Differentiating primary progressive aphasias in a brief sample of connected speech
- 23 July 2013
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 81 (4), 329-336
- https://doi.org/10.1212/wnl.0b013e31829c5d0e
Abstract
Objective: A brief speech expression protocol that can be administered and scored without special training would aid in the differential diagnosis of the 3 principal forms of primary progressive aphasia (PPA): nonfluent/agrammatic PPA, logopenic variant PPA, and semantic variant PPA. Methods: We used a picture-description task to elicit a short speech sample, and we evaluated impairments in speech-sound production, speech rate, lexical retrieval, and grammaticality. We compared the results with those obtained by a longer, previously validated protocol and further validated performance with multimodal imaging to assess the neuroanatomical basis of the deficits. Results: We found different patterns of impaired grammar in each PPA variant, and additional language production features were impaired in each: nonfluent/agrammatic PPA was characterized by speech-sound errors; logopenic variant PPA by dysfluencies (false starts and hesitations); and semantic variant PPA by poor retrieval of nouns. Strong correlations were found between this brief speech sample and a lengthier narrative speech sample. A composite measure of grammaticality and other measures of speech production were correlated with distinct regions of gray matter atrophy and reduced white matter fractional anisotropy in each PPA variant. Conclusions: These findings provide evidence that large-scale networks are required for fluent, grammatical expression; that these networks can be selectively disrupted in PPA syndromes; and that quantitative analysis of a brief speech sample can reveal the corresponding distinct speech characteristics.Keywords
This publication has 31 references indexed in Scilit:
- The non-fluent/agrammatic variant of primary progressive aphasiaThe Lancet Neurology, 2012
- Connected speech production in three variants of primary progressive aphasiaBrain, 2010
- Evaluation of volume-based and surface-based brain image registration methodsNeuroImage, 2010
- Speech errors in progressive non-fluent aphasiaBrain and Language, 2010
- Primary progressive aphasia: clinicopathological correlationsNature Reviews Neurology, 2010
- Reversal of the concreteness effect in semantic dementiaCognitive Neuropsychology, 2009
- Non-fluent speech in frontotemporal lobar degenerationJournal of Neurolinguistics, 2009
- Clinical and Pathological Continuum of Multisystem TDP-43 ProteinopathiesArchives of Neurology, 2009
- Alzheimer and frontotemporal pathology in subsets of primary progressive aphasiaAnnals of Neurology, 2008
- Symmetric diffeomorphic image registration with cross-correlation: Evaluating automated labeling of elderly and neurodegenerative brainMedical Image Analysis, 2007