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Published on: July 2, 2013
Why are patients with progressive nonfluent aphasia nonfluent?
D Gunawardena1, S Ash, C McMillan
1Department of Neurology, 3 Gates, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104-4283, USA.
Neurology
|August 18, 2010
Summary
Nonfluent speech in progressive nonfluent aphasia (PNFA) is linked to grammar deficits and left frontal-temporal brain atrophy. This study clarifies the neural basis of impaired speech fluency in PNFA patients.
Area of Science:
- Neuroscience
- Linguistics
- Neurology
Background:
- Nonfluent speech is a key characteristic of progressive nonfluent aphasia (PNFA).
- This speech pattern is often linked to deficits in syntax, motor-speech planning, and executive functions.
- Brain imaging reveals left inferior frontal atrophy in PNFA patients.
Purpose of the Study:
- To explore the cognitive and neural underpinnings of nonfluent speech in progressive nonfluent aphasia (PNFA).
- To differentiate the factors contributing to nonfluent speech in PNFA compared to behavioral-variant frontotemporal dementia (bvFTD).
Main Methods:
- Compared 16 PNFA patients, 12 bvFTD patients, and 13 controls using speech samples and neuropsychological tests.
- Quantified speech fluency (words per minute) and analyzed its relationship with grammatical, motor-speech, and executive functions.
- Used structural MRI to assess cortical thickness and its correlation with speech fluency and cognitive measures in PNFA and bvFTD.
Main Results:
- PNFA patients exhibited significantly reduced speech fluency (WPM) compared to controls and bvFTD patients.
- Grammatical measures predicted WPM in PNFA, while executive measures predicted WPM in bvFTD.
- Cortical thinning in left inferior frontal and anterior-superior temporal regions correlated with reduced WPM in PNFA, particularly with impaired grammar.
Conclusions:
- Grammatical processing difficulties, associated with left inferior frontal and anterior-superior temporal disease, likely contribute to nonfluent speech in PNFA.
- The findings highlight the distinct neural and cognitive bases for nonfluent speech in PNFA versus bvFTD.
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