Neuroimaging in Primary Progressive Aphasia Neuroimaging is a standard part of a primary progressive aphasia (PPA) diagnostic work-up and an important component of research investigating changes in the speech-language network in patients with PPA. In this paper, structural neuroimaging, including computed tomography (CT), magnetic resonance imaging (MRI), and diffusion tensor imaging (DTI), as well as ... Article
Article  |   October 01, 2014
Neuroimaging in Primary Progressive Aphasia
Author Affiliations & Notes
  • Borna Bonakdarpour
    Ken and Ruth Davee Department of Neurology, Cognitive Neurology and Alzheimer Disease Center, Northwestern University Feinberg School of Medicine, Chicago, IL
  • Financial Disclosure: Borna Bonakdarpour is an Instructor in Neurology at Northwestern University Feinberg School of Medicine.
    Financial Disclosure: Borna Bonakdarpour is an Instructor in Neurology at Northwestern University Feinberg School of Medicine.×
  • Nonfinancial Disclosure: Borna Bonakdarpour has no nonfinancial interests related to the content of this article.
    Nonfinancial Disclosure: Borna Bonakdarpour has no nonfinancial interests related to the content of this article.×
Article Information
Special Populations / Older Adults & Aging / Language Disorders / Aphasia / Articles
Article   |   October 01, 2014
Neuroimaging in Primary Progressive Aphasia
SIG 2 Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, October 2014, Vol. 24, 145-156. doi:10.1044/nnsld24.4.145
SIG 2 Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, October 2014, Vol. 24, 145-156. doi:10.1044/nnsld24.4.145

Neuroimaging is a standard part of a primary progressive aphasia (PPA) diagnostic work-up and an important component of research investigating changes in the speech-language network in patients with PPA. In this paper, structural neuroimaging, including computed tomography (CT), magnetic resonance imaging (MRI), and diffusion tensor imaging (DTI), as well as functional neuroimaging, including single photon emission computed tomography (SPECT), positron emission tomography (PET), and functional MRI (fMRI), are discussed. Neuroimaging, in conjunction with meticulous clinical and neuropsychological evaluation, can increase diagnostic certainty for PPA subtyping and identification of underlying pathology, which is important for justification of potential pharmacological treatments, such as cholinesterase inhibitors. MRI and, more recently, DTI, have expanded our knowledge of structural brain changes in PPA, including gray matter abnormalities as well as alterations in neuronal tracts. SPECT and PET provide information regarding brain regional blood perfusion (SPECT) or metabolism (PET). Recently, thanks to PET ligands that bind to amyloid protein, it has become possible to diagnose or rule out Alzheimer pathology as a cause for PPA and tau imaging may be forthcoming. Finally, fMRI provides a unique window into brain-behavior relations for language as well as reorganization of the language network in disease. fMRI has also been used to gauge the effects of therapeutic interventions, including language treatment, and can be used for implementation of neuromodulatory mediations, such as repetitive transcranial magnetic stimulation (TMS).

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