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Logopenic-variant Primary Progressive Aphasia

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Brought to you by the Residents & Fellows Section of Neurology®.

February 20, 2015

Logopenic-variant is a subcategory within the primary progressive aphasias (PPA).  Classically, the triad of word retrieval difficulties, impaired sentence repetition and phonologic errors characterizes logopenic-variant PPA.  Interestingly, numerous previous studies have demonstrated close correlations between this entity and Alzheimer disease pathology.  Similar to Alzheimer pathology, patients with this variant of PPA frequently have left temporoparietal atrophy, increased amyloid-ligand binding and SPECT and PET findings consistent with typical AD.  An increased prevalence of APOEe4 carriers and CSF biomarkers for AD has also been seen in cohorts with logopenic-variant PPA.  Recent studies have found that the classic triad is infrequently encountered and Alzheimer disease-related PPA may be more variable than previously believed and encompass a larger spectrum of mixed-aphasia PPA patients.

References  

  1. Harris JM, Gall C, Thompson JC, et al.  Classification and pathology of primary progressive aphasia.  Neurology 2013; 81: 1832-1839.
  2. Sajjadi SA, Patterson K, Nestor PJ.  Logopenic, mixed, or Alzheimer-related aphasia?  Neurology 2014; 82: 1127-1131.

Submitted by James Addington, M.D. Resident Physician, Department of Neurology, University of Virginia 

Dr. Addington is a member of the Resident and Fellow Section of Neurology.

For more clinical pearls and other articles of interest to neurology trainees, visit the Neurology Residents & Fellows page.  Listen to this week's Neurology Podcast.

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