Abstract Details

Title Longitudinal Decline in Lexical Retrieval is Related to AD Pathologic Burden in Middle Frontal, Superior and Temporal Regions in Progressive Aphasia

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 9-013

Objective To determine whether regional specificity of Alzheimer’s disease (AD) neuropathology in primary progressive aphasia (PPA) patients is associated with faster lexical retrieval decline.

Background

Logopenic-variant Primary Progressive Aphasia (lvPPA) is an atypical variant of Alzheimer’s disease (AD) characterized by impaired lexical retrieval. However, lvPPA with AD neuropathology remains difficult to distinguish. We compared rate of longitudinal decline on the Boston Naming Test (BNT) in PPA patients with autopsy-confirmed AD and non-AD pathology and tested how decline was predicted by pathologic density in regions associated with lexical retrieval.

Design/Methods

Participants included 24 autopsy-confirmed PPA patients (AD pathology=13, non-AD=11) from the Penn Frontotemporal Degeneration Center. Pathology severity was graded on a traditional 0-3 point scale in regions associated with naming: superior temporal (STG), angular (ANG), and middle frontal gyri (MFG) and control regions in visual cortex (VIS) and cingulate (CING). Lexical retrieval was assessed longitudinally on the BNT. A linear mixed-effects model (LME) tested for the relationship between pathology and longitudinal BNT performance. LME models related BNT decline to pathology burden in language areas.

Results BNT accuracy at baseline (t=0.43; p=0.66) and longitudinal testing duration (t=-0.64; p=0.52) did not differ between pathology groups. LME model found PPA with AD pathology had faster rate of decline in BNT compared to PPA without AD pathology (p=0.01). Slope of BNT decline was predicted by pathology burden in the STG (t=-2.32, p=0.02), ANG (t=-2.74, p=0.01), and MFG (t=-2.6, p=0.01) but not in the non-language VIS or CING. PPA patients with AD pathology have greater pathology burden in regions related to naming than non-AD PPA patients (p<0.05).

Conclusions Naming declines significantly faster in PPA with AD pathology. Decline in BNT performance is predicted by pathology burden in the naming network, and AD pathology burden in these regions is related to faster antemortem lexical retrieval declines in PPA compared to other pathologies.

Authors/Disclosures
Jessica Bove PRESENTER	No disclosure on file
	No disclosure on file
Katya Rascovsky (University of Pennsylvania Perelman School of Medicine)	No disclosure on file
Murray Grossman, MD, FAAN (University of Pennsylvania)	Dr. Grossman has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology. The institution of Dr. Grossman has received research support from NIH.
David Irwin, MD (University of Pennsylvania)	The institution of Dr. Irwin has received research support from NIH. The institution of Dr. Irwin has received research support from Prevail. The institution of Dr. Irwin has received research support from Passage Bio. The institution of Dr. Irwin has received research support from Alector. The institution of Dr. Irwin has received research support from Transposon. The institution of Dr. Irwin has received research support from Denali. The institution of Dr. Irwin has received research support from Cervo Med.

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