A - 136 Clinical Features of Agrammatism in Spanish Speakers with Non-Fluent/Agrammatic Variant of Primary Progressive Aphasia (Nappa): a Case Study Analysis

Abstract

Abstract Objective A clinical diagnosis of naPPA includes presence of agrammatism and effortful speech (Gorno-Tempini et al., 2011). Agrammatism, specifically verb agreement, has emerged as a key clinical feature distinguishing PPA subtyping in English (Thomson et al., 2012). Patterns of agrammatism in English are well-established and were thought to extend to other languages (Gorno-Tempini et al., 2004; Benedet et al., 1998). Agrammatism in post-stroke Spanish patients has unique linguistic characteristics including gender-object agreement errors (Benedet et al., 1998; Reznik et al., 1995, Ardila, 2001). Research assessing agrammatism in PPA Spanish speakers is limited (Gonzalez et al., 2022). These three cases describe gender agreement errors as a clinical feature of agrammatism in Spanish speakers with naPPA. Method Three Spanish-dominant patients with primary speech deficits underwent neuropsychological evaluation across three outpatient clinics and were diagnosed with naPPA (all had brain MRI, two had FDG-PET). Narrative language samples were analyzed to explore patterns of agrammatic language production. Results Patients made few to no verb agreement errors. Instead, common errors included inconsistent speech sounds and gender disagreement within common object-article pairings, including substitutions in Spanish-language articles like “el” or “la” (e.g., “el silla”). Conclusions These cases revealed gender-object agreement errors as a consistent clinical feature of agrammatism in Spanish naPPA patients. Research assessing the linguistic profiles and agrammatisms of Spanish-speaking PPA patients, with confirmatory neuroimaging and biomarker correlates, is needed to aid clinicians in differentiating PPA subtypes among Spanish speakers. This is especially important with emergence of new disease modifying treatments specifically helpful in some but not all subtypes.