Objectives: To determine patterns of hypometabolism on fluorodeoxyglucose F18 positron emission tomography (FDG-PET) in patients with progressive apraxia of speech (PAS) and primary progressive aphasia (PPA) variants and to use these patterns to further refine current classification. Design:We identified all patients who had FDG-PET and PAS or PPA who were evaluated by an expert speechlanguage pathologist. Patterns of hypometabolism were independently classified by 2 raters blinded to clinical data. Three speech-language pathologists reclassified all patients into 1 of 7 operationally defined categories of PAS and PPA blinded to FDG-PET data.

In the context of a hybrid multiple-baseline design, this study demonstrated the positive effects of a behavioral + pharmacological (dextroamphetamine) treatment for lexical-semantic deficits in an individual with primary progressive aphasia (PPA). Behavioral treatment entailed application of a cuing hierarchy to predicative adjectives in order to facilitate lexical retrieval. Treatment was effective for both antonym and synonym adjectives, although extended practice was required to achieve criterion. Generalization to nontreated adjectives, verbs, and prepositions was observed, and maintenance was difficult to disambiguate from the progressive nature of the disease. It was proposed that the mechanisms of activation and inhibition were responsible for improved performance. Differential effects between behavioral and behavioral + pharmacological treatment were not observed.

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BACKGROUND Among the elicited and observed procedures used to describe, classify, diagnose, measure change, quantify severity, and plan intervention for persons with aphasia, the measurement of connected spoken language has become a stable and valued procedure for many of these purposes. Though recognized, the most valid, reliable, and efficient methods for sampling connected language has received relatively little experimental attention from clinical and experimental aphasiologists. The recently developed Story Retell Procedure (SRP) (Doyle, et al, 2000) has the unique measurement advantage of predetermined targets for the retold stories thus increasing the validity of measuring the accuracy of the connected sample. However, linguistic measures of SRP performance reflect both comprehension and production processing. While the reliability and concurrent validity of the scoring methods for the forms of the SRP have been investigated (McNeil, et al, 2001; McNeil, et al, 2002), concurrent validation of this procedure with other established connected language sampling procedures has not been investigated. This study sought to compare several aspects of the language generated from one of the four forms of the SRP with two other published procedures for eliciting spoken language in persons with aphasia; the "Cinderella Story" (Berndt, Wayland, Rochon, Saffran, & Schwartz, 2000) and the five elicitation tasks (WAB & BDAE picture, two sequenced picture; two novel pictures, two procedural language tasks, and two personal information tasks) published by Nicholas and Brookshire (1993). METHOD To date, thirteen persons with aphasia who were defined by their performance on the Porch Index of Communicative Ability (Porch, 1981), the Revised Token Test (McNeil & Prescott, 1978) and on an immediate and delayed language recall task of the Assessment Battery of Communication in Dementia (Bayles & Tomoeda, 1993) have completed the seven language elicitation procedures describe above and their data have been analyzed. The data from seven additional subjects will be included for the final presentation. Biographical and selection data are summarized for each subjects in Table 1. The experimental tasks were administered in random order across participants and later transcribed and analyzed using SALT (Miller & Chapman, 1998) software. Eight measures of verbal productivity [number of story propositions (#Prop), number, percent, and number per minute Correct Information Units (# and %CIU and CIU/Min), number and percent Story Propositions (# and %SP), number of Utterances (#U), number of words (#W), and number of words per minute (#WPM), mean length of utterance (MLU), type-token ratio (TTR)]; two measures of syntactic complexity [number of conjunctions (#C), number of grammatically well-formed sentences (#GWF)], and three measure of verbal disruption [number of mazes (#Mz), number of abandoned sentences (#AS), percent of intelligible words (%IW)] were calculated for each of the seven language elicitation tasks. Data were analyzed within...