Longitudinal changes in behaviour, mood and functional capacity in the primary progressive aphasia variants

Area of Science:

• Neurodegenerative diseases
• Neurology
• Psychiatry

Background:

• Primary progressive aphasia (PPA) is a neurodegenerative syndrome impacting speech and language.
• Behavioral, mood, and functional deficits in PPA are less understood.
• PPA comprises distinct variants, including logopenic (lv-PPA), non-fluent (nfv-PPA), and semantic (sv-PPA).

Purpose of the Study:

• To examine the distinct profiles of behavioral, mood, and functional capacity changes across PPA variants.
• To assess how these profiles evolve over time (approximately 6 years).
• To evaluate the relationship between these changes and overall cognitive decline in PPA.

Main Methods:

• 145 individuals with PPA (41 lv-PPA, 44 nfv-PPA, 60 sv-PPA) were assessed annually.
• Behavior, mood, and function were measured using the Cambridge Behavioural Inventory-Revised (CBI-R) carer questionnaire.
• Overall cognition was assessed annually using the Addenbrooke's Cognitive Examination-III.

Main Results:

• Distinct behavioral, mood, and functional profiles were observed across PPA variants.
• sv-PPA patients exhibited greater behavioral, eating, and motivational disturbances compared to other variants.
• Memory problems were more pronounced in sv-PPA and lv-PPA than in nfv-PPA.
• sv-PPA showed a slower cognitive decline rate than lv-PPA, and a parallel rate to nfv-PPA.

Conclusions:

• The evolving behavioral, mood, and functional capacity profiles in PPA variants are distinct and extend beyond language deficits.
• These findings highlight the importance of considering non-language symptoms in PPA management.
• Understanding these distinct trajectories is crucial for effective clinical management and caregiver support.