Motor speech disorders associated with primary progressive aphasia

Abstract

Background Primary progressive aphasia (PPA) and conditions that overlap with it can be accompanied by motor speech disorders. Recognition and understanding of motor speech disorders can contribute to a fuller clinical understanding of PPA and its management as well as its localization and underlying pathology. Aims To review the types of motor speech disorders that may occur with PPA, its primary variants, and its overlap syndromes (progressive supranuclear palsy syndrome, corticobasal syndrome, motor neuron disease), as well as with primary progressive apraxia of speech. Main Contribution The review should assist clinicians' and researchers' understanding of the relationship between motor speech disorders and PPA and its major variants. It also highlights the importance of recognizing neurodegenerative apraxia of speech as a condition that can occur with little or no evidence of aphasia. Conclusion Motor speech disorders can occur with PPA. Their recognition can contribute to clinical diagnosis and management of PPA and to understanding and predicting the localization and pathology associated with PPA variants and conditions that can overlap with them.

Slowed articulation rate is a sensitive diagnostic marker for identifying non-fluent primary progressive aphasia

“…Reduced articulation rate in nfvPPA, therefore, reflects motor impairment as a primary source of non-fluency in this population. This result is also consistent with clinical descriptions that establish apraxia of speech—and less frequently, dysarthria—as conditions associated with nfvPPA (Duffy, Strand, & Josephs, 2014). In the current sample, 10 of 11 participants diagnosed with nfvPPA had apraxic speech characteristics as judged by a speech language pathologist, thus providing additional support for the suggestion that slowed articulation rate is a characteristic speech feature in this group.…”

“…This result is consistent with the absence of a primary motor deficit among the more fluent subtypes, although a marginally significant difference in articulation rate between lvPPA and svPPA subgroups is also consistent with reports of secondary motor speech involvement in a minority of lvPPA individuals (Duffy et al, 2014). …”

Clinical and imaging progression over 10 years in a patient with primary progressive apraxia of speech and autopsy-confirmed corticobasal degeneration

“…Action (verb)(Woods et al, 2005) and Letter (FAS) fluency(Loonstra, Tarlow, & Sellers, 2001) tasks served as indices of rapid-word retrieval ability. The severity of his motor speech disorder was quantified using the Motor Speech Disorder (MSD) scale(Yorkston, Strand, Miller, Hillel, & Smith, 1993) and the AOS rating scale (ASRS)(Duffy, Strand, & Josephs, 2014). Dysarthria severity was measured on a 0–4 scale based on all spoken language tests of the WAB plus additional speech tasks.…”

Temporal acoustic measures distinguish primary progressive apraxia of speech from primary progressive aphasia

“…We will use the designation nfPPA when referring to the literature on the nonfluent/agrammatic variant of PPA in which AOS and agrammatism are considered core features (Gorno-Tempini et al, 2011) and one or both problems can be present. Although AOS occurs very frequently in nfPPA (Duffy, Strand, & Josephs, 2014; Ogar et al, 2007), in this study we did not examine individuals who had both AOS and agrammatism. It is generally accepted that AOS does not occur in the semantic variant of PPA and that it is uncommon in the logopenic variant of PPA (lvPPA), although AOS errors can be difficult to distinguish from the phonological errors associated with lvPPA (Croot, Ballard, Leyton, & Hodges, 2012).…”