title: Lack of Frank Agrammatism in the Nonfluent Agrammatic Variant of Primary Progressive Aphasia.
abstract: OBJECTIVE
  Frank agrammatism, defined as the omission and/or substitution of grammatical morphemes with associated grammatical errors, is variably reported in patients with nonfluent variant primary progressive aphasia (nfPPA). This study addressed whether frank agrammatism is typical in agrammatic nfPPA patients when this feature is not required for diagnosis.
  
  
  METHODS
  We assessed grammatical production in 9 patients who satisfied current diagnostic criteria. Although the focus was agrammatism, motor speech skills were also evaluated to determine whether dysfluency arose primarily from apraxia of speech (AOS), instead of, or in addition to, agrammatism. Volumetric MRI analyses provided impartial imaging-supported diagnosis.
  
  
  RESULTS
  The majority of cases exhibited neither frank agrammatism nor AOS.
  
  
  CONCLUSIONS
  There are nfPPA patients with imaging-supported diagnosis and preserved motor speech skills who do not exhibit frank agrammatism, and this may persist beyond the earliest stages of the illness. Because absence of frank agrammatism is a subsidiary diagnostic feature in the logopenic variant of PPA, this result has implications for differentiation of the nonfluent and logopenic variants, and indicates that PPA patients with nonfluent speech in the absence of frank agrammatism or AOS do not necessarily have the logopenic variant.
authors: Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Ont., Canada; Toronto Rehabilitation Institute, Toronto, Ont, Canada.
authors: Naida L
authors: NL
authors: Graham
authors: Department of Audiology and Speech-Language Pathology, University of Ottawa, Ottawa, Ont, Canada.
authors: Carol
authors: C
authors: Leonard
authors: University Health Network Memory Clinic, Toronto Western Hospital, Ont., Canada; Department of Medicine (Neurology), University of Toronto, Ont., Canada.
authors: David F
authors: DF
authors: Tang-Wai
authors: Department of Medicine (Neurology), University of Toronto, Ont., Canada; L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Ont., Canada; Rotman Research Institute, University of Toronto, Toronto, Ont., Canada.
authors: Sandra
authors: S
authors: Black
authors: Department of Medicine (Neurology), University of Toronto, Ont., Canada; Rotman Research Institute, University of Toronto, Toronto, Ont., Canada; Department of Psychiatry (Geriatric Psychiatry), University of Toronto, Toronto, Ont., Canada.
authors: Tiffany W
authors: TW
authors: Chow
authors: L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Ont., Canada.
authors: Chris J M
authors: CJ
authors: Scott
authors: L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Ont., Canada.
authors: Alicia A
authors: AA
authors: McNeely
authors: L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Ont., Canada.
authors: Mario
authors: M
authors: Masellis
authors: Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Ont., Canada; Toronto Rehabilitation Institute, Toronto, Ont, Canada.
authors: Elizabeth
authors: E
authors: Rochon
keywords: Apraxia of speech; Diagnostic criteria; Differential diagnosis; Frontotemporal dementia