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. 2013 Nov;127(2):121-6.
doi: 10.1016/j.bandl.2012.12.008. Epub 2013 Feb 8.

Patterns of longitudinal brain atrophy in the logopenic variant of primary progressive aphasia

Jonathan D Rohrer  1 , Francesca Caso, Colin Mahoney, Maya Henry, Howard J Rosen, Gil Rabinovici, Martin N Rossor, Bruce Miller, Jason D Warren, Nick C Fox, Gerard R Ridgway, Maria Luisa Gorno-Tempini
Affiliations

Patterns of longitudinal brain atrophy in the logopenic variant of primary progressive aphasia

Jonathan D Rohrer et al. Brain Lang. 2013 Nov.

Abstract

The logopenic variant of primary progressive aphasia (PPA) is characterised by impaired sentence repetition and word retrieval difficulties. Post mortem studies, amyloid imaging and CSF tau/Aβ measurements suggest Alzheimer's disease (AD) pathology as the underlying cause. Relatively little is known about patterns of progression in patients with the logopenic variant of PPA. 21 patients (3 with post mortem confirmation of AD and 5 with positive amyloid PIB-PET scans) were studied with longitudinal T1-weighted MR imaging (mean interscan interval 1.2years) using volumetric analysis and voxel-based morphometry (VBM). Baseline imaging showed asymmetrical (left greater than right) involvement of the posterior superior temporal and inferior parietal lobes as well as posterior cingulate and medial temporal lobes. The whole brain rate of volume loss was 2.0% per year with a greater rate of left hemisphere atrophy (2.3%/year) than right hemisphere (1.6%/year). Longitudinal VBM analysis showed increasing involvement of other areas in the left hemisphere (temporal, parietal, frontal and caudate) and atrophy of areas in the right hemisphere that had been involved earlier in the disease in the left hemisphere, particularly posterior cingulate/precuneus. With disease progression there was worsening of anomia, sentence repetition and sentence comprehension but consistent with the spread of imaging changes also deficits in single word comprehension, single word repetition and verbal memory. This study shows that the logopenic variant of PPA remains an asymmetrical disease, with spread through the left hemisphere language network but also involvement to a lesser degree of regions in the right hemisphere that mirror the earlier left hemisphere changes.

Keywords: Logopenic aphasia; Primary progressive aphasia.

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Figures

Fig. 1
Fig. 1
Change in brain volume over time in patients with lvPPA as a function of disease duration.
Fig. 2
Fig. 2
Cross-sectional patterns of grey matter atrophy in lvPPA compared to controls. Statistical parametric maps have been thresholded at p < 0.05 after false discovery rate correction over the whole-brain volume and rendered on sagittal (top panel) axial (middle panel) and coronal (bottom panel) sections of a study-specific average group T1-weighted MRI template image in DARTEL space.
Fig. 3
Fig. 3
Longitudinal patterns of grey matter atrophy in lvPPA compared to controls. Statistical parametric maps have been thresholded at p < 0.05 after false discovery rate correction over the whole-brain volume and rendered on sagittal (top panel) axial (middle panel) and coronal (bottom panel) sections of a study-specific average group T1-weighted MRI template image in DARTEL space.
See this image and copyright information in PMC

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