Symptom-led staging for semantic and non-fluent/agrammatic variants of primary progressive aphasia.
In: Alzheimer's & dementia : the journal of the Alzheimer's Association, Jg. 20 (2024), Heft 1, S. 195-210
Online
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Zugriff:
Introduction: Here we set out to create a symptom-led staging system for the canonical semantic and non-fluent/agrammatic variants of primary progressive aphasia (PPA), which present unique diagnostic and management challenges not well captured by functional scales developed for Alzheimer's disease and other dementias.
Methods: An international PPA caregiver cohort was surveyed on symptom development under six provisional clinical stages and feedback was analyzed using a mixed-methods sequential explanatory design.
Results: Both PPA syndromes were characterized by initial communication dysfunction and non-verbal behavioral changes, with increasing syndromic convergence and functional dependency at later stages. Milestone symptoms were distilled to create a prototypical progression and severity scale of functional impairment: the PPA Progression Planning Aid ("PPA-Squared").
Discussion: This work introduces a symptom-led staging scheme and functional scale for semantic and non-fluent/agrammatic variants of PPA. Our findings have implications for diagnostic and care pathway guidelines, trial design, and personalized prognosis and treatment for PPA.
Highlights: We introduce new symptom-led perspectives on primary progressive aphasia (PPA). The focus is on non-fluent/agrammatic (nfvPPA) and semantic (svPPA) variants. Foregrounding of early and non-verbal features of PPA and clinical trajectories is featured. We introduce a symptom-led staging scheme for PPA. We propose a prototype for a functional impairment scale, the PPA Progression Planning Aid.
(© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
| Titel: |
Symptom-led staging for semantic and non-fluent/agrammatic variants of primary progressive aphasia.
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| Autor/in / Beteiligte Person: | Hardy, CJD ; Taylor-Rubin, C ; Taylor, B ; Harding, E ; Gonzalez, AS ; Jiang, J ; Thompson, L ; Kingma, R ; Chokesuwattanaskul, A ; Walker, F ; Barker, S ; Brotherhood, E ; Waddington, C ; Wood, O ; Zimmermann, N ; Kupeli, N ; Yong, KXX ; Camic, PM ; Stott, J ; Marshall, CR ; Oxtoby, NP ; Rohrer, JD ; Volkmer, A ; Crutch, SJ ; Warren, JD |
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| Zeitschrift: | Alzheimer's & dementia : the journal of the Alzheimer's Association, Jg. 20 (2024), Heft 1, S. 195-210 |
| Veröffentlichung: | 2020- : Hoboken, NJ : John Wiley & Sons, Ltd. ; <i>Original Publication</i>: Orlando, FL : Elsevier, Inc., 2024 |
| Medientyp: | academicJournal |
| ISSN: | 1552-5279 (electronic) |
| DOI: | 10.1002/alz.13415 |
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