title: Grammatical comprehension deficits in non-fluent/agrammatic primary progressive aphasia.
abstract: OBJECTIVE
  Grammatical comprehension difficulty is an essential supporting feature of the non-fluent/agrammatic variant of primary progressive aphasia (naPPA), but well-controlled clinical measures of grammatical comprehension are unavailable.
  
  
  OBJECTIVE
  To develop a measure of grammatical comprehension and examine this comparatively in PPA variants and behavioural-variant frontotemporal degeneration (bvFTD) and to assess the neuroanatomic basis for these deficits with volumetric grey matter atrophy and whole-brain fractional anisotropy (FA) in white matter tracts.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Academic medical centre.
  
  
  METHODS
  39 patients with variants of PPA (naPPA=12, lvPPA=15 and svPPA=12), 27 bvFTD patients without aphasia and 12 healthy controls.
  
  
  METHODS
  Grammatical comprehension accuracy.
  
  
  RESULTS
  Patients with naPPA had selective difficulty understanding cleft sentence structures, while all PPA variants and patients with bvFTD were impaired with sentences containing a centre-embedded subordinate clause. Patients with bvFTD were also impaired understanding sentences involving short-term memory. Linear regressions related grammatical comprehension difficulty in naPPA to left anterior-superior temporal atrophy and reduced FA in corpus callosum and inferior frontal-occipital fasciculus. Difficulty with centre-embedded sentences in other PPA variants was related to other brain regions.
  
  
  CONCLUSIONS
  These findings emphasise a distinct grammatical comprehension deficit in naPPA and associate this with interruption of a frontal-temporal neural network.
authors.affiliation: Department of Neurology and Penn FTD Center, University of Pennsylvania, , Philadelphia, Pennsylvania, USA.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Charles
authors.forename: Christopher
authors.initials: C
authors.lastname: Olm
authors.forename: John
authors.initials: J
authors.lastname: Powers
authors.forename: Sharon
authors.initials: S
authors.lastname: Ash
authors.forename: David J
authors.initials: DJ
authors.lastname: Irwin
authors.forename: Corey T
authors.initials: CT
authors.lastname: McMillan
authors.forename: Katya
authors.initials: K
authors.lastname: Rascovsky
authors.forename: Murray
authors.initials: M
authors.lastname: Grossman
mesh_terms: D000368:Aged; D016880:Anisotropy; D001039:Aphasia, Broca / Q000175:diagnosis / Q000473:pathology / Q000523:psychology; D001041:Aphasia, Wernicke / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D001921:Brain / Q000473:pathology; D016022:Case-Control Studies; D032882:Comprehension; D056324:Diffusion Tensor Imaging; D006801:Humans; D008875:Middle Aged; D059906:Neuroimaging; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000473:pathology; D057178:Primary Progressive Nonfluent Aphasia / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D013702:Temporal Lobe / Q000473:pathology
keywords: Aphasia; Behavioural Disorder; Brain Mapping; Dementia
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