Journal of Speech, Language, and Hearing Research Vol.55 S1562-S1572 October 2012. doi:10.1044/1092-4388(2012/11-0323)
© American Speech-Language-Hearing Association
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Supplement: Apraxia of Speech: Concepts and Controversies

Apraxia of Speech and Phonological Errors in the Diagnosis of Nonfluent/Agrammatic and Logopenic Variants of Primary Progressive Aphasia

Karen Croota,,b
Kirrie Ballarda
Cristian E. Leytonc,,d
John R. Hodgesc,,d
a University of Sydney, New South Wales, Australia
b ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, New South Wales, Australia
c Neuroscience Research Australia, Sydney, New South Wales, Australia
d University of New South Wales, Sydney, Australia

Correspondence to Karen Croot: karenc{at}psych.usyd.edu.au

Purpose: The International Consensus Criteria for the diagnosis of primary progressive aphasia (PPA; Gorno-Tempini et al., 2011) propose apraxia of speech (AOS) as 1 of 2 core features of nonfluent/agrammatic PPA and propose phonological errors or absence of motor speech disorder as features of logopenic PPA. We investigated the sensitivity and specificity of AOS and phonological errors as markers for these variants and also investigated the relationship between AOS, phonological errors, and findings on C-labeled Pittsburgh Compound B (PiB)–positron emission tomography (PET) imaging associated with putative Alzheimer-type pathology.

Method: Connected speech and word repetition in 23 people with PPA who underwent PiB-PET imaging were rated for apraxic versus phonological disruption by 1 rater who was blind to diagnosis and by 2 raters who were blind to PiB-PET results.

Results: Apraxic characteristics had high sensitivity for nonfluent/agrammatic PPA, and phonological errors had high sensitivity for logopenic PPA; however, phonological errors showed lower specificity for logopenic PPA. On PiB imaging, 8 of 9 people with predominant AOS returned negative results, whereas participants with no or questionable AOS with and without phonological errors returned positive results.

Conclusions: Attention to AOS and phonological errors may help counter some of the inherent limitations of diagnosis-by-exclusion in the current International Consensus Criteria for diagnosing PPA.

KEY WORDS: speech production, nonfluent progressive aphasia, apraxia of speech, phonological errors, frontotemporal dementia, Alzheimer's disease, brain imaging


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