Classification of primary progressive aphasia: challenges and complexities

Tippett, Donna C.

doi:10.12688/f1000research.21184.1

Cited by 38 publications

(28 citation statements)

References 84 publications

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“…Each variant of PPA is statistically associated with distinct etiologies, with lvPPA being most commonly associated with AD neuropathology. Even so, clinical and neuroanatomic delineations between PPA syndromes can be muddled, 13,46,47 and it is critical to identify specific Abbreviations: ANOVA, analysis of variance; BNT, Boston Naming Test. Notes: Akaike information criterion (AIC), Bayesian information criterion (BIC), and log likelihood (logLik) assess model fit for BNT (A) and Forward Span (B) Models.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal naming and repetition relates to AD pathology and burden in autopsy‐confirmed primary progressive aphasia

Cousins

Bove

Giannini

et al. 2021

A&D Transl Res & Clin Interv

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Introduction In primary progressive aphasia (PPA) patients with autopsy‐confirmed Alzheimer's disease (AD) or frontotemporal lobar degeneration (FLTD), we tested how the core clinical features of logopenic PPA—naming and repetition—change over time and relate to pathologic burden. Methods In PPA with AD (n = 13) or FTLD (n = 16) pathology, Boston Naming Test and Forward Digit Span measured longitudinal naming and repetition; as reference, Mini‐Mental State Examination (MMSE) measured global cognition. Pathologic burden in left peri‐Sylvian regions was related to longitudinal cognitive decline. Results PPA with AD showed greater decline in naming (P = 0.021) and repetition (P = 0.020), compared to FTLD; there was no difference in MMSE decline (P = 0.99). Across all PPA, declining naming (P = 0.0084) and repetition (P = 0.011) were associated with angular, superior‐middle temporal (naming P = 0.014; repetition P = 0.011) and middle frontal (naming P = 0.041; repetition P = 0.030) pathologic burden. Discussion Unique longitudinal profiles of naming and repetition performance in PPA with AD are related to left peri‐Sylvian pathology.

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Section: Discussionmentioning

confidence: 99%

Longitudinal naming and repetition relates to AD pathology and burden in autopsy‐confirmed primary progressive aphasia

Cousins

Bove

Giannini

et al. 2021

A&D Transl Res & Clin Interv

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“…Unclassifiable cases of PPA were reported in several studies in which the diagnostic criteria for PPA were used. 3 These classification issues appeared to be particularly important for lvPPA. For example, Sajjadi et al 4 carried out a factor analysis of the results of 46 individuals diagnosed with PPA in a set of language tests.…”

Section: Introductionmentioning

confidence: 99%

Heterogeneity of repetition abilities in logopenic variant primary progressive aphasia

Macoir¹,

Martel‐Sauvageau

Bouvier³

et al. 2021

Dement. neuropsychol.

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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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“…One of the challenges in PPA classification arises because of the involvement of repetition impairment as the core criterion in the 2011 classification. There is accumulating evidence showing that repetition impairment can be evident in all three subtypes of PPA with variable ranges of severity 24–27. In contrast, subtyping of PPA in non-English-speaking cohorts can be even more problematic, especially in a routine clinical setting with limited evaluation time and support by specialized personnel such as speech pathologists or clinical linguists.…”

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confidence: 99%

Utility of the Repeat and Point Test for Subtyping Patients With Primary Progressive Aphasia

Seçkin

Ricard

Raiser

et al. 2022

Alzheimer Disease &Amp; Associated Disorders

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Background: Primary progressive aphasia (PPA) may present with three distinct clinical sybtypes: semantic variant PPA (svPPA), nonfluent/agrammatic variant PPA (nfvPPA), and logopenic variant PPA (lvPPA). Objective: The aim was to examine the utility of the German version of the Repeat and Point (R&P) Test for subtyping patients with PPA. Method: During the R&P Test, the examiner reads out aloud a noun and the participants are asked to repeat the word and subsequently point to the corresponding picture. Data from 204 patients (68 svPPA, 85 nfvPPA, and 51 lvPPA) and 33 healthy controls were analyzed. Results: Controls completed both tasks with >90% accuracy. Patients with svPPA had high scores in repetition (mean=9.2±1.32) but low scores in pointing (mean=6±2.52). In contrast, patients with nfvPPA and lvPPA performed comparably in both tasks with lower scores in repetition (mean=7.4±2.7 for nfvPPA and 8.2±2.34 for lvPPA) but higher scores in pointing (mean=8.9±1.41 for nfvPPA and 8.6±1.62 for lvPPA). The R&P Test had high accuracy discriminating svPPA from nfvPPA (83% accuracy) and lvPPA (79% accuracy). However, there was low accuracy discriminating nfvPPA from lvPPA (<60%). Conclusion: The R&P Test helps to differentiate svPPA from 2 nonsemantic variants (nfvPPA and lvPPA). However, additional tests are required for the differentiation of nfvPPA and lvPPA.

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Classification of primary progressive aphasia: challenges and complexities

Cited by 38 publications

References 84 publications

Longitudinal naming and repetition relates to AD pathology and burden in autopsy‐confirmed primary progressive aphasia

Longitudinal naming and repetition relates to AD pathology and burden in autopsy‐confirmed primary progressive aphasia

Heterogeneity of repetition abilities in logopenic variant primary progressive aphasia

Utility of the Repeat and Point Test for Subtyping Patients With Primary Progressive Aphasia

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