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Semin Speech Lang 2018; 39(03): 231-241
DOI: 10.1055/s-0038-1660782
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Assessment of Individuals with Primary Progressive Aphasia

Maya L. Henry
1   Department of Communication Sciences and Disorders, University of Texas, Austin, Texas
,
Stephanie M. Grasso
1   Department of Communication Sciences and Disorders, University of Texas, Austin, Texas
› Author Affiliations
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Publication History

Publication Date:
22 June 2018 (online)

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Abstract

Speech–language pathologists play a crucial role in the assessment and treatment of individuals with primary progressive aphasia (PPA). The speech–language evaluation is a critical aspect of the diagnostic and rehabilitative process, informing differential diagnosis as well as intervention planning and monitoring of cognitive-linguistic status over time. The evaluation should include a thorough case history and interview and a detailed assessment of speech–language and cognitive functions, with tasks designed to detect core and associated deficits outlined in current diagnostic criteria. In this paper, we review assessments that can be utilized to examine communication and cognition in PPA, including general aphasia batteries designed for stroke and/or progressive aphasia as well as tests of specific cognitive-linguistic functions, including naming, object/person knowledge, single-word and sentence comprehension, repetition, spontaneous speech/language production, motor speech, written language, and nonlinguistic cognitive domains. The comprehensive evaluation can inform diagnostic decision making and facilitate planning of interventions that are tailored to the patient's current status and likely progression of deficits. As such, the speech–language evaluation allows the medical team to provide individuals with PPA and their families with appropriate recommendations for the present and the future.

Keywords

primary progressive aphasia - assessment - diagnosis - dementia

Disclosures

Maya Henry, Ph.D., CCC-SLP, is an assistant professor in the Department of Communication Sciences and Disorders at the University of Texas, Austin. Her research is funded by the National Institutes of Health and the Darrell K Royal Fund for Alzheimer's Research. She has no nonfinancial disclosures.


Stephanie Grasso, M.A., CCC-SLP, is a doctoral student at The University of Texas at Austin. Her research is funded by the National Institutes of Health. She has no nonfinancial disclosures.


 

  • References

  • 1 Gorno-Tempini ML, Hillis AE, Weintraub S. , et al. Classification of primary progressive aphasia and its variants. Neurology 2011; 76 (11) 1006-1014
    CrossrefPubMedGoogle Scholar
  • 2 Mesulam MM. Primary progressive aphasia. Ann Neurol 2001; 49 (04) 425-432
    CrossrefPubMedGoogle Scholar
  • 3 Gorno-Tempini ML, Dronkers NF, Rankin KP. , et al. Cognition and anatomy in three variants of primary progressive aphasia. Ann Neurol 2004; 55 (03) 335-346
    CrossrefPubMedGoogle Scholar
  • 4 Sajjadi SA, Patterson K, Arnold RJ, Watson PC, Nestor PJ. Primary progressive aphasia: a tale of two syndromes and the rest. Neurology 2012; 78 (21) 1670-1677
    CrossrefPubMedGoogle Scholar
  • 5 Harris JM, Gall C, Thompson JC. , et al. Classification and pathology of primary progressive aphasia. Neurology 2013; 81 (21) 1832-1839
    CrossrefPubMedGoogle Scholar
  • 6 Mesulam MM, Wieneke C, Thompson C, Rogalski E, Weintraub S. Quantitative classification of primary progressive aphasia at early and mild impairment stages. Brain 2012; 135 (Pt 5): 1537-1553
    CrossrefPubMedGoogle Scholar
  • 7 Wicklund MR, Duffy JR, Strand EA, Machulda MM, Whitwell JL, Josephs KA. Quantitative application of the primary progressive aphasia consensus criteria. Neurology 2014; 82 (13) 1119-1126
    CrossrefPubMedGoogle Scholar
  • 8 Rascovsky K, Grossman M. Clinical diagnostic criteria and classification controversies in frontotemporal lobar degeneration. Int Rev Psychiatry 2013; 25 (02) 145-158
    CrossrefPubMedGoogle Scholar
  • 9 Grossman M. Biomarkers in the primary progressive aphasias. Aphasiology 2014; 28 (8-9): 922-940
    CrossrefPubMedGoogle Scholar
  • 10 Spinelli EG, Mandelli ML, Miller ZA. , et al. Typical and atypical pathology in primary progressive aphasia variants. Ann Neurol 2017; 81 (03) 430-443
    CrossrefPubMedGoogle Scholar
  • 11 Harciarek M, Sitek EJ, Kertesz A. The patterns of progression in primary progressive aphasia—implications for assessment and management. Aphasiology 2014; 28 (8–9): 964-980
    CrossrefPubMedGoogle Scholar
  • 12 Gorno-Tempini ML, Murray RC, Rankin KP, Weiner MW, Miller BL. Clinical, cognitive and anatomical evolution from nonfluent progressive aphasia to corticobasal syndrome: a case report. Neurocase 2004; 10 (06) 426-436
    CrossrefPubMedGoogle Scholar
  • 13 Etcheverry L, Seidel B, Grande M. , et al. The time course of neurolinguistic and neuropsychological symptoms in three cases of logopenic primary progressive aphasia. Neuropsychologia 2012; 50 (07) 1708-1718
    CrossrefPubMedGoogle Scholar
  • 14 Kertesz A. Western Aphasia Battery™—Revised (WAB–R™). San Antonio, TX: Pearson Clinical; 2006
    Google Scholar
  • 15 Goodglass H, Kaplan E, Barresi B, Weintraub S, Segal O. The Boston Diagnostic Aphasia Examination (BDAE). 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2001
    Google Scholar
  • 16 Kertesz A, McMonagle P, Blair M, Davidson W, Munoz DG. The evolution and pathology of frontotemporal dementia. Brain 2005; 128 (Pt 9): 1996-2005
    CrossrefPubMedGoogle Scholar
  • 17 Kertesz A, Jesso S, Harciarek M, Blair M, McMonagle P. What is semantic dementia? A cohort study of diagnostic features and clinical boundaries. Arch Neurol 2010; 67 (04) 483-489
    CrossrefPubMedGoogle Scholar
  • 18 Battista P, Miozzo A, Piccininni M. , et al. Primary progressive aphasia: a review of neuropsychological tests for the assessment of speech and language disorders. Aphasiology 2017; 31 (12) 1359-1378
    CrossrefPubMedGoogle Scholar
  • 19 Leyton CE, Villemagne VL, Savage S. , et al. Subtypes of progressive aphasia: application of the International Consensus Criteria and validation using β-amyloid imaging. Brain 2011; 134 (Pt 10): 3030-3043
    CrossrefPubMedGoogle Scholar
  • 20 Billette OV, Sajjadi SA, Patterson K, Nestor PJ. SECT and MAST: new tests to assess grammatical abilities in primary progressive aphasia. Aphasiology 2015; 29 (10) 1135-1151
    CrossrefPubMedGoogle Scholar
  • 21 Hodges JR, Martinos M, Woollams AM, Patterson K, Adlam ALR. Repeat and Point: differentiating semantic dementia from progressive non-fluent aphasia. Cortex 2008; 44 (09) 1265-1270
    CrossrefPubMedGoogle Scholar
  • 22 Savage S, Hsieh S, Leslie F, Foxe D, Piguet O, Hodges JR. Distinguishing subtypes in primary progressive aphasia: application of the Sydney language battery. Dement Geriatr Cogn Disord 2013; 35 (3-4): 208-218
    CrossrefPubMedGoogle Scholar
  • 23 Sapolsky D, Domoto-Reilly K, Dickerson BC. Use of the Progressive Aphasia Severity Scale (PASS) in monitoring speech and language status in PPA. Aphasiology 2014; 28 (8-9): 993-1003
    CrossrefPubMedGoogle Scholar
  • 24 Morris JC. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 1993; 43 (11) 2412-2414
    PubMedGoogle Scholar
  • 25 Knopman DS, Weintraub S, Pankratz VS. Language and behavior domains enhance the value of the clinical dementia rating scale. Alzheimers Dement 2011; 7 (03) 293-299
    CrossrefPubMedGoogle Scholar
  • 26 Thompson CK, Lukic S, King MC, Mesulam MM, Weintraub S. Verb and noun deficits in stroke-induced and primary progressive aphasia: The Northwestern Naming Battery. Aphasiology 2012; 26 (05) 632-655
    CrossrefPubMedGoogle Scholar
  • 27 Weintraub S, Mesulam MM, Wieneke C, Rademaker A, Rogalski EJ, Thompson CK. The Northwestern Anagram Test: measuring sentence production in primary progressive aphasia. Am J Alzheimers Dis Other Demen 2009; 24 (05) 408-416
    CrossrefPubMedGoogle Scholar
  • 28 Breining BL, Lala T, Martínez Cuitiño M. , et al. A brief assessment of object semantics in primary progressive aphasia. Aphasiology 2014; 29 (04) 1-18
    PubMedGoogle Scholar
  • 29 Strand EA, Duffy JR, Clark HM, Josephs K. The Apraxia of Speech Rating Scale: a tool for diagnosis and description of apraxia of speech. J Commun Disord 2014; 51: 43-50
    CrossrefPubMedGoogle Scholar
  • 30 Kaplan E, Goodglass H, Weintraub S. Boston Naming Test. Philadelphia, PA: Lippincott Williams & Wilkins; 2001
    Google Scholar
  • 31 Hodges JR, Graham N, Patterson K. Charting the progression in semantic dementia: implications for the organisation of semantic memory. Memory 1995; 3 (3-4): 463-495
    CrossrefPubMedGoogle Scholar
  • 32 Hodges JR, Patterson K. Semantic dementia: a unique clinicopathological syndrome. Lancet Neurol 2007; 6 (11) 1004-1014
    CrossrefPubMedGoogle Scholar
  • 33 Hodges JR, Patterson K, Oxbury S, Funnell E. Semantic dementia. Progressive fluent aphasia with temporal lobe atrophy. Brain 1992; 115 (Pt 6): 1783-1806
    CrossrefPubMedGoogle Scholar
  • 34 Henry ML, Wilson SM, Rapsack SZ. Primary progressive aphasia. In: Nair AK, Sabbagh M. , eds. Handbook of geriatric neurology. New York, NY: Prentice-Hall; 2014
    Google Scholar
  • 35 Binney RJ, Henry ML, Babiak M. , et al. Reading words and other people: a comparison of exception word, familiar face and affect processing in the left and right temporal variants of primary progressive aphasia. Cortex 2016; 82: 147-163
    CrossrefPubMedGoogle Scholar
  • 36 Patterson K, Hodges JR. Semantic dementia: one window on the structure and organisation of semantic memory. Handb Neuropsychol 2000; 2: 313-333
    PubMedGoogle Scholar
  • 37 Rogers TT, Lambon Ralph MA, Garrard P. , et al. Structure and deterioration of semantic memory: a neuropsychological and computational investigation. Psychol Rev 2004; 111 (01) 205-235
    CrossrefPubMedGoogle Scholar
  • 38 Jefferies E, Lambon Ralph MA. Semantic impairment in stroke aphasia versus semantic dementia: a case-series comparison. Brain 2006; 129 (Pt 8): 2132-2147
    CrossrefPubMedGoogle Scholar
  • 39 Howard D, Patterson K. Pyramids and palm trees: a test of semantic access from pictures and words. Bury St Edmunds, UK: Thames Val Test Co; 1992
    Google Scholar
  • 40 Snowden JS, Thompson JC, Neary D. Knowledge of famous faces and names in semantic dementia. Brain 2004; 127 (Pt 4): 860-872
    CrossrefPubMedGoogle Scholar
  • 41 Dunn LM, Dunn LM. Manual for the Peabody Picture Vocabulary Test-Revised. Circle Pines, MN: American Guidance Service; 1981
    Google Scholar
  • 42 Thompson CK. Northwestern assessment of verbs and sentences. Evanston, IL: Northwestern University; 2011. Available at: http://northwestern.flintbox.com/public/project/9299/ . Accessed June 7, 2018
    PubMedGoogle Scholar
  • 43 Wilson SM, DeMarco AT, Henry ML. , et al. Variable disruption of a syntactic processing network in primary progressive aphasia. Brain 2016; 139 (11) 2994-3006
    CrossrefPubMedGoogle Scholar
  • 44 Gorno-Tempini ML, Brambati SM, Ginex V. , et al. The logopenic/phonological variant of primary progressive aphasia. Neurology 2008; 71 (16) 1227-1234
    CrossrefPubMedGoogle Scholar
  • 45 Mesulam M, Wieneke C, Rogalski E, Cobia D, Thompson C, Weintraub S. Quantitative template for subtyping primary progressive aphasia. Arch Neurol 2009; 66 (12) 1545-1551
    CrossrefPubMedGoogle Scholar
  • 46 Ogar JM, Dronkers NF, Brambati SM, Miller BL, Gorno-Tempini ML. Progressive nonfluent aphasia and its characteristic motor speech deficits. Alzheimer Dis Assoc Disord 2007; 21 (04) S23-S30
    CrossrefPubMedGoogle Scholar
  • 47 Henry ML, Gorno-Tempini ML. The logopenic variant of primary progressive aphasia. Curr Opin Neurol 2010; 23 (06) 633-637
    CrossrefPubMedGoogle Scholar
  • 48 Rohrer JD, Ridgway GR, Crutch SJ. , et al. Progressive logopenic/phonological aphasia: erosion of the language network. Neuroimage 2010; 49 (01) 984-993
    CrossrefPubMedGoogle Scholar
  • 49 Bayles KA, Tomoeda CK, Rein JA. Phrase repetition in Alzheimer's disease: effect of meaning and length. Brain Lang 1996; 54 (02) 246-261
    CrossrefPubMedGoogle Scholar
  • 50 Wertz RT, LaPointe LL, Rosenbek JC. Apraxia of Speech in Adults: The Disorder and Its Management. New York: Grune and Stratton; 1984
    Google Scholar
  • 51 Duffy JR. Motor Speech Disorders: Substrates, Differential Diagnosis, and Management. St. Louis, MO: Elsevier Mosby; 2013
    Google Scholar
  • 52 Wilson SM, Henry ML, Besbris M. , et al. Connected speech production in three variants of primary progressive aphasia. Brain 2010; 133 (Pt 7): 2069-2088
    CrossrefPubMedGoogle Scholar
  • 53 Brambati SM, Ogar J, Neuhaus J, Miller BL, Gorno-Tempini ML. Reading disorders in primary progressive aphasia: a behavioral and neuroimaging study. Neuropsychologia 2009; 47 (8-9): 1893-1900
    CrossrefPubMedGoogle Scholar
  • 54 Henry ML, Beeson PM, Alexander GE, Rapcsak SZ. Written language impairments in primary progressive aphasia: a reflection of damage to central semantic and phonological processes. J Cogn Neurosci 2012; 24 (02) 261-275
    CrossrefPubMedGoogle Scholar
  • 55 Rapcsak SZ, Beeson PM, Henry ML. , et al. Phonological dyslexia and dysgraphia: cognitive mechanisms and neural substrates. Cortex 2009; 45 (05) 575-591
    CrossrefPubMedGoogle Scholar
  • 56 Kay J, Lesser R, Coltheart M. PALPA: Psycholinguistic Assessments of Language Processing in Aphasia. Hove: Lawrence Erlbaum Associates Ltd; 1992
    Google Scholar
  • 57 Woollams AM, Ralph MA, Plaut DC, Patterson K. SD-squared: on the association between semantic dementia and surface dyslexia. Psychol Rev 2007; 114 (02) 316-339
    CrossrefPubMedGoogle Scholar
  • 58 Jefferies E, Lambon Ralph MA, Jones R, Bateman D, Patterson K. Surface dyslexia in semantic dementia: a comparison of the influence of consistency and regularity. Neurocase 2004; 10 (04) 290-299
    CrossrefPubMedGoogle Scholar
  • 59 Patterson K, Hodges JR. Deterioration of word meaning: implications for reading. Neuropsychologia 1992; 30 (12) 1025-1040
    CrossrefPubMedGoogle Scholar
  • 60 Bettcher BM, Sturm VE. Neuropsychological assessment of Primary Progressive Aphasia (PPA). SIG 2. Perspect Neurophysiol Neurogenic Speech Lang Disord 2014; 24 (04) 128-136
    CrossrefPubMedGoogle Scholar
  • 61 Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12 (03) 189-198
    CrossrefPubMedGoogle Scholar
  • 62 Nasreddine ZS, Phillips NA, Bédirian V. , et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53 (04) 695-699
    CrossrefPubMedGoogle Scholar
  • 63 Osher JE, Wicklund AH, Rademaker A, Johnson N, Weintraub S. The mini-mental state examination in behavioral variant frontotemporal dementia and primary progressive aphasia. Am J Alzheimers Dis Other Demen 2007; 22 (06) 468-473
    PubMedGoogle Scholar
  • 64 Kukull W, Knopman D, Mesulam MM. , et al. Standardized data collection and diagnostic formulation for FTLD clinical exam: The FTLD Module. Dement Geriatr Cogn Disord 2012; 34: 226-227
    PubMedGoogle Scholar
  • 65 Kramer JH, Jurik J, Sha SJ. , et al. Distinctive neuropsychological patterns in frontotemporal dementia, semantic dementia, and Alzheimer disease. Cogn Behav Neurol 2003; 16 (04) 211-218
    CrossrefPubMedGoogle Scholar