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Primary progressive aphasia in Alzheimer’s disease does not predict amnesia

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A small study found that patients with primary progressive aphasia (PPA) with Alzheimer’s disease had long-term memory retention.

Episodic memory was preserved in the first test and did not decline after 2.35 years. At that time, PPA symptoms had been present for 6.26 years, but language skills were significantly reduced, reported M. Marcel Meslam, a medical doctor at the Feinberg School of Medicine at Northwestern University in Chicago. , And co-author Neurology..

“The memory of people with primary progressive aphasia was initially unaffected, but it was unclear if they had maintained memory function for years,” Meslam said in a statement. “Most memory tests depended on the language skills these people lost or lost, making it difficult to determine.”

PPA is a neurodegenerative condition characterized by prominent language problems that worsen over time. Approximately 40% of patients with PPA present with atypical symptoms of Alzheimer’s disease and are often associated with a log-decreasing mutation of PPA.

The study included 17 PPA patients with Alzheimer’s disease compared to 14 with typical Alzheimer’s disease. PPA participants came from the northwest PPA research program There was also evidence of Alzheimer’s disease autopsy or biomarkers, and there were at least two consecutive visits with verbal and memory assessments. The pathology of Alzheimer’s disease was based on autopsy of 8 participants, 3 cerebrospinal fluid biomarkers, and 6 amyloid PET. Ten participants were men and 11 were logopenic PPA. The age at onset of symptoms ranged from 47 to 74 years, with an average of 59 years.

A typical group of Alzheimer’s disease included eight men and six women in the northwest. Alzheimer’s Disease Center He suffered from Alzheimer’s disease as the primary neuropathological diagnosis at autopsy. The average age of onset of symptoms was 66 years. In this group, both language memory and language function declined over time with the same severity.

Imaging performed only in the PPA group showed asymmetric left-sided medium-temporal atrophy. At necropsy, bilateral hippocampal neurofibrillary tangles were seen in both groups. Compared to the typical Alzheimer’s disease group, the PPA group had a lower incidence and lower frequency of mid-temporal TDP-43 pathology. APOE4 Genotype.

“Perhaps the most interesting finding is that memory preservation of the PPA-Alzheimer’s disease group is found in the medial temporal lobe structure of both groups, despite similarly widespread pathology,” said Seyed Ahmad of the University of California, Irvine. Sajjadi, MD, PhD said. , And co-author Ancillary editorial.. “Therefore, the medial temporal lobe structure of patients with PPA-Alzheimer’s disease can be considered resilient and intolerant to Alzheimer’s disease.”

The lack of right medial temporal lobe atrophy in the PPA group supports this idea. “This means the separation of neurodegeneration and pathology in patients with PPA-Alzheimer’s disease,” the editor writes.

“It seems reasonable to conclude that neurodegeneration correlates with the clinical manifestations of these patients, rather than just the presence of a medical condition, coupled with the broader cortical atrophy of the left hemisphere in the PPA group.” They added. “This is an important concept in the era of developing targeted therapies for people with no or minimal cognitive impairment.”

The limits of the study include the relatively small sample size. Autopsy was not available in all PPA cases. In addition, episodic memory was evaluated in different tests in the two groups.

  • Judy George Covering MedPage Today’s neurology and neuroscience news, brain aging, Alzheimer’s disease, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s disease, ALS, concussion, CTE, sleep, I’m writing about pain and so on. To follow

Disclosure

Neither the author nor the editor of the study reported disclosure.

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