Sentence comprehension and voxel-based morphometry in progressive nonfluent aphasia, semantic dementia, and nonaphasic frontotemporal dementia

Peelle, Jonathan E.; Troiani, Vanessa; Gee, James C.; Moore, Peachie; McMillan, Corey T.; Vesely, Luisa; Grossman, Murray

doi:10.1016/j.jneuroling.2008.01.004

Cited by 101 publications

(109 citation statements)

References 60 publications

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“…This inferior frontal involvement is not unexpected given the presence of agrammatic aphasia in this group and the known association between Broca area and agrammatic aphasia. 29,30 Similarities were also noted with the DTI analysis. In contrast to PPAOS and dominant AOS, the agPPA group showed widespread abnormalities for all imaging modalities.…”

supporting

confidence: 69%

Syndromes dominated by apraxia of speech show distinct characteristics from agrammatic PPA

et al. 2013

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Objective: We assessed whether clinical and imaging features of subjects with apraxia of speech (AOS) more severe than aphasia (dominant AOS) are more similar to agrammatic primary progressive aphasia (agPPA) or to primary progressive AOS (PPAOS).Methods: Sixty-seven subjects (PPAOS 5 18, dominant AOS 5 10, agPPA 5 9, age-matched controls 5 30) who all had volumetric MRI, diffusion tensor imaging, F18-fluorodeoxyglucose and C11-labeled Pittsburgh compound B (PiB)-PET scanning, as well as neurologic and speech and language assessments, were included in this case-control study. AOS was classified as either type 1, predominated by sound distortions and distorted sound substitutions, or type 2, predominated by syllabically segmented prosodic speech patterns. Results:The dominant AOS subjects most often had AOS type 2, similar to PPAOS. In contrast, agPPA subjects most often had type 1 (p 5 0.01). Both dominant AOS and PPAOS showed focal imaging abnormalities in premotor cortex, whereas agPPA showed widespread involvement affecting premotor, prefrontal, temporal and parietal lobes, caudate, and insula. Only the dominant AOS and PPAOS groups showed midbrain atrophy compared with controls. No differences were observed in PiB binding across all 3 groups, with the majority being PiB negative. Conclusion:These results suggest that dominant AOS is more similar to PPAOS than agPPA, with dominant AOS and PPAOS exhibiting a clinically distinguishable subtype of progressive AOS compared with agPPA. Neurology â 2013;81:337-345 GLOSSARY agPPA 5 agrammatic primary progressive aphasia; AOS 5 apraxia of speech; ASRS 5 Apraxia of Speech Rating Scale; DTI 5 diffusion tensor imaging; FA 5 fractional anisotropy; FDG 5 F18-fluorodeoxyglucose; MD 5 mean diffusivity; NOS 5 not otherwise specified; PiB 5 Pittsburgh compound B; PPA 5 primary progressive aphasia; PPAOS 5 primary progressive apraxia of speech; PSPS 5 progressive supranuclear palsy syndrome; TDP-43 5 TAR DNA binding protein of 43 kDa; WAB 5 Western Aphasia Battery.The term apraxia of speech (AOS) is used to denote a motor speech disorder in which abnormalities reflect deficits in the programming of movements for speech production.1,2 Although usually caused by left hemisphere stroke, AOS can also be associated with neurodegenerative disease, and when it is the only sign or symptom, it is labeled primary progressive AOS (PPAOS).3,4 Unlike PPAOS, the term primary progressive aphasia (PPA) is reserved for a neurodegenerative disorder in which the most salient feature is language dysfunction. 5-7 Agrammatic PPA (agPPA) is one subtype of PPA, characterized by specific abnormalities that affect grammar and syntax in verbal or written expression. 8,9 Although it is recognized that many subjects with agPPA may have AOS, the most salient feature of agPPA is aphasia. In fact, to be diagnosed with any variant of PPA, 8 language difficulty must be the most prominent clinical feature at symptom onset and for the initial phases of the disease; deficits cannot be due to "disruption o...

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confidence: 69%

Syndromes dominated by apraxia of speech show distinct characteristics from agrammatic PPA

et al. 2013

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“…Previous work has shown limited grammatic expression and comprehension in PNFA. 4,12,26 We examined small groups of patients, and our observations require confirmation with larger groups. Prior work with other patients with PPA has related semantic memory difficulty to nonfluent speech in semantic dementia, 5 but additional work is needed to examine factors contributing to nonfluent speech in the logopenic variant of PPA.…”

Section: Resultsmentioning

confidence: 99%

“…In PNFA, left inferior frontal cortex (IFC) atrophy is associated with grammatic processing, 12 and an fMRI study shows reduced left IFC recruitment during grammatic processing. 13 Patients with PNFA also have atrophy in left insula, an area associated with motorspeech errors, 7 and in left dorsolateral prefrontal cortex, an area associated with mental search.…”

mentioning

confidence: 99%

Why are patients with progressive nonfluent aphasia nonfluent?

Gunawardena¹,

Ash²,

McMillan³

et al. 2010

Neurology

101

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“…Deficits in syntax comprehension are evidenced by impairment of sentence comprehension, initially only for the most difficult syntactic constructions, such as negative passives and object relative clauses (e.g., "The car that the truck hit was green"). 8,9,11,37,38 While sentence comprehension can also be impaired in logopenic variants, in the nonfluent presentation, the impairment is clearly influenced by the grammatical complexity of the sentence. Single-word comprehension and object knowledge are usually relatively spared in nonfluent patients and this feature is helpful in early differential diagnosis.…”

Section: Nonfluent/agrammatic Variant Ppa (Also Known As Progressive mentioning

confidence: 99%

Classification of primary progressive aphasia and its variants

Gorno-Tempini¹,

Hillis²,

Weıntraub³

et al. 2011

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This article provides a classification of primary progressive aphasia (PPA) and its 3 main variants to improve the uniformity of case reporting and the reliability of research results. Criteria for the 3 variants of PPA-nonfluent/agrammatic, semantic, and logopenic-were developed by an international group of PPA investigators who convened on 3 occasions to operationalize earlier published clinical descriptions for PPA subtypes. Patients are first diagnosed with PPA and are then divided into clinical variants based on specific speech and language features characteristic of each subtype. Classification can then be further specified as "imaging-supported" if the expected pattern of atrophy is found and "with definite pathology" if pathologic or genetic data are available. The working recommendations are presented in lists of features, and suggested assessment tasks are also provided. These recommendations have been widely agreed upon by a large group of experts and should be used to ensure consistency of PPA classification in future studies. Future collaborations will collect prospective data to identify relationships between each of these syndromes and specific biomarkers for a more detailed understanding of clinicopathologic correlations. Neurology

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Sentence comprehension and voxel-based morphometry in progressive nonfluent aphasia, semantic dementia, and nonaphasic frontotemporal dementia

Cited by 101 publications

References 60 publications

Syndromes dominated by apraxia of speech show distinct characteristics from agrammatic PPA

Syndromes dominated by apraxia of speech show distinct characteristics from agrammatic PPA

Why are patients with progressive nonfluent aphasia nonfluent?

Classification of primary progressive aphasia and its variants

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