title: Patterns of longitudinal brain atrophy in the logopenic variant of primary progressive aphasia.
abstract: The logopenic variant of primary progressive aphasia (PPA) is characterised by impaired sentence repetition and word retrieval difficulties. Post mortem studies, amyloid imaging and CSF tau/Aβ measurements suggest Alzheimer's disease (AD) pathology as the underlying cause. Relatively little is known about patterns of progression in patients with the logopenic variant of PPA. 21 patients (3 with post mortem confirmation of AD and 5 with positive amyloid PIB-PET scans) were studied with longitudinal T1-weighted MR imaging (mean interscan interval 1.2years) using volumetric analysis and voxel-based morphometry (VBM). Baseline imaging showed asymmetrical (left greater than right) involvement of the posterior superior temporal and inferior parietal lobes as well as posterior cingulate and medial temporal lobes. The whole brain rate of volume loss was 2.0% per year with a greater rate of left hemisphere atrophy (2.3%/year) than right hemisphere (1.6%/year). Longitudinal VBM analysis showed increasing involvement of other areas in the left hemisphere (temporal, parietal, frontal and caudate) and atrophy of areas in the right hemisphere that had been involved earlier in the disease in the left hemisphere, particularly posterior cingulate/precuneus. With disease progression there was worsening of anomia, sentence repetition and sentence comprehension but consistent with the spread of imaging changes also deficits in single word comprehension, single word repetition and verbal memory. This study shows that the logopenic variant of PPA remains an asymmetrical disease, with spread through the left hemisphere language network but also involvement to a lesser degree of regions in the right hemisphere that mirror the earlier left hemisphere changes.
authors: Dementia Research Centre, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK. Electronic address: j.rohrer@ucl.ac.uk.
authors: Jonathan D
authors: JD
authors: Rohrer
authors: Francesca
authors: F
authors: Caso
authors: Colin
authors: C
authors: Mahoney
authors: Maya
authors: M
authors: Henry
authors: Howard J
authors: HJ
authors: Rosen
authors: Gil
authors: G
authors: Rabinovici
authors: Martin N
authors: MN
authors: Rossor
authors: Bruce
authors: B
authors: Miller
authors: Jason D
authors: JD
authors: Warren
authors: Nick C
authors: NC
authors: Fox
authors: Gerard R
authors: GR
authors: Ridgway
authors: Maria Luisa
authors: ML
authors: Gorno-Tempini
mesh_terms: D000368:Aged; D018888:Aphasia, Primary Progressive / Q000473:pathology*; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged
keywords: Logopenic aphasia; Primary progressive aphasia
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