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Cognitive decline in logopenic aphasia: more than losing words
Cristian E Leyton1, Sharpley Hsieh, Eneida Mioshi
1Neuroscience Research Australia, Randwick, Australia.
Neurology
|February 8, 2013
Summary
Logopenic variant primary progressive aphasia (lv-PPA) patients experience rapid, widespread cognitive decline leading to dementia. Semantic variant primary progressive aphasia (sv-PPA) patients show slower, language-specific changes.
Area of Science:
- Neurology
- Cognitive Neuroscience
- Linguistics
Background:
- Primary progressive aphasia (PPA) presents with progressive language impairment.
- Distinguishing between PPA variants is crucial for prognosis and management.
- Logopenic (lv-PPA) and semantic (sv-PPA) variants have distinct clinical profiles.
Purpose of the Study:
- To longitudinally track cognitive and language changes in patients with lv-PPA and sv-PPA.
- To compare the rate and pattern of neurodegeneration between these two PPA variants.
Main Methods:
- A cohort of 13 lv-PPA and 11 sv-PPA patients underwent annual assessments for 3 years.
- Cognitive function was evaluated using the Mini-Mental State Examination and Addenbrooke's Cognitive Examination-revised (ACE-R).
- Language abilities were assessed using single-word processing tasks; some patients also underwent Pittsburgh Compound B PET scans.
Main Results:
- Despite similar baseline impairment, lv-PPA patients exhibited faster, generalized cognitive decline, often progressing to dementia within a year.
- sv-PPA patients demonstrated slower cognitive decline, primarily affecting verbally mediated tasks.
- PET scans indicated differing patterns of neurodegeneration between the two groups (details not specified in abstract).
Conclusions:
- lv-PPA is associated with rapid progression towards global dementia.
- sv-PPA is characterized by a prolonged period of semantic impairment.
- The ACE-R is a suitable tool for monitoring disease progression in PPA, relevant for clinical trials.
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