What are the 3 variants of Primary Progressive Aphasia (PPA)?
- Nonfluent agrammatic variant - nfvPPA
- Fluent (semantic) variant - svPPA
- Logopenic Variant - IvPPA
PPA variant can be diagnosed only after the following are established:
What must the patient NOT have:
- Insidious onset, gradual progression and
Must have all 3:
1. Language impairment is the most prominant clinical feature
2. Language difficulty is the cause of impaired ADL’s
3. Aphasia is the most prominent feature at onset and in early stages
Must NOT have:
1. Be better accounted for by other neurodegenerative, psychiatric, or medical disorders
2. Have initial episodic memory, visual memory, and/or visuo-perceptual impairments
3. Have prominent initial behavioural disturbances
Nonfluent-agrammatic PPA is a ______________ based disorder.
Phonologically
On neuroimaging, of the nonfluent-agrammatic variant PPA, you would see…
- Unilateral in the inferior frontal part of the dominant hemisphere
What is the criteria for Nonfluent - agrammatic PPA?
At least one must be present:
1. Agrammatism
2. Apraxia of speech
At least 2 of the following 3 features:
1. Impaired complex syntax
2. Spared comprehension of single words
3. Spared object knowledge
What is the problem with the criteria for Nonfluent - agrammatic PPA?
It is very similar to Broca’s
What are some hallmarks of PPA?
- People will go about their daily life as they would normally
- No underlying cognitive impairments, no physical
- It is just language
What is the status of semantic knowledge in nonfluent-agrammatic PPA?
Preserved
What is the criterion for Fluent-semantic variant PPA?
Both must be present:
1. Impaired confrontation naming
2. Impaired comprehension of single words
At least 3 of the following 4 features:
1. Impaired object knowledge
2. Surface dyslexia or dysgraphia
3. Spared repetition
4. Spared syntax and motor speech
Describe the Semantic (Fluent) PPA (svPPA)?
- People might hear a word and then it disappears
- Phonology needs to meet semantics for understanding, however, there is no semantic system for it to meet
Where is the neurological damage in Semantic (fluent) variant PPA?
- Anterior temporal lobes (bilaterla)
- Language part comes from the left hemisphere
(If right hemisphere problems exist it creates cognitive problems and is coined semantic dementia)
What is the most prominent feature in Logopenic progressive aphasia (IvPPA)?
Anomia
Where is the neurological damage in Logopenic Variant PPA?
- Unilateral and starts in the posterior temporal regions, dominant hemisphere
What is the difference in neurological damage in Logopenic Variant PPA and AD?
- In logopenic variant PPA there is unilateral damage that starts in the posterior temporal regions, the dominant hemisphere
- In AD, it starts in the temporal parietal lobes BUT bilaterally
What is the criteria for Logopenic Variant PPA?
Both must be present:
1. Impaired single word retrieval (naming and conversation)
2. Impaired repetition of sentences and phrases
At least 3 of the following 4 features:
1. Phonological errors on naming and in conversations
2. Spared single-word comprehension and object knowledge
3. Spared motor ability
4. Absence of agrammatism
go onwards from the decision making tree
