- Last edited on November 24, 2021
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geri:dementia:primary-progressive-aphasia-ppa [on June 2, 2019] |
geri:dementia:primary-progressive-aphasia-ppa [on June 29, 2020] |
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====== Primary Progressive Aphasia (PPA) ====== | ====== Primary Progressive Aphasia (PPA) ====== | ||
+ | {{INLINETOC}} | ||
===== Primer ===== | ===== Primer ===== | ||
**Primary Progressive Aphasia (PPA)** is a neurological syndrome associated with certain types of dementia. [[geri:dementia:alzheimers|Alzheimer’s Disease]] and [[geri:dementia:frontotemporal|frontotemporal dementia]] are the most common underlying forms of dementia in which PPA occurs. PPA typically begins as gradual, subtle language deficits that progresses to a nearly complete inability to speak. | **Primary Progressive Aphasia (PPA)** is a neurological syndrome associated with certain types of dementia. [[geri:dementia:alzheimers|Alzheimer’s Disease]] and [[geri:dementia:frontotemporal|frontotemporal dementia]] are the most common underlying forms of dementia in which PPA occurs. PPA typically begins as gradual, subtle language deficits that progresses to a nearly complete inability to speak. | ||
- | ==== Variants ==== | + | <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success">See also article: **[[neurology:approach-aphasia|]]**</alert> |
+ | ===== Variants ===== | ||
There are three variants of PPA: | There are three variants of PPA: | ||
- | - Semantic (the dominant type and is present in most instances of PPA) | + | - **Semantic** (the dominant type and is present in most instances of PPA) |
- | - Logopenic (LPA), due to atrophy in the left posterior temporal cortex and inferior parietal lobule | + | - **Logopenic** (LPA), due to atrophy in the left posterior temporal cortex and inferior parietal lobule |
- | - Non-fluent/agrammatic (stumbling for words, grammar is very poor) | + | - **Non-fluent/agrammatic** (stumbling for words, grammar is very poor) |
+ | <WRAP group> | ||
+ | |||
+ | <WRAP third column> | ||
+ | ==== Semantic ==== | ||
+ | **Both** of: | ||
+ | - Impaired confrontation naming (i.e. - showing an object or a line drawing of an object (e.g. - a spoon) to a patient and requesting the correct verbal label for that object) | ||
+ | - Impaired single word comprehension | ||
+ | At least ''3'' of 4: | ||
+ | - Impaired object knowledge | ||
+ | - Surface dyslexia/dysgraphia | ||
+ | - Spared repetition | ||
+ | - Spared speech production | ||
+ | |||
+ | </WRAP> | ||
+ | <WRAP third column> | ||
+ | ==== Logopenic ==== | ||
+ | **Both** of: | ||
+ | - Impaired single word retrieval | ||
+ | - Impaired repetition | ||
+ | |||
+ | At least ''3'' of 4: | ||
+ | - Speech errors in spontaneous speech and naming | ||
+ | - Spared single-word comprehension and object knowledge | ||
+ | - Spared motor speech | ||
+ | - Absence of frank agrammatism | ||
+ | </WRAP> | ||
+ | |||
+ | <WRAP third column> | ||
+ | ==== Non-fluent/Agrammatic ==== | ||
+ | The **Non-fluent/Agrammatic** subtype is characterized by distortion of word and sentence construction. This includes abnormal order of words (i.e. - syntax), distortion of word endings, misuse of pronouns, and a lack of grammatical words such as articles (words that define a noun as specific or unspecific, e.g. - //a, an, the//) and prepositions (these are words show the relationship between the noun and pronoun in a sentence, e.g. - //at, for, in, off, on, over, under, into, upon, onto, out of, from within//) | ||
+ | |||
+ | At least ''1'' of 2: | ||
+ | - Agrammatism | ||
+ | - Apraxia of speech | ||
+ | At least ''2'' of 3: | ||
+ | - Impaired complex comprehension | ||
+ | - Spared single-word comprehension | ||
+ | - Spared object knowledge | ||
+ | </WRAP> | ||
+ | </WRAP> | ||
===== Diagnostic Criteria ===== | ===== Diagnostic Criteria ===== | ||
* [[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059138/|Gorno-Tempini, M. L., Hillis, A. E., Weintraub, S., Kertesz, A., Mendez, M., Cappa, S. E. E. A., ... & Manes, F. (2011). Classification of primary progressive aphasia and its variants. Neurology, WNL-0b013e31821103e6.]] | * [[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059138/|Gorno-Tempini, M. L., Hillis, A. E., Weintraub, S., Kertesz, A., Mendez, M., Cappa, S. E. E. A., ... & Manes, F. (2011). Classification of primary progressive aphasia and its variants. Neurology, WNL-0b013e31821103e6.]] | ||
+ | ===== Rating Scales ===== | ||
+ | **Progressive Aphasia Severity Score (PASS)** | ||
+ | * Articulation | ||
+ | * Fluency | ||
+ | * Syntax and grammar | ||
+ | * Word retrieval and expression | ||
+ | * Repetition | ||
+ | * Auditory comprehension | ||
+ | * Single word comprehension | ||
+ | * Reading | ||
+ | * Writing | ||
+ | * Functional communication |