Primary Progressive Aphasia and Stroke Aphasia

Murray Grossman, MDCM, FAAN; ; David J. Irwin, MD; Behavioral Neurology and Psychiatry p. 745-767 June 2018, Vol.24, No.3 doi: 10.1212/CON.0000000000000618
Review Articles
BROWSE ARTICLES
Article as PDF
Article Level Metrics
-- Select an option --

PURPOSE OF REVIEW: This article summarizes the clinical and anatomic features of the three named variants of primary progressive aphasia (PPA): semantic variant PPA, nonfluent/agrammatic variant PPA, and logopenic variant PPA. Three stroke aphasia syndromes that resemble the PPA variants (Broca aphasia, Wernicke aphasia, and conduction aphasia) are also presented.

RECENT FINDINGS: Semantic variant PPA and Wernicke aphasia are characterized by fluent speech with naming and comprehension difficulty; these syndromes are associated with disease in different portions of the left temporal lobe. Patients with nonfluent/agrammatic variant PPA or Broca aphasia have nonfluent speech with grammatical difficulty; these syndromes are associated with disease centered in the left inferior frontal lobe. Patients with logopenic variant PPA or conduction aphasia have difficulty with repetition and word finding in conversational speech; these syndromes are associated with disease in the left inferior parietal lobe. While PPA and stroke aphasias resemble one another, this article also presents their distinguishing features.

SUMMARY: Primary progressive and stroke aphasia syndromes interrupt the left perisylvian language network, resulting in identifiable aphasic syndromes.

Address correspondence to Dr Murray Grossman, 2 Gibson, Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, mgrossma@pennmedicine.upenn.edu.

RELATIONSHIP DISCLOSURE: Dr Grossman serves as an associate editor of Neurology; as a consultant for the Association for Frontotemporal Degeneration, Bracco, and UCB, SA; and on the scientific advisory boards of the Association for Frontotemporal Degeneration and Biogen. Dr Grossman receives research/grant support from Avid Radiopharmaceuticals, the National Institutes of Health (AG017586, AG052943, AG038490, and NS053488), and Piramal Enterprises Ltd. Dr Irwin receives research/grant support from the BrightFocus Foundation and the National Institutes of Health (K23 NS088341-01).

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Drs Grossman and Irwin report no disclosures.

CONTINUUM AUDIO INTERVIEW AVAILABLE ONLINE

© 2018 American Academy of Neurology