First Symptoms of Primary Progressive Aphasia and Alzheimer's Disease in Brazilian Individuals.

Talita Gallas Dos Reis,Francisco Scornavacca,Bárbara Costa Beber,Thais Helena Machado,Liana Lisboa Fernandez,Paulo Caramelli

doi:10.3389/fneur.2021.628406

Abstract

Background: Primary Progressive Aphasia (PPA) is characterized by progressive language impairment due to focal degeneration of brain areas related to linguistic processing. The detection and differential diagnosis of PPA can be difficult with clinical features that may overlap with features of other neurological conditions, such as Alzheimer's disease (AD). The scientific production on PPA in Latin American patients is still scarce. This study investigated the first symptoms in a Brazilian sample of patients with PPA in comparison with AD patients.Method: We compared the first symptoms reported by caregivers of people with PPA (n = 20; semantic variant n = 8, non-fluent variant n = 7, logopenic variant n = 3, and unclassified cases n = 2) and AD (n = 16). Data were collected through the application of a structured questionnaire that was presented in an interview format to the caregiver who knew the patient best.Results: Anomia, paraphasias and motor speech difficulties were the first symptoms capable of differentiating patients with PPA from those with AD, while memory was exclusive of AD. Among the PPA variants, anomia was the initial symptom associated with the semantic variant, while motor speech difficulties were associated with the non-fluent variant. The results are discussed considering the unique cultural and sociodemographic characteristics of this studied population.Conclusion: This study demonstrated that some of the initial symptoms of PPA patients may be unique to clinical variants of PPA and of AD, and their investigation may be useful for the early and differential diagnosis of this population.

Highlights

Primary progressive aphasia (PPA) is a neurological syndrome characterized by a progressive and prominent language impairment
Anomia, paraphasias and motor speech difficulties were the first symptoms capable of differentiating patients with PPA from those with Alzheimer’s disease (AD), while memory was exclusive of AD
Among the PPA variants, anomia was the initial symptom associated with the semantic variant, while motor speech difficulties were associated with the non-fluent variant

Summary

Introduction

Primary progressive aphasia (PPA) is a neurological syndrome characterized by a progressive and prominent language impairment. Non-fluent/agrammatic variant (nfvPPA): mainly characterized by non-fluent oral expression, and may include apraxia of speech and/or agramatism, with the production of simple and short sentences, slowed speech, errors in articulatory movements, changes in prosody and substitutions of speech sounds. These symptoms result from the involvement of fronto-insular areas of the left hemisphere. Logopenic variant (lvPPA): characterized by difficulty in repeating sentences and finding words at the time of oral communication, including phonological errors in speech The symptoms in this variant are due to a neurodegeneration at the left temporoparietal junction. This study investigated the first symptoms in a Brazilian sample of patients with PPA in comparison with AD patients

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