A longitudinal linguistic analysis of written text production in a case of semantic variant primary progressive aphasia

Heitkamp, Nari; Schumacher, Rahel; Croot, Karen; de Langen, Ernst G.; Monsch, Andreas U.; Baumann, Thomas; Danek, Adrian (2016). A longitudinal linguistic analysis of written text production in a case of semantic variant primary progressive aphasia. Journal of Neurolinguistics, 39, pp. 26-37. Elsevier 10.1016/j.jneuroling.2015.12.002

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The semantic variant of primary progressive aphasia (svPPA) presents with a degradationof semantic knowledge due to atrophy of the anterior temporal lobe and is characterizedby impaired confrontation naming and impaired single-word comprehension. So far, littleis known about the development of symptoms and their order of occurrence in the pre-clinical phase, and information regarding written text production is scarce.We had the unique opportunity to analyze the diary of a man written over a time span of12 years before he was diagnosed with svPPA. We sought to identify the earliest indicatorsof cognitive change in his diary entries, and to track the important changes over time.Based on transcripts of the entries (one week every six months) we assessed the overallstructure, vocabulary, surface dysgraphia and semantic paraphasia, syntax, andmorphology. We found changes in all domains up to seven years before the clinicaldiagnosis. The earliest changes concerned the vocabulary, with decreased variety andincreased use of high frequency words. This was followed by syntactic and morphologicalerrors. We found no increase of surface dysgraphia. Semantic paraphasias increased onlyduring the last three years but characterized the entries of the last year.We were therefore able to further corroborate recentfindings regarding difficulties in themorpho-syntactic domain in this patient group. In this natural context for written textproduction, such errors seem, in addition to changes in vocabulary, to be thefirst errortypes to appear, possibly as a result of compensating for the degradation of semanticrepresentations.

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