Quantifying progression in primary progressive aphasia with structural neuroimaging

Alzheimers Dement. 2021 Oct;17(10):1595-1609. doi: 10.1002/alz.12323. Epub 2021 Mar 30.

Abstract

Introduction: The term primary progressive aphasia (PPA) sums up the non-fluent (nfv), the semantic (sv), and the logopenic (lv) variant. Up to now, there is only limited data available concerning magnetic resonance imaging volumetry to monitor disease progression.

Methods: Structural brain imaging and an extensive assessment were applied at baseline and up to 4-year(s) follow-up in 269 participants. With automated atlas-based volumetry 56 brain regions were assessed. Atrophy progression served to calculate sample sizes for therapeutic trials.

Results: At baseline highest atrophy appeared in parts of the left frontal lobe for nfvPPA (-17%) and of the left temporal lobe for svPPA (-34%) and lvPPA (-24%). Severest progression within 1-year follow-up occurred in the basal ganglia in nfvPPA (-7%), in the hippocampus/amygdala in svPPA (-9%), and in (medial) temporal regions in lvPPA (-6%).

Conclusion: PPA presents as a left-dominant, mostly gray matter sensitive disease with considerable atrophy at baseline that proceeds variant-specific.

Keywords: atlas-based volumetry; disease progression; frontotemporal dementia; longitudinal magnetic resonance imaging; primary progressive aphasia; sample size calculation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aphasia, Primary Progressive* / classification
  • Aphasia, Primary Progressive* / pathology
  • Atrophy / pathology
  • Brain / pathology
  • Disease Progression
  • Female
  • Frontal Lobe / pathology
  • Gray Matter / pathology
  • Humans
  • Image Processing, Computer-Assisted*
  • Longitudinal Studies
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Temporal Lobe / pathology