Emily Joy Rogalski1, Jaiashre Sridhar2, Adam Martersteck2, Benjamin Rader2, Derin Cobia3, Anupa K Arora4, Angela J Fought5, Eileen H Bigio6, Sandra Weintraub7, Marek-Marsel Mesulam8, Alfred Rademaker5. 1. Cognitive Neurology and Alzheimer's Disease Center, Northwestern University (NU) Feinberg School of Medicine, Chicago, IL, USA; NU Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL, USA. Electronic address: erogalski@gmail.com. 2. Cognitive Neurology and Alzheimer's Disease Center, Northwestern University (NU) Feinberg School of Medicine, Chicago, IL, USA. 3. Department of Psychology, Brigham Young University, Provo, UT, USA. 4. Avid Radiopharmaceuticals Inc, Philadelphia, PA, USA. 5. NU Feinberg School of Medicine, Department of Preventive Medicine, Chicago, IL, USA. 6. NU Feinberg School of Medicine, Department of Pathology, Chicago, IL, USA. 7. Cognitive Neurology and Alzheimer's Disease Center, Northwestern University (NU) Feinberg School of Medicine, Chicago, IL, USA; NU Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL, USA. 8. Cognitive Neurology and Alzheimer's Disease Center, Northwestern University (NU) Feinberg School of Medicine, Chicago, IL, USA; NU Feinberg School of Medicine, Department of Neurology, Chicago, IL, USA.
Abstract
INTRODUCTION: Primary progressive aphasia (PPA) displays variable progression trajectories that require further elucidation. METHODS: Longitudinal quantitation of atrophy and language over 12 months was completed for PPA patients with and without positive amyloid PET (PPAAβ+ and PPAAβ-), an imaging biomarker of underlying Alzheimer's disease. RESULTS: Over 12 months, both PPA groups showed significantly greater cortical atrophy rates in the left versus right hemisphere, with a more widespread pattern in PPAAβ+. The PPAAβ+ group also showed greater decline in performance on most language tasks. There was no obligatory relationship between the logopenic PPA variant and amyloid status. Effect sizes from quantitative MRI data were more robust than neuropsychological metrics. DISCUSSION: Preferential language network neurodegeneration is present in PPA irrespective of amyloid status. Clinical and anatomical progression appears to differ for PPA due to Alzheimer's disease versus non-Alzheimer's disease neuropathology, a distinction that may help to inform prognosis and the design of intervention trials.
INTRODUCTION:Primary progressive aphasia (PPA) displays variable progression trajectories that require further elucidation. METHODS: Longitudinal quantitation of atrophy and language over 12 months was completed for PPA patients with and without positive amyloid PET (PPAAβ+ and PPAAβ-), an imaging biomarker of underlying Alzheimer's disease. RESULTS: Over 12 months, both PPA groups showed significantly greater cortical atrophy rates in the left versus right hemisphere, with a more widespread pattern in PPAAβ+. The PPAAβ+ group also showed greater decline in performance on most language tasks. There was no obligatory relationship between the logopenic PPA variant and amyloid status. Effect sizes from quantitative MRI data were more robust than neuropsychological metrics. DISCUSSION: Preferential language network neurodegeneration is present in PPA irrespective of amyloid status. Clinical and anatomical progression appears to differ for PPA due to Alzheimer's disease versus non-Alzheimer's disease neuropathology, a distinction that may help to inform prognosis and the design of intervention trials.
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