The Japanese journal of neuropsychology

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ArticleTitle	Logopenic progressive aphasia -the third variant of primary progressive aphasia
Language	J
AuthorList	Nanayo Ogawa, Yoshiyuki Nishio
Affiliation	Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine
Publication	Japanese Journal of Neuropsychology: 26 (4), 294-303, 2010
Received
Accepted
Abstract	Logopenic progressive aphasia (LPA) is a clinical syndrome that has been recently proposed by Gorno-Tempini et al. (2004) as the third variant of primary progressive aphasia (PPA) of degenerative origin following progressive non-fluent aphasia (PNFA) and semantic dementia (SD). The core clinical features are sparse spontaneous speech with word finding difficulty and repetition impairment. Other important linguistic features include lack of articulatory distortions, abundant phonological paraphasias, and relative preservation of language comprehension, which are reminiscent of conduction aphasia. Decreased digit and word spans indicate verbal short term memory impairment. In contrast, episodic memory is relatively preserved. In a majority of patients with LPA, dyscalculia and constructional deficits also develop in the course of the disease. Atrophy in the posterior superior temporal and inferior parietal lobes in the dominant hemisphere on magnetic resonance imaging (MRI) and hypoperfusion or hypometabolism in these regions on positron emission tomography (PET) or single photon emission computed tomography (SPECT) are the neuroimaging hallmarks of LPA. Pathological studies suggest the relationship between the LPA phenotype and Alzheimer's disease pathology. In this paper, we described an illustrative case of LPA, in which we underwent extensive neuropsychological examinations and neuroimagings. The language disturbance was characterized by fluent but sparse spontaneous speech and defective repetition not only in sentences but also in long-syllable words. The patient could comprehend and orally describe words that could not be repeated. Scores on the digit span task and memory tests were low. However, the patient's day-to-day memory was almost preserved. Atrophy and decreased blood flow were found in the posterior portion of the left parietal lobe. Our observation in this patient suggests that defective phonology with preserved semantics and defective verbal short term memory are the features of linguistic symptoms in early stage of LPA.
Keywords	fluent aphasia, phonological paraphasia, verbal short term memory, temporoparietal lobe, Alzheimer disease