Apraxia of Speech and Phonological Errors in the Diagnosis of Nonfluent/Agrammatic and Logopenic Variants of Primary Progressive Aphasia PurposeThe International Consensus Criteria for the diagnosis of primary progressive aphasia (PPA; Gorno-Tempini et al., 2011) propose apraxia of speech (AOS) as 1 of 2 core features of nonfluent/agrammatic PPA and propose phonological errors or absence of motor speech disorder as features of logopenic PPA. We investigated the sensitivity and ... Supplement: Apraxia of Speech: Concepts and Controversies
Supplement: Apraxia of Speech: Concepts and Controversies  |   October 01, 2012
Apraxia of Speech and Phonological Errors in the Diagnosis of Nonfluent/Agrammatic and Logopenic Variants of Primary Progressive Aphasia
 
Author Affiliations & Notes
  • Karen Croot
    University of Sydney, New South Wales, Australia
  • Kirrie Ballard
    University of Sydney, New South Wales, Australia
  • Cristian E. Leyton
    Neuroscience Research Australia, Sydney, New South Wales, Australia
  • John R. Hodges
    Neuroscience Research Australia, Sydney, New South Wales, Australia
  • Correspondence to Karen Croot: karenc@psych.usyd.edu.au
  • Editor: Anne Smith
    Editor: Anne Smith×
  • Associate Editor: Wolfram Ziegler
    Associate Editor: Wolfram Ziegler×
Article Information
Speech, Voice & Prosodic Disorders / Apraxia of Speech & Childhood Apraxia of Speech / Special Populations / Older Adults & Aging / Language Disorders / Aphasia / Speech, Voice & Prosody
Supplement: Apraxia of Speech: Concepts and Controversies   |   October 01, 2012
Apraxia of Speech and Phonological Errors in the Diagnosis of Nonfluent/Agrammatic and Logopenic Variants of Primary Progressive Aphasia
Journal of Speech, Language, and Hearing Research, October 2012, Vol. 55, S1562-S1572. doi:10.1044/1092-4388(2012/11-0323)
History: Received June 19, 2012 , Accepted June 28, 2012
 
Journal of Speech, Language, and Hearing Research, October 2012, Vol. 55, S1562-S1572. doi:10.1044/1092-4388(2012/11-0323)
History: Received June 19, 2012; Accepted June 28, 2012
Web of Science® Times Cited: 20

PurposeThe International Consensus Criteria for the diagnosis of primary progressive aphasia (PPA; Gorno-Tempini et al., 2011) propose apraxia of speech (AOS) as 1 of 2 core features of nonfluent/agrammatic PPA and propose phonological errors or absence of motor speech disorder as features of logopenic PPA. We investigated the sensitivity and specificity of AOS and phonological errors as markers for these variants and also investigated the relationship between AOS, phonological errors, and findings on C-labeled Pittsburgh Compound B (PiB)–positron emission tomography (PET) imaging associated with putative Alzheimer-type pathology.

MethodConnected speech and word repetition in 23 people with PPA who underwent PiB-PET imaging were rated for apraxic versus phonological disruption by 1 rater who was blind to diagnosis and by 2 raters who were blind to PiB-PET results.

ResultsApraxic characteristics had high sensitivity for nonfluent/agrammatic PPA, and phonological errors had high sensitivity for logopenic PPA; however, phonological errors showed lower specificity for logopenic PPA. On PiB imaging, 8 of 9 people with predominant AOS returned negative results, whereas participants with no or questionable AOS with and without phonological errors returned positive results.

ConclusionsAttention to AOS and phonological errors may help counter some of the inherent limitations of diagnosis-by-exclusion in the current International Consensus Criteria for diagnosing PPA.

Acknowledgments
This article originated from a presentation given at the “Apraxia of Speech: Mechanisms and Symptoms” satellite workshop during the 6th International Conference on Speech Motor Control in Groningen, the Netherlands, June 2011. The article was prepared while the first author was a visiting researcher at the Clinical Neuropsychology Research Group (EKN), Clinic for Neuropsychology, City Hospital München, Germany. This research was supported, in part, by National Health and Medical Research Council of Australia Project Grant 630489 and by Australian Research Council Federation Fellowship FF0776229 (to the fourth author). We thank Theresa Schoelderle for discussion of the participants' dysarthria.
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