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Neuropsychological Profiles of Patients with Progressive Apraxia of Speech and Aphasia

Published online by Cambridge University Press:  22 July 2021

Angelina J. Polsinelli Open the ORCID record for Angelina J. Polsinelli [Opens in a new window] ,
Mary M. Machulda ,
Peter R. Martin ,
Joseph R. Duffy ,
Heather M. Clark ,
Alissa M. Butts ,
Hugo Botha ,
Val J. Lowe ,
Jennifer L. Whitwell  and
Keith A. Josephs
...Show all authors
Angelina J. Polsinelli
Affiliation:
Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
Mary M. Machulda
Affiliation:
Department of Psychiatry and Psychology, Division of Neuropsychology, Mayo Clinic, Rochester, MN, USA
Peter R. Martin
Affiliation:
Department of Biomedical Statistics & Informatics, Mayo Clinic, Rochester, MN, USA
Joseph R. Duffy
Affiliation:
Department of Neurology, Mayo Clinic, Rochester, MN, USA
Heather M. Clark
Affiliation:
Department of Neurology, Mayo Clinic, Rochester, MN, USA
Alissa M. Butts
Affiliation:
Department of Neurology, Division of Neuropsychology, Medical College of Wisconsin, Madison, WI, USA
Hugo Botha
Affiliation:
Department of Neurology, Mayo Clinic, Rochester, MN, USA
Val J. Lowe
Affiliation:
Department of Neuroradiology, Mayo Clinic, Rochester, MN, USA
Jennifer L. Whitwell
Affiliation:
Department of Neuroradiology, Mayo Clinic, Rochester, MN, USA
Keith A. Josephs
Affiliation:
Department of Neurology, Mayo Clinic, Rochester, MN, USA
Rene L. Utianski*
Affiliation:
Department of Neurology, Mayo Clinic, Rochester, MN, USA
*
*Correspondence and reprint requests to: Rene L. Utianski, PhD, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55904, USA. E-mail: utianski.rene@mayo.edu
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Abstract

Objective:

To characterize and compare the neuropsychological profiles of patients with primary progressive apraxia of speech (PPAOS) and apraxia of speech with progressive agrammatic aphasia (AOS-PAA).

Method:

Thirty-nine patients with PPAOS and 49 patients with AOS-PAA underwent formal neurological, speech, language, and neuropsychological evaluations. Cognitive domains assessed included immediate and delayed episodic memory (Wechsler Memory Scale-Third edition; Logical Memory; Visual Reproduction; Rey Auditory Verbal Learning Test), processing speed (Trail Making Test A), executive functioning (Trail Making Test B; Delis-Kaplan Executive Functioning Scale – Sorting), and visuospatial ability (Rey-Osterrieth Complex Figure copy).

Results:

The PPAOS patients were cognitively average or higher in the domains of immediate and delayed episodic memory, processing speed, executive functioning, and visuospatial ability. Patients with AOS-PAA performed more poorly on tests of immediate and delayed episodic memory and executive functioning compared to those with PPAOS. For every 1 unit increase in aphasia severity (e.g. mild to moderate), performance declined by 1/3 to 1/2 a standard deviation depending on cognitive domain. The degree of decline was stronger within the more verbally mediated domains, but was also notable in less verbally mediated domains.

Conclusion:

The study provides neuropsychological evidence further supporting the distinction of PPAOS from primary progressive aphasia and should be used to inform future diagnostic criteria. More immediately, it informs prognostication and treatment planning.

Keywords

Primary progressive apraxia of speechPrimary progressive aphasiaAgrammatic aphasiaFrontotemporal dementiaMotor speech disorderNonfluent primary progressive aphasia
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 28 , Issue 5 , May 2022 , pp. 441 - 451
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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