Revue de neuropsychologie


Can we predict the pathology of primary progressive aphasia? Volume 3, issue 4, Décembre 2011

CMRR et neuropsychologie, Pôle de psychiatrie et neurologie, CHU, BP 217, 38043 Grenoble Cedex 9 & Laboratoire de psychologie et neurocognition, Université Pierre Mendes France, Grenoble, UMR CNRS 5105

Primary progressive aphasia (PPA) is a progressive and isolated deterioration of linguistic abilities, resulting from atrophy of left perisylvian regions. In two-third of cases, frontotemporal lobar degeneration is the underlying cause; in the remaining one-third, Alzheimer type lesions are found. Three clinical subtypes of PPA have been described: a non fluent agrammatic type (PNFA), a semantic type (assimilated to semantic dementia, SD), and a logopenic type (LA). Recent criteria have been elaborated for the diagnosis (Gorno-Tempini et al., 2011). This classification seems useful since each type of PPA results from different lesions: tau pathology for PNFA, TDP43 pathology for SD, and Alzheimer type lesions for LA. However, the prediction is not optimal at an individual level. Furthermore, it is not applicable at the initial stage of PPA, where anomia is isolated. For these reasons, research protocols should include biomarkers (tau and amyloid detection in the CSF, PET with amyloid markers) to improve prediction.