The Classification and Language Description of Patients with Primary Progressive Aphasia Using the Mini Linguistic State Examination Test

Abstract

Introduction. Primary progressive aphasia (PPA) is a clinical syndrome characterized by a progressive deterioration in language and speech. It is classified into three variants based on symptom patterns: logopenic, semantic, and non-fluent. Due to the lack of fully reliable and valid screening tests for diagnosing PPA and its variants, a Spanish version of the Mini Linguistic State Examination (MLSE) has recently been introduced. Materials and methods. This study aimed to describe the language impairments in a small sample of six patients with PPA and classify them into the three variants using the decision tree and syndrome guide proposed by the MLSE authors. Results. The findings demonstrate the test's utility in classifying some PPA variants through a qualitative analysis of patient performance and error types. The study revealed a 50% accuracy rate for the decision tree and an 83.33% accuracy rate when using the syndrome guide. Discussion. This discrepancy arises because the decision tree often classified cases as logopenic variant PPA (lvPPA) when working memory was significantly impaired. Specifically, it tended to misclassify patients with semantic, motor, or speech impairments as having lvPPA due to its reliance on the sentence repetition task for assessing working memory.

Keywords: PPA logopenic variant; PPA non-fluent variant; PPA semantic variant; mini linguistic state examination Spanish version; primary progressive aphasia.

Figure 1

Decision tree developed by Matias-Guiu et al. (2021) [28]. svPPA—semantic variant PPA; nfvPPA—non-fluent PPA; lvPPA—logopenic variant PPA. HC = healthy control.