PCC) and quantitative structural imaging asymmetries to differentiate PPA from AD patients. A greater left-lateralized temporo-parietal atrophy (higher accuracy for the PCC, 81.4%) and metabolic neurodegenerative changes in PCC (accuracy 76.8%) was demonstrated in PPA versus AD. The combined multiparametric approach increased the accuracy to 94%in the differential diagnosis between these two neurodegenerative diseases.

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

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.

Clinical Characteristic in Primary Progressive Aphasia in Relation to Alzheimer’s Disease Biomarkers

2021 ◽  
pp. 1-13
Author(s):  
Sung Hoon Kang ◽  
Hanna Cho ◽  
Jiho Shin ◽  
Hang-Rai Kim ◽  
Young Noh ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Language Impairment ◽  
Amyloid Β ◽  
Primary Progressive Aphasia ◽  
Cortical Atrophy ◽  
Clinical Feature ◽  
Progressive Aphasia ◽  
Disease Biomarkers ◽  
Primary Progressive

Background: Primary progressive aphasia (PPA) is associated with amyloid-β (Aβ) pathology. However, clinical feature of PPA based on Aβ positivity remains unclear. Objective: We aimed to assess the prevalence of Aβ positivity in patients with PPA and compare the clinical characteristics of patients with Aβ-positive (A+) and Aβ-negative (A–) PPA. Further, we applied Aβ and tau classification system (AT system) in patients with PPA for whom additional information of in vivo tau biomarker was available. Methods: We recruited 110 patients with PPA (41 semantic [svPPA], 27 non-fluent [nfvPPA], 32 logopenic [lvPPA], and 10 unclassified [ucPPA]) who underwent Aβ-PET imaging at multi centers. The extent of language impairment and cortical atrophy were compared between the A+ and A–PPA subgroups using general linear models. Results: The prevalence of Aβ positivity was highest in patients with lvPPA (81.3%), followed by ucPPA (60.0%), nfvPPA (18.5%), and svPPA (9.8%). The A+ PPA subgroup manifested cortical atrophy mainly in the left superior temporal/inferior parietal regions and had lower repetition scores compared to the A–PPA subgroup. Further, we observed that more than 90%(13/14) of the patients with A+ PPA had tau deposition. Conclusion: Our findings will help clinicians understand the patterns of language impairment and cortical atrophy in patients with PPA based on Aβ deposition. Considering that most of the A+ PPA patents are tau positive, understanding the influence of Alzheimer’s disease biomarkers on PPA might provide an opportunity for these patients to participate in clinical trials aimed for treating atypical Alzheimer’s disease.

O2-14-01: HETEROGENEOUS LANGUAGE PROFILES IN PATIENTS WITH PRIMARY PROGRESSIVE APHASIA DUE TO ALZHEIMER'S DISEASE

2014 ◽  
Vol 10 ◽  
pp. P196-P197
Author(s):  
Antoinette M. Keulen ◽  
Eva Louwersheimer ◽  
L.C. Jiskoot ◽  
John C. van Swieten ◽  
Yolande A.L. Pijnenburg
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Primary Progressive Aphasia ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Language Profiles

Making the Right Connections: Maximizing Lexical Generalization in Lexical Impairments in Primary Progressive Aphasia and Alzheimer's Disease

2021 ◽  
pp. 1-16
Author(s):  
Ashleigh Beales ◽  
Anne Whitworth ◽  
Jade Cartwright ◽  
Peter K. Panegyres ◽  
Robert T. Kane
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Family Members ◽  
Primary Progressive Aphasia ◽  
Lexical Retrieval ◽  
Connected Speech ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Word Classes ◽  
The Impact

Purpose Positive intervention effects following lexical retrieval interventions are increasingly reported with people with progressive language impairments; however, generalization of therapy gains are less frequently evident and less well understood. This study sought to explore the impact of specific therapy ingredients on generalization outcomes. Method Twelve participants with progressive lexical retrieval deficits (four each with semantic variant primary progressive aphasia, logopenic variant primary progressive aphasia, and Alzheimer's disease, amnestic presentation) and their family members participated in a 6-week intervention that aimed to increase access to different word classes (nouns, verbs, and adjectives) through a strategic self-cueing approach. Generalization was actively facilitated through strategy practice in connected speech. Repeated baselines of picture naming and connected speech were conducted prior to intervention and repeated immediately post and at 6 weeks following intervention. Results All three diagnostic groups showed significant improvements in naming performance post-intervention for all word classes and for both treated and untreated items, demonstrating consistent treatment effectiveness and generalization at the word level. No changes in the informativeness or efficiency of connected speech were found. Conclusions Despite heterogeneity across participants, widespread evidence of both treatment effects and generalization to untreated items was found for all diagnostic groups and word classes. The consistent within-level generalization across all groups is explored here in relation to optimization of strategy use through incorporation of cognitive scaffolds, strategic practice at the connected speech level, and the inclusion of family members. The absence of across-level generalization to connected speech is also explored. Supplemental Material https://doi.org/10.23641/asha.14219771

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