Logopenic Primary Progressive Aphasia

Based on Marshall et al., 2018

This PPA variant has several synonyms:

• Language-variant Alzheimer’s disease
• Logopenic variant of PPA

“Logopenic PPA” ≠ “Alzheimer's amnesic variant” which has been evolving for 3 years and which is starting to show language disorders!

It is important to clearly understand that logopenic PPA is a variant of PPA, which means that the patient’s first and main complaint is an evolving language deficit. Therefore, a patient diagnosed with a classic amnestic Alzheimer’s disease who shows language difficulties after a few years is not considered a patient with logopenic PPA.

In this variant, people mainly notice a word retrieval problem in spontaneous speech.

Diagnostic features
Must be present:
Impaired word retrieval in spontaneous speech and naming Impaired repetition of sentences, mostly in the latter part of long and complex sentences
At least three features among the following:
Phonological errors in spontaneous speech and naming Spared single-word comprehension and object knowledge Spared motor speech Absence of frank agrammatism

Diagnostic features based on Gorno-Tempini et al., 2011

Videos courtesy of Dr Marilu Gorno-Tempini's team at
University of San Francisco (California), Memory and Aging Center

Other signs and symptoms often associated with logopenic PPA:

• Isolation, anxiety and depression
• Irritability
• In more severe cases:
  1. Memory impairment, because in 86% of logopenic PPA cases, the underlying pathology is Alzheimer’s disease (Bergeron et al., 2018, Annals of Neurology)
  2. Calculation impairment
  3. Apperceptive visual agnosia (incapacity to recognize, copy or match simple shapes).
• Possible perioral myoclonia

Testimonial

Mrs Simard’s experience with the logopenic variant of PPA

• PPA in a few words
  (00:00 to 00:60)
• The first symptoms
  (00:60 to 04:08)
• And the diagnosis is…
  (04:08 to 07:55)
• The course of the disease
  (07:55 to 09:14)
• Daily challenges
  (09:14 to 19:24)
• In retrospective
  (19:24 to the end)

Resources:

• Association des proches aidants de la Capitale-Nationale: https://www.apacn.org/
• Baluchon Alzheimer: https://baluchonalzheimer.com/
• Monastère des Augustines: https://monastere.ca/en
• Alzheimer’s Society: https://alzheimer.ca/federationquebecoise/en
• AQDR : https://www.aqdr.org/
• The Association for Frontotemporal Degeneration: https://www.theaftd.org

Need advice for your patients and their relatives?

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