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Clinical and neuroimaging characteristics of clinically unclassifiable primary progressive aphasia. Brain Lang 2019 10;197:104676

Date

08/17/2019

Pubmed ID

31419589

Pubmed Central ID

PMC6726500

DOI

10.1016/j.bandl.2019.104676

Scopus ID

2-s2.0-85070652080   19 Citations

Abstract

Many patients who meet core/root criteria for Primary Progressive Aphasia (PPA) are not classifiable as a recognized variant and are often excluded from neuroimaging studies. Here, we detail neurological, neuropsychological, speech and language assessments, and anatomic and molecular neuroimaging (MRI, PiB-PET, and FDG-PET) for fifteen (8 female) clinically unclassifiable PPA patients. Median age of onset was 64a??years old with median 3a??years disease duration at exam. Three patients were amyloid positive on PiB-PET. 14/15 patients had abnormal FDG-PETs with left predominant hypometabolism, affecting frontal, temporal, parietal, and even occipital lobes. Patients had mild to severe clinical presentations. Visualization of the FDG-PETs principal component analysis revealed patterns of hypometabolism similar to those seen in the PPA variants and suggests the brain regions affected in unclassifiable PPA patients are no different from those who are more easily classifiable. These findings may inform future modifications to the diagnostic criteria to improve diagnostic classification.

Author List

Utianski RL, Botha H, Martin PR, Schwarz CG, Duffy JR, Clark HM, Machulda MM, Butts AM, Lowe VJ, Jack CR Jr, Senjem ML, Spychalla AJ, Whitwell JL, Josephs KA

Author

Alissa Butts PhD Assistant Professor in the Neurology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Aphasia, Primary Progressive
Brain
Female
Humans
Language Tests
Magnetic Resonance Imaging
Male
Middle Aged
Neuroimaging
Positron-Emission Tomography
Principal Component Analysis
Speech