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O4‐04‐03: Logopenic aphasia in Alzheimer's disease: Clinical variant or clinical feature?
Author(s) -
Ahmed Samrah,
Jager Celeste,
Haigh AnneMarie,
Garrard Peter
Publication year - 2012
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2012.05.1654
Subject(s) - primary progressive aphasia , aphasia , dementia , semantic dementia , psychology , frontotemporal dementia , audiology , fluency , verbal fluency test , disease , medicine , cognition , pathology , cognitive psychology , neuropsychology , neuroscience , mathematics education
found in the setting of Alzheimer’s disease (HpScl-AD). Limbic predominant AD (LP-AD) has greater NFT in hippocampus than cortex and is common in elderly (Murray et al., Lancet Neurology, 2010). The purpose of this study was to examine the frequency, as well as the pathologic, demographic, clinical, and genetic features of LP-AD, HpScl-AD, and HpScl. Methods: LP-AD, HpScl-AD and HpScl cases were selected for study; 105 men and 202 women, ranging in age from 65 to 105 years. Demographic and clinical data were collected, including education, family history, age of onset, disease duration, and Mini-Mental Status Examination (MMSE). MAPT and APOE were examined for genetic differences across cases. Results: LP-AD (n 1⁄4 153) had more CA1-subiculum NFT compared to HpScl-AD (n 1⁄4 110) and HpScl (n 1⁄4 44), the latter having only a median count of one NFT (see Table). Cortical NFT, however, were higher in HpScl-AD compared to LP-AD and only rarely found in HpScl. TDP-43 pathology was found more commonly in both HpScl and HpScl-AD, compared to LPAD. Family history was more frequent in both HpScl groups, compared to LP-AD. HpScl-AD had the youngest age of onset and longest disease duration, compared to both HpScl and LP-AD. The HpScl cases were the oldest at disease onset, but had the shortest disease duration. Longitudinal decline on MMSE approached significance with HpScl showing an even slower rate of decline than LP-AD, and HpScl-AD showing the fastest rate. The MAPT H2H2 genotype was not found in either HpScl-AD or HpScl, but was present in some LP-AD. APOE-ε4 allele was highest in both LP-AD and HpScl-AD, compared to HpScl. Conclusions: Our data suggest an independent overlap between HpScl-AD/HpScl (e.g. family history, TDP-43 positivity, MAPT) and HpScl-AD/LP-AD (e.g. NFT density, longitudinal decline, APOE). We also provide supportive evidence that “pure” HpScl may have unique clinicopathologic and genetic features that could aid in the differential diagnosis from AD (e.g. sparse NFT, age onset, APOE).