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Profiling the linguistic and neural heterogeneity and similarity of semantic and logopenic PPA variants
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Poster E25 in Poster Session E, Thursday, October 26, 10:15 am - 12:00 pm CEST, Espace Vieux-Port
Gaia Chiara Santi1, Cristina Polito2, Valentina Esposito3, Francesca Conca3, Silvia Caminiti4, Cecilia Boccalini5, Carmen Morinelli6, Valentina Berti7, Salvatore Mazzeo2,7, Valentina Bessi7, Alessandra Marcone8, Kim Se-Kang9, Sandro Iannaccone8, Sandro Sorbi2,7, Daniela Perani5,10, Stefano Cappa1,3, Eleonora Catricalà1; 1Istituto Universitario di Studi Superiori Pavia -IUSS, 2IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy, 3IRCCS Mondino Neurological Institute, Pavia, Italy, 4University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy, 5Vita-Salute San Raffaele University, Milan, 6SOD Neurologia 1, Dipartimento Neuromuscolo-Scheletrico e Degli Organi di Senso, Azienda Ospedaliera-Universitaria Careggi, Florence, Italy, 7Nuclear Medicine - Department of Biomedical Experimental and Clinical Sciences "Mario Serio" University of Florence, 8Department of Rehabilitation and Functional Recovery, San Raffaele Hospital, Milan, 9Department of Psychology, Fordham University, New York, U.S.A., 10Nuclear Medicine Unit, Faculty of Psychology, IRCCS San Raffaele Hospital, Milan
Aims: According to the current criteria the semantic (sv) and logopenic (lv) variants of Primary Progressive Aphasia (PPA) are typically characterized by semantic impairment, and by lexical/phonological processing and verbal working memory deficits, respectively. However, lexical impairments have been reported also in svPPA, and semantic deficits may be present in lvPPA. We applied a multidimensional approach considering the core language components specific for svPPA and lvPPA, in order to characterize overlaps and differences of the two syndromes, aiming at a precise definition of PPA language profiles and of their anatomical counterparts at individual level. Methods: Sixty-seven patients (22 svPPA, 23 lvPPA, 19 lvPPA+, and 11 sv-lv-mixed-PPA) completed the SAND battery and underwent an FDG-PET scan. Semantic (SEM), phonological (PHON) and working memory (WM) errors were quantified from the SAND tests. Metabolic values were extracted from 9 ROIs, selected according to the previous literature. Behavioral data were entered into the Profile Analysis based on Multidimensional Scaling (PAMS), which identifies core profiles, representing the prototypical response pattern of the data, as well as the respective distance of each patient from the core profiles. Each patient could belong to one or to the combination of more core profiles. Correlation analysis was performed between metabolism and significant tasks for each profile in the whole group. Results: Four core profiles were extracted: the 1st profile reflected a lexical retrieval impairment (reduced production of nouns in a picture description); the 2nd profile showed an impairment at SEM level (naming, semantic association) with preserved PHON (in non words repetition); the 3rd showed a pattern of impairment encompassing PHON/WM abilities (in non words repetition and sentence comprehension). The majority of svPPA showed a predominant impairment at lexical and SEM level with preserved PHON/WM. The majority of lv-PPA and some mixed PPA showed lexical and PHON/WM impairment. Some svPPA, lvPPA and mixed PPA showed a pattern of impairment at lexical and WM level. The majority of lvPPA+ showed lexical and PHON/SEM impairment. A reduced number of nouns was predicted by metabolism in the left posterior middle temporal gyrus (MTG), superior temporal gyrus (STG) and anterior STG. SEM errors in naming task were predicted by the metabolism in the fusiform gyrus, PHON errors in non-words repetition by the anterior fusiform gyrus and posterior MTG, WM errors in sentence comprehension by the activity of the middle/superior frontal gyrus, the inferior parietal lobe and the posterior MTG. Conclusions: Contrary to svPPA, both logopenic and mixed-PPA patients are identified in several profiles. Overall, our results suggest the importance of individual heterogeneity, interpretable in terms of both differences and overlaps in linguistic performance and neural correlates, easily represented along a multidimensional space.
Topic Areas: Meaning: Lexical Semantics, Language Production