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Alzheimer's pathology in primary progressive aphasia
Jonathan D Rohrer1, Martin N Rossor, Jason D Warren
1Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, Queen Square, London, UK.
Neurobiology of Aging
|June 29, 2010
Summary
Logopenic/phonological aphasia (LPA) is a subtype of primary progressive aphasia (PPA) often linked to Alzheimer's disease (AD). This study defines LPA features in AD patients, revealing specific language and memory deficits and distinct patterns of brain atrophy.
Area of Science:
- Neuroscience
- Neurology
- Linguistics
Background:
- Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by progressive language impairment.
- Logopenic/phonological aphasia (LPA) is a PPA subtype frequently associated with Alzheimer's disease (AD) pathology.
- The specific clinical and neuroimaging features of PPA with AD pathology, particularly LPA, require further definition.
Purpose of the Study:
- To define the neurological and neuropsychological features of primary progressive aphasia associated with Alzheimer's disease pathology.
- To characterize the pattern of cortical atrophy in patients with LPA and confirmed or biomarker-supported AD.
- To explore the concept of LPA as a potential unihemispheric presentation of AD.
Main Methods:
- Retrospective identification of 14 patients with PPA and confirmed AD or AD biomarkers (CSF).
- Analysis of neurological and neuropsychological assessments, including language function, memory, and digit span.
- Neuroimaging analysis to determine patterns of cortical thinning using MRI.
Main Results:
- All patients presented with LPA, characterized by nonfluent speech, phonemic errors, and reduced digit span.
- Impaired verbal episodic memory was observed in most patients.
- Cortical thinning was prominent in left posterior superior temporal, inferior parietal, medial temporal, and posterior cingulate regions, with further involvement in anterior/frontal and right hemisphere areas in severe cases.
Conclusions:
- Logopenic/phonological aphasia in the context of Alzheimer's disease presents with a distinct pattern of language and memory deficits.
- The observed atrophy patterns suggest a potential unihemispheric (left-dominant) presentation of AD in LPA.
- Further research is warranted to understand the relationship between LPA, language dysfunction, and Alzheimer's disease progression.
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