A Reliable and Rapid Language Tool for the Diagnosis, Classification, and Follow-Up of Primary Progressive Aphasia Variants

Stéphane Epelbaum; Yasmina Michel Saade; Constance Flamand Roze; Emmanuel Roze; Sophie Ferrieux; Céline Arbizu; Marie Nogues; Carole Azuar; Bruno Dubois; Sophie Tezenas du Montcel; Marc Teichmann

doi:10.3389/fneur.2020.571657

A Reliable and Rapid Language Tool for the Diagnosis, Classification, and Follow-Up of Primary Progressive Aphasia Variants

Front Neurol. 2021 Jan 5:11:571657. doi: 10.3389/fneur.2020.571657. eCollection 2020.

Authors

Stéphane Epelbaum^{1

2

3}, Yasmina Michel Saade¹, Constance Flamand Roze⁴, Emmanuel Roze^{2

5}, Sophie Ferrieux¹, Céline Arbizu¹, Marie Nogues¹, Carole Azuar^{1

2}, Bruno Dubois^{1

2}, Sophie Tezenas du Montcel⁶, Marc Teichmann^{1

2}

Affiliations

¹ Department of Neurology, National Reference Center for "PPA and rare dementias", Institute for Memory and Alzheimer's Disease, Pitié Salpêtrière Hospital, AP-HP, Paris, France.
² Institut du Cerveau, ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, Paris, France.
³ Inria, Aramis-project team, 'APHP-INRIA collaboration', Paris, France.
⁴ Centre Hospitalier Sud-Francilien, Université Paris Sud, Corbeil-Essonnes, Service de Neurologie et Unité Neurovasculaire, Corbeil-Essonnes, France.
⁵ Department of Neurology, Pitié Salpêtrière Hospital, AP-HP, Paris, France.
⁶ Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France.

Abstract

Background: Primary progressive aphasias (PPA) have been investigated by clinical, therapeutic, and fundamental research but examiner-consistent language tests for reliable reproducible diagnosis and follow-up are lacking. Methods: We developed and evaluated a rapid language test for PPA ("PARIS") assessing its inter-examiner consistency, its power to detect and classify PPA, and its capacity to identify language decline after a follow-up of 9 months. To explore the reliability and specificity/sensitivity of the test it was applied to PPA patients (N = 36), typical amnesic Alzheimer's disease (AD) patients (N = 24) and healthy controls (N = 35), while comparing it to two rapid examiner-consistent language tests used in stroke-induced aphasia ("LAST", "ART"). Results: The application duration of the "PARIS" was ~10 min and its inter-rater consistency was of 88%. The three tests distinguished healthy controls from AD and PPA patients but only the "PARIS" reliably separated PPA from AD and allowed for classifying the two most frequent PPA variants: semantic and logopenic PPA. Compared to the "LAST" and "ART," the "PARIS" also had the highest sensitivity for detecting language decline. Conclusions: The "PARIS" is an efficient, rapid, and highly examiner-consistent language test for the diagnosis, classification, and follow-up of frequent PPA variants. It might also be a valuable tool for providing end-points in future therapeutic trials on PPA and other neurodegenerative diseases affecting language processing.

Keywords: Alzheiemer's disease; diagnosis; language; primary progressive aphasia; test.