Can MRI Visual Assessment Differentiate the Variants of Primary-Progressive Aphasia?

Sheikh‐Bahaei, Nasim; Cross, J. Helen; Gillard, Jonathan H.; Scoffings, Daniel; Nestor, Peter J.

doi:10.3174/ajnr.a5126

Cited by 29 publications

(29 citation statements)

References 48 publications

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“…SD cases have hypometabolism and atrophy centred on the ATL bilaterally (Mummery et al, 2000), which data from other methods in healthy participants and patient groups has shown to be a key region for the formation of coherent concepts (Lambon Ralph et al, 2010). This finding agrees with Sajjadi et al (2017) who found that the atrophy patterns for SD were more easily distinguishable (high sensitivity and specificity) than the other forms of PPA.…”

Section: Discussionsupporting

confidence: 92%

Graded, multi-dimensional intragroup and intergroup variations in primary progressive aphasia and post-stroke aphasia

Ingram

Halai

Pobric

et al. 2019

Preprint

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Language impairments caused by stroke (post-stroke aphasia) and neurodegeneration (primary progressive aphasia) have overlapping symptomatology, nomenclature and are classically divided into categorical subtypes. Surprisingly, primary progressive aphasia (PPA) and post-stroke aphasia (PSA) have rarely been directly compared in detail. Rather previous studies have compared certain subtypes (e.g., semantic variants) or have focussed on a specific cognitive/linguistic task (e.g., reading). This study assessed a large range of linguistic and cognitive tasks across the full spectra of PSA and PPA. We applied varimax-rotated principal component analysis to explore the underlying structure of the variance in the assessment scores. Similar phonological, semantic and fluencyrelated components were found for PSA and PPA. A combined principal component analysis across the two aetiologies revealed graded intragroup and intergroup variations on all four extracted components. Classification analysis was employed to test, formally, whether there were any categorical boundaries for any subtypes of PPA or PSA. Semantic dementia proved to form a true diagnostic category (i.e., within group homogeneity and distinct between group differences), whereas there was considerable overlap and graded variations within and between other subtypes of PPA and PSA. These results suggest that (a) a multi-dimensional rather than categorical classification system may be a better conceptualisation of aphasia from both causes, and (b) despite the very different types of pathology, these broad classes of aphasia have considerable features in common.

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Section: Discussionsupporting

confidence: 92%

Graded, multi-dimensional intragroup and intergroup variations in primary progressive aphasia and post-stroke aphasia

Ingram

Halai

Pobric

et al. 2019

Preprint

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“…Table 2, at QL in 9 (patients 1-9) of the 18 (50%) cases, the HA were in the temporoparietal cortex and in limbic structures, in most cases bilaterally and predominantly in the left hemisphere, with the highest negative z score value mainly in the temporoparietal and temporal lateral cortex at QN. At QL in 6 of 18 (33.3%) patients (10)(11)(12)(13)(14)(15), the HA were in the frontoparietal and frontotemporal regions with the highest negative z score value at QN, in the prefrontal and temporal regions. However, in the remaining 3 of 18 (16.7%) patients (16)(17)(18) in whom the HA at QL appeared widespread and irregular in both cortical hemispheres, QN localized the highest z score negative value in the prefrontal and parietal areas bilaterally.…”

Section: Resultsmentioning

confidence: 95%

“…Diagnosis and classification of the different variants of PPA, namely nfvPPA, svPPA, and lvPPA, by clinical and neuropsychological analyses may be difficult; however, an early correct diagnosis allows adequate treatment, and influences disease progression as well as prognosis [6,[21][22][23]. Thus, it has been necessary to employ neuroimaging procedures as standard and functional MRI, the latter still limited [10,25,26]. Brain metabolic 18 F-FDG PET studies, using QL, have also been utilized with favorable results in the diagnosis of PPA and in the discrimination of the different variants [27].…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…Globally, the combined use of QL and QN evidenced that the two procedures concordantly permitted to achieve a correct diagnosis in 8 of 18 (44.4%) cases, as lvPPA in 4 cases (5)(6)(7)(8) and as nfvPPA in 4 cases (12)(13)(14)(15). In the other 10 of 18 (55.6%) patients, only QN could be useful for the correct diagnosis, as lvPPA in 5 cases (1,2,3,11,16) and as nfvPPA in the remaining 5 cases (4,9,10,17,18). Case 3 is illustrated in Figure 1.…”

Section: Group a As Illustrated Inmentioning

confidence: 93%

“…Standard magnetic resonance imaging (MRI) has high specificity [2,7], and left frontal inferior and insular atrophy is detected in nfvPPA, predominantly left-sided, bilateral anterior temporal atrophy in svPPA, and left temporoparietal atrophy in lvPPA [7,8]. However, MRI has low sensitivity in the early phases, in particular in nfvPPA and lvPPA [9,10], and only after disease progression, when atrophy affects larger areas, the diagnosis could be supported [11]. Moreover, the suggested use of functional MRI, despite of being able to define language network changes [11][12][13], is still limited.…”

Section: Introductionmentioning

confidence: 99%

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Qualitative and Quantitative Analyses of Brain <sup>18</sup>Fluoro-Deoxy-Glucose Positron Emission Tomography in Primary Progressive Aphasia

Nuvoli

Tanda

Stazza

et al. 2019

Dement Geriatr Cogn Disord

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KeywordsPrimary progressive aphasia · Dementia · Brain 18 fluoro-deoxy-glucose positron emission neuroimaging Abstract Background: A primary progressive aphasia (PPA) diagnosis is generally based on clinical criteria, but often symptoms and signs may overlap in the different forms. Recent data have evidenced that brain 18 fluoro-deoxy-glucose positron emission tomography ( 18 F-FDG PET) could support the clinical diagnosis, since specific metabolic patterns are described for the different variants. Aims: We further evaluated the usefulness of 18 F-FDG PET, by both visual qualitative (QL) and quantitative (QN) methods in the initial diagnosis of PPA, focusing on the classification of different variants. Moreover, we also analyzed the role of 18 F-FDG PET in clarifying the association of PPA with the early phase of Alzheimer's disease (AD) or frontotemporal (FTD) dementias. Methods: We consecutively enrolled 35 patients with clinical symptoms of aphasia, suspect of or attributable to PPA. Patients were classified into two groups: 18 cases with clinical symptoms of aphasia but normal neuropsychological tests and an unclear classification of a specific PPA variant (group A) and 17 cases with clinical and neuropsychological signs attributable to PPA with an uncertain differential diagnosis between AD and FTD (group B). All patients underwent brain 18 F-FDG PET/CT, and images were evaluated both by QL and QN, the latter applying an automated analysis program that produced brain regional metabolic maps and normal age-matched control group comparative analysis (z score). Results: 18 F-FDG PET showed different patterns of bilateral cortical hypometabo-lism in the two groups. The combined use of QL and QN permitted to achieved a correct PPA variant diagnosis in 8 of 18 (44.4%) cases of group A and in 14 of 17 (82.3%) of group B, while only QN could support the correct classification of PPA variants in 10 of 18 (55.6%) cases of group A and in 3 of 17 (17.7%) cases of group B in whom the procedure better localized the hypometabolic areas. Conclusions: Brain 18 F-FDG PET had an elevated performance in the early diagnosis of PPA variants and in the advanced PPA AD/FTD classification. QL clarified the development of AD or FTD in advanced PPA cases and supported the differential diagnosis of a PPA variant in a few early cases. QN 18 F-FDG PET evaluation better contributed to the early diagnosis of an unclear metabolic pattern. To correctly identify all cases, patients with diffuse cortical hypometabolism were also included. Larger series are necessary to confirm these data.A total of 35 consecutive patients (15 males, 20 females, aged 53-80 years, mean ± SD value: 69 ± 6.0) with clinical symptoms of aphasia, suspect of or attributable to PPA, were enrolled retrospectively. All patients were investigated for neurological familiar diseases, neurological non-PPA affections, and generally related diseases (hypertension and diabetes mellitus). Laboratory analyses excluded secondary cognitive disorders.Neurological examinations, basal...

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Logopenic Variant Primary Progressive Aphasia

Roytman

Chiang

2021

Hybrid PET/MR Neuroimaging

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Purpose-The aim of this review is to explore the evolution of the logopenic variant of primary progressive aphasia as a distinct clinical entity and to outline recent advances that have clarified its clinical characteristics, neural underpinnings and potential genetic and pathological bases. This is particularly relevant as researchers attempt to identify clinico-pathological relationships in subtypes of primary progressive aphasia in hopes of utilizing language phenotype as a marker of underlying disease.Recent findings-Recent work has served to refine and expand upon the clinical phenotype of the logopenic variant. Logopenic patients show a unique pattern of spared and impaired language processes that reliably distinguish this syndrome from other variants of progressive aphasia. Specifically, they exhibit deficits in naming and repetition in the context of spared semantic, syntactic and motor speech abilities. Further, there is a growing body of evidence indicating a possible link between the logopenic variant phenotype and specific pathological and genetic correlates.Summary-Findings indicate that the logopenic variant is a distinct subtype of progressive aphasia that may hold value as a predictor of underlying pathology. Additional research, however, is warranted in order to further clarify the cognitive-linguistic profile and to confirm its relation to certain pathological and genetic processes.

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Can MRI Visual Assessment Differentiate the Variants of Primary-Progressive Aphasia?

Cited by 29 publications

References 48 publications

Graded, multi-dimensional intragroup and intergroup variations in primary progressive aphasia and post-stroke aphasia

Graded, multi-dimensional intragroup and intergroup variations in primary progressive aphasia and post-stroke aphasia

Qualitative and Quantitative Analyses of Brain <sup>18</sup>Fluoro-Deoxy-Glucose Positron Emission Tomography in Primary Progressive Aphasia

Logopenic Variant Primary Progressive Aphasia

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