PPA is a neurological condition that occurs due to damage to the areas of the brain that control speech and language. People with PPA gradually lose the ability to speak, write, read, and/or understand what others are saying, with no impairment in speech, memory, or the ability to express themselves in relation to behavior.
“We have found that each of these diseases attacks a different part of the language network“, said lead author, Dr. M. Marsel Mesulam, director of Northwestern’s Mesulam Center for Cognitive Neuroscience and Alzheimer’s Disease.
In some cases, the disease affects the area responsible for grammar, in other cases the area responsible for understanding words. Each disease progresses at a different rate and has different implications for intervention.
In this new study, up to 118 cases of PPA were reviewed. So it is based on the largest set of autopsies PPA ever assembled.
How does disease attack the brain?
In 118 consecutive autopsies of PPA patients, the primary diagnosis is Alzheimer’s disease in 42% of cases.
In 10 percent of cases, Pick’s disease was found. Pick’s disease is a type of frontal dementia that causes progressive loss of mental function, affecting the frontal and temporal lobes of the brain.
The primary diagnosis is conversion-responsive type A DNA-binding protein disease [TDP(A)] in 10 percent of patients and TDP (C) in 11 percent of cases.
Active response DNA-binding protein is a major pathological marker for anterior lobe degenerative conditions with certain inclusions.
Research also shows that word comprehension is lost for some patients, while others lose grammar. In addition, the disease is often misdiagnosed in its early stages, so many people miss out on treatment.
Patients diagnosed with PPA were enrolled in a longitudinal study. They are made to undergo a language and brain structure test and their brain function is visual.
The underlying disease, in 40% of PPA cases, is a very unusual form of Alzheimer’s disease. That’s unusual, according to the study, as it impairs language rather than memory. Also, it can start much earlier when a person is under 65.
In 60% of cases, the disease that causes PPA belongs to a completely different group of diseases called frontotemporal lobar degeneration (FTLD)..
People with this condition may experience weakness, muscle loss or atrophy, involuntary small muscle twitches, difficulty speaking, and difficulty swallowing.
There are several approaches at the disease and symptom levels, once the underlying disease is diagnosed. The trick is to approach the PPA on both levels concurrently.
How to treat such patients?
A patient with Alzheimer’s disease can be treated with drugs and put into clinical trials. Another type of speech therapy will be offered to people who have difficulty understanding words. Stimulating the nerve cells in the brain works best for people who have difficulty understanding words.
Anti-anxiety medications and behavioral therapy can be used to treat anxiety around word-finding.
What to do next?
Researchers are now working towards improving diagnostic accuracy through new biomarkers to determine whether a patient’s PPA is caused by Alzheimer’s disease or anterior lobe degeneration.
They also intend to find pharmacological treatments tailored to each underlying PPA and individualized interventions, along with symptomatic nonpharmacological interventions based on the nature of the impairment. language as psychological intervention.
Source: Medindia
