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Eur J Neurol. 2016 Apr;23(4):704-12. doi: 10.1111/ene.12902. Epub 2016 Feb 22.

Validating new diagnostic imaging criteria for primary progressive aphasia via anatomical likelihood estimation meta-analyses.

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Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
Leipzig University Medical Center, IFB Adiposity Diseases, Leipzig, Germany.
Clinic of Cognitive Neurology, University of Leipzig, Leipzig, Germany.
Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.
FTLD Consortium Germany, Leipzig, Germany.


Recently, diagnostic clinical and imaging criteria for primary progressive aphasia (PPA) have been revised by an international consortium (Gorno-Tempini et al. Neurology 2011;76:1006-14). The aim of this study was to validate the specificity of the new imaging criteria and investigate whether different imaging modalities [magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (FDG-PET)] require different diagnostic subtype-specific imaging criteria. Anatomical likelihood estimation meta-analyses were conducted for PPA subtypes across a large cohort of 396 patients: firstly, across MRI studies for each of the three PPA subtypes followed by conjunction and subtraction analyses to investigate the specificity, and, secondly, by comparing results across MRI vs. FDG-PET studies in semantic dementia and progressive nonfluent aphasia. Semantic dementia showed atrophy in temporal, fusiform, parahippocampal gyri, hippocampus, and amygdala, progressive nonfluent aphasia in left putamen, insula, middle/superior temporal, precentral, and frontal gyri, logopenic progressive aphasia in middle/superior temporal, supramarginal, and dorsal posterior cingulate gyri. Results of the disease-specific meta-analyses across MRI studies were disjunct. Similarly, atrophic and hypometabolic brain networks were regionally dissociated in both semantic dementia and progressive nonfluent aphasia. In conclusion, meta-analyses support the specificity of new diagnostic imaging criteria for PPA and suggest that they should be specified for each imaging modality separately.


logopenic progressive aphasia; meta-analysis; primary progressive aphasia; progressive nonfluent aphasia; semantic dementia

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