Neuropsychological Profiles Differ among the Three Variants of Primary Progressive Aphasia

Abstract

The objective of this study was to describe the neuropsychological profiles of the three variants of primary progressive aphasia (PPA). Based on a comprehensive speech and language evaluation, 91 subjects were classified as logopenic (lvPPA = 51), semantic (svPPA = 13), or agrammatic (agPPA = 27). All subjects completed a separate neuropsychological evaluation assessing verbal and visual memory, processing speed, executive function, and visuospatial function. The groups did not differ on demographic variables or on measures of disease duration or aphasia severity. There were group differences on aspects of learning and memory, as well as aspects of executive and visuospatial functions, primarily with the lvPPA group performing lower than the agPPA and svPPA groups. The agPPA group showed subtle deficits consistent with frontal lobe impairment, whereas neurocognitive weaknesses in the svPPA group were restricted to temporal lobe functions. The pattern of neurocognitive dysfunction in lvPPA suggests disease involvement of frontal lobe functions in addition to temporoparietal functions. These neurocognitive findings emphasize the value of a comprehensive neuropsychological evaluation of individuals who present with primary language disturbance, given the pattern of cognitive deficits may provide additive information for differentiating these clinical syndromes. (JINS, 2015, 21, 1–7)

Primary progressive aphasia: a clinical approach

“…The patient may struggle to understand more complex sentences and to hold verbal information in mind. While language is (by definition) the leading and dominant issue, there is frequently a history of associated extra-linguistic difficulties extending to the realms of memory (e.g., forgetfulness, repetitiveness or route-finding problems), praxis (e.g., use of work equipment, tools or household gadgets) or visuo-spatial awareness (e.g., inability to judge distances accurately, find exits or locate items in plain sight) [ 65 , 66 ].…”

Classification of primary progressive aphasia: challenges and complexities

“…For example, those with lvPPA demonstrate difficulties in verbal working memory 5 , which can be assessed using a digit span task. Visuospatial abilities and visual memory also have been studied in PPA, revealing deficits in this patient population, especially in lvPPA [66][67][68][69] found that delayed figure copying was relatively spared in nfaPPA and significantly more impaired in lvPPA and svPPA. They also found an association between PPA variants and scores on immediate figure copying with a greater percentage of those with nfaPPA scoring within normal limits than those with lvPPA and svPPA.…”

An interdisciplinary approach aiding the diagnosis of primary progressive aphasia: A case report

“…Regarding the cognitive profile in the PPA, the subject exhibited a possible logopenic variant of PPA, her complaints were still centered on language skills, but objectively impairment was also identified in the performance of some abilities of executive function. 4 , 5 …”