Abstract Details

Title Spontaneous Speech Alterations and Evolution in Primary Progressive Aphasia Variants

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 9-010

Objective To identify: (i) which features of speech (alone or in combination with standard language tests and/or brain gray matter [GM] volumes) most effectively distinguish primary progressive aphasia (PPA) variants; (ii) how spontaneous speech evolved over time, and (iii) the best combination of features predicting speech evolution in each PPA variant.

Background An accurate speech characterization in PPA could positively impact on diagnosis and patient management.

Design/Methods 95 PPA patients (40 nfvPPA, 35 svPPA, 20 lvPPA) underwent the “Picnic Scene” test and structural MRI. A subgroup of 34 patients underwent a similar follow-up. Stepwise regression models were used to identify the speech parameters that best distinguished the groups, also incorporating GM volumes, standard language tests, age, sex and education. In each PPA group, linear mixed effect models were performed for defining speech changes over time, and the prediction analysis were conducted using variables from the best stepwise models.

Results The best models to differentiating PPA variants included: left temporal and middle frontal volumes, and syntax production features when comparing nfvPPA vs svPPA (R²=0.89); lexical contents, syntax complexity, left temporal and insular brain volumes in nfvPPA vs lvPPA (R²=0.81); left temporal volumes and speech production rates in svPPA vs lvPPA (R²=0.86). Over time, nfvPPA patients showed more phonological errors, which were predicted by syntax production features at baseline. SvPPA and lvPPA showed reduced naming and reduced number of words in sentences, respectively, which were predicted by baseline left temporal volumes.

Conclusions The stepwise regression models that best distinguish the three PPA variants included both speech features and GM volumes. By combining all these variables, increased accuracy was found mainly when nfvPPA and lvPPA were compared. Over time, the PPA variants showed different speech trajectories, which were predicted at baseline by speech features and integrity of specific brain volumes.

Authors/Disclosures
Edoardo G. Spinelli, MD PRESENTER	Dr. Spinelli has nothing to disclose.
Elisa Canu (Ospedale San Raffaele)	The institution of Elisa Canu has received research support from Italian Ministry of Health .
Laura Lumaca	No disclosure on file
Veronica Castelnovo, MSc (San Raffaele Scientific Institute, Vita-Salute San Raffaele University)	Dr. Castelnovo has nothing to disclose.
Silvia Basaia	Silvia Basaia has nothing to disclose.
Sofia Santicioli	No disclosure on file
Elena Gatti	No disclosure on file
Alessandra Lamanuzzi	No disclosure on file
Giordano Cecchetti (San Raffaele Hospital)	Giordano Cecchetti has nothing to disclose.
Francesca Caso, MD (Universita' Vita Salute San Raffaele)	Dr. Caso has nothing to disclose.
Giuseppe Magnani	Giuseppe Magnani has nothing to disclose.
Paola Caroppo	Paola Caroppo has nothing to disclose.
Sara Prioni (Fondazione IRCCS Istituto Neurologico Carlo Besta)	Sara Prioni has nothing to disclose.
Cristina Villa	No disclosure on file
Stefano F. Cappa, MD	Dr. Cappa has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elservier. The institution of Dr. Cappa has received research support from Italian Minsitry of Health.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Federica Agosta (San Raffaele Scientific Institute)	Federica Agosta has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Philips. Federica Agosta has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier INC.

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