Echolalia in patients with primary progressive aphasia

Abstract

Objective This study aimed to examine echolalia and its related symptoms and brain lesions in primary progressive aphasia (PPA). Methods Forty‐five patients with PPA were included: 19 nonfluent/agrammatic variant PPA (nfvPPA), 5 semantic variant PPA, 7 logopenic variant PPA, and 14 unclassified PPA patients. We detected echolalia in unstructured conversations. An evaluation of language function and the presence of parkinsonism, grasp reflex, imitation behaviour, and disinhibition were assessed. We also measured regional cerebral blood flow (rCBF) using single‐photon emission computed tomography. Results Echolalia was observed in 12 nfvPPA and 2 unclassified PPA patients. All patients showed mitigated echolalia. We compared nfvPPA patients with echolalia (echolalia group) to those without echolalia (non‐echolalia group). The median age of the echolalia group was significantly lower than that of the non‐echolalia group, and the echolalia group showed a significantly worse auditory comprehension performance than the non‐echolalia group. In contrast, the performance of repetition tasks was not different between the two groups. The prevalence of imitation behaviour in the echolalia group was significantly higher than that in the non‐echolalia group. The rCBFs in the bilateral pre‐supplementary motor area and bilateral middle cingulate cortex in the echolalia group were significantly lower than those in the non‐echolalia group. Conclusions These findings suggest that echolalia is characteristic of nfvPPA patients with impaired comprehension. Reduced inhibition of the medial frontal cortex with release activity of the anterior perisylvian area account for the emergence of echolalia.

Dyslexia and dysgraphia of primary progressive aphasia in Chinese: A systematic review

“…The number of patients with svPPA in our study was significantly larger than that of other subtypes. While there is no agreement concerning which subtype of PPA is the most common: a multicenter study from France suggested that the most common subtype is lvPPA ( 34 ), whereas nfvPPA predominates in our research in Japan ( 36 ). Since our study was more affected by publication bias, in that svPPA patients are more suitable for case reports due to their characteristic language impairments compared to other PPA subtypes, it is preferable to refer to other Chinese case-control or cohort studies.…”

Echolalia from a transdiagnostic perspective

“…Echolalia is encountered in several other clinical and medical populations, including intellectual disabilities, neurodegenerative dementias ( Ota et al, 2020 ; Torres-Prioris & Berthier, 2020 ), schizophrenia ( Lee, 2004 ), post-epileptic states, Alzheimer's ( Da Cruz, 2010 ), Fragile X syndrome ( Paul et al, 1987 ), Catatonia ( Haroche et al, 2020 ), and Rubinstein-Taybi Syndrome ( Chung, 1998 ). Echolalia has also been investigated in unique medical cases, such as a case study of a 20-year-old male with a germinoma surrounding the bilateral ventriculus lateralis ( Suzuki et al, 2012 ), the case of a 57-year-old female with neuropsychiatric systemic lupus erythematosus ( Zapor et al, 2001 ) in adolescent-onset of encephalopathy ( Sharawat & Panda, 2021 ) and encephalitis ( Gurrera, 2019 ).…”

“…Echolalia can be used as a way for individuals with limited self-generated language to communicate functionally ( Gernsbacher et al, 2016 ); however, echolalia in some forms has been reported to negatively impact one's quality of life, contributing to lower social acceptance and reduced vocational and independent living opportunities ( Paul et al, 2005 ). Despite echolalia being recently reviewed in several diagnostic-specific outlets, including reviews of echolalia in aphasia (e.g., Ota et al, 2020 ; Torres-Prioris & Berthier, 2020 ) and autism (e.g., Cohn et al, 2022 ; Gernsbacher et al, 2016 ; Luyster et al, 2022 ), no research to date has reviewed echolalia from a transdiagnostic perspective. Critically, given the prevalence of echolalia in clinical groups and the number of publications in the past decade exploring echolalia, a literature review that consolidates the findings from a transdiagnostic perspective and provides transdiagnostic clinical recommendations is warranted.…”

Echolalia: Paying attention to a forgotten clinical feature of primary progressive aphasia

“…The article by Ota and co-workers [7] focused for the first time on the study of echolalia in a group of 45 PPA patients. The authors found echolalia in 12 patients with nfvPPA and in two patients with unclassified PPA.…”