Primary progressive aphasia is a relatively newly recognized subtype of dementia. Dementia is a clinical condition, in which a progressive decline of mental and emotional capacities occurs (Mesulam 2000:159). It affects fifty million people worldwide, with ten million new cases yearly (N.U. Dementia 2017). There is a wide variety of symptoms, including the loss or decline of memory, ability to focus, difficulties with reasoning, communication and language (Alzheimer's Society 2005:3), interfering with the independence of the daily living situation and activities (Mesulam 2000:159).
To this day, Primary progressive aphasia is often misdiagnosed, because of its unpopularity and therefore lack of knowledge of many people. Those misdiagnoses steal valuable time to find effective treatments, which, at least, could slow down the progressive nature of the illness. Studying the relationship between language impairments and affected parts of the brain in Primary progressive aphasia, allows us to reach a better understanding of the language network in the brain and pushes forward the search for effective treatments or even a cure.
This termpaper presents a review of literature, especially by Mesulam, on Primary progressive aphasia and the language impairments, declining progressively throughout the illness. The question this paper tries to answer is, what kinds of language impairments can be present in Primary progressive aphasia and which parts of the brain are responsible for certain deficits, when affected by different diseases. It will give information about the most common language impairments seen in patients, because no case is exactly the same and not everybody experiences the same difficulties. Furthermore, the paper will explore the language network of the brain, where it is located, which parts it includes and which parts play a role in Primary progressive aphasia, for short PPA.
To look at the clinical picture from another perspective, a 14- years follow-up case study will give an example of speech impairments of a patient diagnosed with Primary progressive aphasia and show the neuropathological findings of the affected brain parts, which are responsible for the specific impairments.
Table of Contents
1. Introduction
2. Primary progressive aphasia
3. Language impairments and the affected parts of the brain of Primary progressive aphasia patients
4. Case Study
4.1. Critical review of the case study
5. Conclusion
6. Bibliography
Research Objectives and Core Topics
This paper aims to explore the clinical characteristics and neuropathological basis of Primary Progressive Aphasia (PPA), specifically examining the correlation between progressive language impairment and localized brain atrophy. By reviewing existing literature and analyzing a longitudinal case study, the research seeks to identify which language functions are disrupted when specific brain regions are affected by neurodegenerative processes.
- Overview of Primary Progressive Aphasia as a subtype of frontotemporal lobar degeneration.
- Identification of the language network in the human brain and its vulnerability to atrophy.
- Categorization of clinical variants: nonfluent/agrammatic, semantic, and logopenic.
- Neuropathological analysis through a 14-year follow-up case study of a patient.
Excerpt from the Book
4. Case Study
This case study will give an example of a patient diagnosed with Primary progressive aphasia and how his speech progressed in the course of the illness. It will provide a better understanding of how the language impairments affect the every day speech and comprehension.
In the year 1997, the Department of Neurology and the Institute of Neuropathology of the RWTH Aachen published a 14-year follow-up study, which displayed a case of primary progressive aphasia (Schwarz 1998:115). The study focuses on a right-handed, fifty-six year old German male. Due to privacy reasons, the authors used the man's initials, which were "H.S.". Symptoms of Primary progressive aphasia were first noticed by his friends and family, when he was fiftythree (Schwarz 1998:116).
On November 1985 the examiners saw H.S. for the first time. At that time the man was fiftysix years old and prematurely retired from his job as a police officer. His social live and driving abilities were described as perfectly fine. H.S. had to perform the "Aachen Aphasia Test", which test results revealed a fluent speech language disorder. Impairments found were: semantic disturbance in speech production and also comprehension tasks and picture naming. They also did an intelligence test, which disclosed a mild, overall impairment with a low verbal performance and verbal memory. Parts of the brain affected were revealed by a CT scan. What was found was an overall brain volume reduction, with atrophic temporal convexities and enlarged sylvian fissures.
Chapter Summary
1. Introduction: Outlines the definition of Primary Progressive Aphasia as a subtype of dementia and sets the research goal of identifying the relationship between language deficits and brain atrophy.
2. Primary progressive aphasia: Explains the classification of PPA within frontotemporal lobar degeneration and describes the progressive nature of the disorder and its impact on the language network.
3. Language impairments and the affected parts of the brain of Primary progressive aphasia patients: Details the specific brain regions involved in the language network and how their dysfunction leads to clinical symptoms like anomia and agrammatism.
4. Case Study: Presents a 14-year follow-up observation of a specific patient, tracking the decline in speech and cognitive abilities over time compared with neuropathological findings.
4.1. Critical review of the case study: Evaluates the methodology and findings of the 1998 case study in light of more recent diagnostic criteria and the potential impact of co-occurring conditions like Parkinson's disease.
5. Conclusion: Summarizes the necessity of continued research into the brain's complex functions to improve diagnosis and one day achieve a cure for the disease.
6. Bibliography: Lists the academic sources and medical studies used to compile the research on PPA and its clinical variants.
Keywords
Primary Progressive Aphasia, PPA, Dementia, Language Network, Frontotemporal Lobar Degeneration, Atrophy, Anomia, Agrammatism, Speech Impairment, Neurodegeneration, Clinical Variants, Neuropathology, Semantic Dementia, Language Comprehension, Cognitive Neurology
Frequently Asked Questions
What is the primary focus of this academic paper?
The paper focuses on understanding Primary Progressive Aphasia (PPA), specifically investigating how various language impairments correlate with specific areas of brain atrophy.
What are the central themes discussed in the text?
Central themes include the definition of PPA, the mapping of the brain's language network, the three clinical variants of the disease, and a longitudinal case study demonstrating the progression of symptoms.
What is the main research question?
The research seeks to determine what types of language impairments occur in PPA patients and which specific regions of the brain are responsible for these deficits when affected by disease.
Which scientific methods are utilized?
The paper employs a qualitative literature review combined with a critical analysis of a 14-year follow-up case study to bridge clinical symptoms with neuropathological evidence.
What does the main body of the work cover?
The main body covers the theoretical background of language networks in the brain, the clinical identification of PPA subtypes, and a detailed examination of a patient's cognitive and speech decline over more than a decade.
How are the key terms defining this work?
The work is defined by terms such as PPA, neurodegeneration, frontotemporal lobar degeneration, and specific linguistic deficits like anomia and agrammatism.
How has the diagnostic process for PPA changed since the 1998 case study?
The paper highlights that while early diagnosis was often difficult and lacked standardization, modern criteria established between 2006 and 2009 now categorize PPA into three distinct variants (nonfluent/agrammatic, semantic, and logopenic) to improve accuracy.
Why is the 14-year follow-up case study considered potentially complex?
The case study is complex because the patient eventually developed symptoms of Parkinson's disease, making it difficult to discern whether the final total loss of speech and movement was caused solely by PPA or by the interaction with Parkinson's pathology.
What is the significance of the "language network" mentioned in the text?
The language network is identified as the cluster of regions in the left hemisphere, including Broca's and Wernicke's areas, which are critical for speech production, syntax, and comprehension; its degradation is the primary cause of PPA symptoms.
- Citar trabajo
- Anja Drack (Autor), 2018, Primary progressive aphasia and the parts of the brain affected, Múnich, GRIN Verlag, https://www.grin.com/document/493030
