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Differentiating primary progressive aphasias in a brief sample of connected speech
Open accessAbstract
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.
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“Across primary progressive aphasia variants, ASLA markers capture syndromespecific patterns 49-53 that predict underlying neuropathology years before death 7 and correlate with variant-specific atrophy, 53-56 even longitudinally. 57”
From Speech and language markers of neurodegeneration: a call for global equity (2023) · cites this paper as [56]
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Metadata
- Authors
- Ash, S., Evans, E., O'Shea, J., Powers, J., Boller, A., Weinberg, D., Haley, J., McMillan, C., Irwin, D. J., Rascovsky, K., & Grossman, M.
- Affiliations
- University of Pennsylvania (US)
- Venue
- Neurology
- Published
- 2013-07-23
- Volume
- 81
- Issue
- 4
- Pages
- 329-336
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC3772830
- OpenAlex
- W2100387103
- Cited by
- 171
- References
- 38
- Citations by year
- 2026: 14 · 2025: 18 · 2024: 16 · 2023: 16 · 2022: 22 · 2021: 18 · 2020: 11 · 2019: 5 · 2018: 16 · 2017: 12 · 2016: 9 · 2015: 10 · 2014: 3 · 2013: 1
- FWCI
- 5.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wyncote Foundation
- National Institutes of Health
- National Institute on Aging (R01AG038490, R01AG015116, P01AG017586, AG038490, AG032953, AG-017586, AG015116, P01AG032953, T32AG000255)
- National Institute of Neurological Disorders and Stroke (NS053488, P50NS053488, NS044266, R01NS044266)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Health Sciences › Medicine › Clinical Neurology › Amyotrophic Lateral Sclerosis Research
- Keywords
- primary progressive aphasia, differential diagnosis, logopenic variant PPA, semantic variant PPA, picture description task, speech production, grammaticality, speech rate, word retrieval, disfluency, false starts, gray matter atrophy, white matter fractional anisotropy
- MeSH terms
- Aged, Aged, 80 and over, Atrophy, Brain, Brain Mapping, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Semantics, Speech, Aphasia, Primary Progressive, Frontotemporal Dementia
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