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Published on: August 12, 2019
Quantitative application of the primary progressive aphasia consensus criteria
Meredith R Wicklund1, Joseph R Duffy, Edythe A Strand
1From the Division of Behavioral Neurology (M.R.W., K.A.J.), Speech Pathology, Department of Neurology (J.R.D., E.A.S.), Division of Neurocognitive Disorders, Department of Psychiatry and Psychology (M.M.M.), and Division of Radiology Research, Department of Radiology (J.L.W.), Mayo Clinic, Rochester, MN.
Current criteria for classifying primary progressive aphasia (PPA) variants are not sensitive enough, leaving many patients unclassified. Modifications are needed to improve diagnostic accuracy for these neurodegenerative speech and language disorders.
Area of Science:
- Neurology
- Linguistics
- Neuroimaging
Background:
- Primary progressive aphasia (PPA) is a neurodegenerative disorder affecting speech and language.
- Diagnostic criteria aim to classify PPA into distinct syndromic variants.
- Quantitative assessment tools are crucial for accurate diagnosis.
Purpose of the Study:
- To evaluate the efficacy of consensus criteria in classifying PPA subtypes.
- To assess the performance of a quantitative speech and language battery against established criteria.
- To identify limitations in current diagnostic approaches for PPA.
Main Methods:
- Prospective recruitment of 105 participants with neurodegenerative speech and language disorders.
- Utilized neurologic, neuropsychological, speech/language testing, and MRI.
- Applied consensus criteria with specific cutoffs and employed hierarchical cluster analysis for unclassified cases.
Main Results:
- 69% of 84 participants were classified into agrammatic, semantic, or logopenic PPA variants.
- 31% of participants remained unclassified by the consensus criteria.
- Cluster analysis revealed two groups resembling mild logopenic and semantic PPA, with corresponding gray matter loss patterns.
Conclusions:
- Quantitative application of PPA consensus criteria identifies major variants but has limited sensitivity.
- A significant proportion of individuals with PPA were not classifiable using current criteria.
- The study highlights the need for revising PPA consensus criteria to enhance diagnostic accuracy.
