Writing Abilities in Primary Progressive Aphasia: A Scoping Literature Review

Given the central role of writing and typing in contemporary communication, integrating writing assessments into clinical practice is crucial for improving the diagnosis and management of primary progressive aphasia (PPA). This scoping review summarizes evidence on writing abilities in PPA, examining task types, their strengths and limitations, the linguistic features of stimuli, and the influence of language differences.

A literature search was conducted using the Google Scholar and PubMed databases. We included papers published in peer-reviewed journals and written in English that present data from at least one PPA subject and report a quantitative score relative to a writing task. Fifty-one studies were included (forty-seven behavioral; four with neuroimaging).

Overall, the literature is fragmented, with marked variability in task design and the control of psycholinguistic variables. Writing to dictation is the most frequently used task but fails to capture the full spectrum of writing impairments, whereas tasks tapping lexico-semantic, morpho-syntactic, and discourse-level abilities are rarely employed. At the syndromic description level, svPPA typically shows surface dysgraphia, nfvPPA presents phonological dysgraphia and agrammatic writing, and lvPPA displays mixed error profiles. Neuroimaging findings are highly heterogeneous.

The review underscores the need for systematic, linguistically grounded approaches to writing assessments in PPA to enhance diagnostic precision and cross-linguistic comparability.