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Chapter 027. Aphasia, Memory Loss, and Other Focal Cerebral Disorders (Part 8)

Language in PPA The language impairment in PPA varies from patient to patient. Some patients cannot find the right words to express thoughts; others cannot understand the meaning of heard or seen words; still others cannot name objects in the environment. The language impairment can be fluent (that is, with normal articulation, flow, and number of words per utterance) or nonfluent. The single most common sign of primary progressive aphasia is anomia, manifested by an inability to come up with the right word during conversation and/or an inability to name objects shown by the examiner. Many patients remain in an. | Chapter 027. Aphasia Memory Loss and Other Focal Cerebral Disorders Part 8 Language in PPA The language impairment in PPA varies from patient to patient. Some patients cannot find the right words to express thoughts others cannot understand the meaning of heard or seen words still others cannot name objects in the environment. The language impairment can be fluent that is with normal articulation flow and number of words per utterance or nonfluent. The single most common sign of primary progressive aphasia is anomia manifested by an inability to come up with the right word during conversation and or an inability to name objects shown by the examiner. Many patients remain in an anomic phase through most of the disease and experience a gradual intensification of wordfinding deficits to the point of near-mutism. Others however proceed to develop distinct forms of agrammatism and or word comprehension deficits. The agrammatism consists of inappropriate word order and misuse of small grammatical words. One patient for example sent the following e-mail to her daughter I will come my house in your car and drive my car into Chicago. . . . You will back get your car and my car park in my driveway. Love Mom. Comprehension deficits if present start with an occasional inability to understand single low-frequency words and gradually progress to encompass the comprehension of conversational speech. The impairments of syntax comprehension naming or writing in PPA are no different from those seen in aphasias of cerebrovascular causes. However they form slightly different patterns. According to a classification proposed by Gorno-Tempini and colleagues three variants of PPA can be recognized an agrammatical variant characterized by poor fluency and impaired syntax a semantic variant characterized by preserved fluency and syntax but poor single word comprehension and a logopenic variant characterized by preserved syntax and comprehension but frequent word-finding pauses during .