title: Behavioral Evolution of Progressive Semantic Aphasia in Comparison with Nonfluent Aphasia.
abstract: BACKGROUND
  Patients with primary progressive aphasia (PPA) usually develop significant behavioral disturbances with progression of the disease. We tested our clinical observation that development of disruptive agitation is more likely in semantic than in nonfluent PPA and examined which clinical variables could be associated with this behavior.
  
  
  METHODS
  We retrospectively analyzed neuropsychiatric scores and the need for behavioral treatments in semantic PPA (n = 41) and nonfluent PPA (n = 39) cases and compared first (1-3 years since the onset of symptoms) and last (5-13 years since the onset) evaluations. Clinical variables and laterality of temporal atrophy were associated with symptoms in semantic PPA cases.
  
  
  RESULTS
  The semantic PPA group developed more frequent (p = 0.03) and intense agitation (p = 0.0008) and had a greater need for antipsychotic drugs (p = 0.001) than the nonfluent PPA group. Presence of agitation was clearly associated with psychotic symptoms (delusions/hallucinations) but was not associated with gender, age at onset, duration of the disease, or laterality of temporal atrophy. In contrast, nonfluent PPA cases were more frequently depressed and treated with antidepressants (p = 0.0007). There were no differences in anxiety, irritability, apathy, perseverations, hyperorality, or abnormal motor behavior.
  
  
  CONCLUSIONS
  Semantic PPA in advanced disease is frequently associated with agitation and psychotic symptoms with fewer mood symptoms, while nonfluent PPA maintains a high prevalence of depression. This implies different treatment and care and support needs for each group.
authors.affiliation: Department of Neurology, Fundacix00F3;n Jimx00E9;nez Dx00ED;az, Madrid, Spain.
authors.forename: Estrella
authors.initials: E
authors.lastname: Gómez-Tortosa
authors.forename: Ricardo
authors.initials: R
authors.lastname: Rigual
authors.forename: Cristina
authors.initials: C
authors.lastname: Prieto-Jurczynska
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mahillo-Fernández
authors.forename: Rosa
authors.initials: R
authors.lastname: Guerrero-López
authors.forename: Julián
authors.initials: J
authors.lastname: Pérez-Pérez
authors.forename: M José
authors.initials: MJ
authors.lastname: Sainz
mesh_terms: D000368:Aged; D018888:Aphasia, Primary Progressive / Q000523:psychology*; D001284:Atrophy; D003702:Delusions / Q000175:diagnosis / Q000209:etiology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D057178:Primary Progressive Nonfluent Aphasia / Q000523:psychology*; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D013702:Temporal Lobe