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Rev Neurol (Paris). 2015 Jan;171(1):16-30. doi: 10.1016/j.neurol.2014.08.004. Epub 2014 Oct 13.

[Specificities of the logopenic variant of primary progressive aphasia].

[Article in French]

Author information

1
CMRR, service de neurologie, CHU, 2, boulevard Fleming, 25030 Besançon, France; Centre Leenaards de la mémoire, CHUV, Lausanne, Suisse. Electronic address: eloi.magnin@laposte.net.
2
CMRR Paris-Sud, AP-HP, 75013 Paris, France.
3
CMRR, CHU de Rouen, 76000 Rouen, France.
4
CMRR, CHU de Grenoble, 38000 Grenoble, France.
5
CMRR, service de neurologie, CHU, 2, boulevard Fleming, 25030 Besançon, France.
6
CMRR, CHU de Rennes, 35000 Rennes, France.
7
CMRR, CHU de Toulouse, 31000 Toulouse, France.

Abstract

The logopenic variant of primary progressive aphasia is a syndrome with neuropsychological and linguistic specificities, including phonological loop impairment for which diagnosis is currently mainly based on the exclusion of the two other variants, semantic and nonfluent/agrammatic primary progressive aphasia. The syndrome may be underdiagnosed due (1) to mild language difficulties during the early stages of the disease or (2) to being mistaken for mild cognitive impairment or Alzheimer's disease when the evaluation of episodic memory is based on verbal material and (3) finally, it is not uncommon that the disorders are attributed to psychiatric co-morbidities such as, for example, anxiety. Moreover, compared to other variants of primary progressive aphasia, brain abnormalities are different. The left temporoparietal junction is initially affected. Neuropathology and biomarkers (cerebrospinal fluid, molecular amyloid nuclear imaging) frequently reveal Alzheimer's disease. Consequently this variant of primary progressive aphasia does not fall under the traditional concept of frontotemporal lobar degeneration. These distinctive features highlight the utility of correct diagnosis, classification, and use of biomarkers to show the neuropathological processes underlying logopenic primary progressive aphasia. The logopenic variant of primary progressive aphasia is a specific form of Alzheimer's disease frequently presenting a rapid decline; specific linguistic therapies are needed. Further investigation of this syndrome is needed to refine screening, improve diagnostic criteria and better understand the epidemiology and the biological mechanisms involved.

KEYWORDS:

Alzheimer's disease; Aphasie progressive primaire; Biomarkers; Biomarqueurs; Logopenic; Logopénique; Maladie d’Alzheimer; Neuropsychologie; Neuropsychology; Primary progressive aphasia

PMID:
25444173
DOI:
10.1016/j.neurol.2014.08.004
[Indexed for MEDLINE]

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