Loss of speech and functional impairment in Alzheimer's disease-related primary progressive aphasia: predictive factors of decline

Neurobiol Aging. 2022 Sep:117:59-70. doi: 10.1016/j.neurobiolaging.2022.05.002. Epub 2022 May 13.

Abstract

We aimed to identify features associated with different disease trajectories in Alzheimer's disease (AD)-related primary progressive aphasia (PPA). We considered 23 patients diagnosed with AD-related PPA. All patients underwent neuropsychological evaluation, 18F-Fluorodeoxyglucose-PET brain scan, CSF biomarkers measurement and APOE genotype analysis at baseline and underwent neurological follow-up for a mean time of 3 years. Patients who progressed to total loss of speech (TLoS+) had greater impairment in writing and higher t-tau concentration as compared to TLoS- patients. Patients who progressed to loss of functional autonomy (LoFA+) had greater impairment in single-word comprehension as compared to patients who maintained autonomy in self-care. Furthermore, 18F-FDG-PET SPM analyses revealed different brain metabolic patterns between TLoS+ and TLoS- and between LoFA+ and LoFA-. In conclusion, linguistic profile, CSF t-tau and brain metabolic pattern might be useful tools to predict progression to total loss of speech and loss of functional autonomy in AD-related PPA patients.

Keywords: Alzheimer's disease; Amyloid biomarkers; Brain metabolism; Disease progression; Neuropsychology; Primary progressive aphasia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alzheimer Disease* / diagnostic imaging
  • Alzheimer Disease* / metabolism
  • Amyloid beta-Peptides / metabolism
  • Aphasia, Primary Progressive* / diagnosis
  • Biomarkers / metabolism
  • Brain / diagnostic imaging
  • Brain / metabolism
  • Fluorodeoxyglucose F18 / metabolism
  • Humans
  • Positron-Emission Tomography
  • Speech
  • tau Proteins / metabolism

Substances

  • Amyloid beta-Peptides
  • Biomarkers
  • tau Proteins
  • Fluorodeoxyglucose F18