Speech and language deficits are often the very first symptoms of neurodegenerative diseases, such as frontotemporal lobar degeneration and Alzheimer's disease. When speech and language deficits remain isolated for the initial phases of the disease, the term primary progressive aphasia (PPA) applies. Characterization of the linguistic impairments can provide information critical for early differential diagnosis, but speec and language functions are rarely assessed in the setting of dementia clinics. Moreover, data from large-scale longitudinal clinical and neuroimaging studies of PPA are not available to guide clinicians in making diagnostic, prognostic or therapeutic decisions. We propose a detailed, five-year longitudinal study of the linguistic, anatomical and biological features of over 300 patients with PPA, thus extending the work we began in 2004. The accrual of this large cohort is possible because the UCSF Memory and Aging Center is the site of an NIH-funded program in atypical and early-age-of-onset dementias. The research project proposed here will take advantage of the infrastructure offered at UCSF and will complement the program by bringing specific linguistic and neuroimaging expertise to the study of the clinical, cognitive and neural mechanisms underlying PPA.
In Aim 1 we will correlate scores in novel language domains with regional brain volumes;
in Aim 2 Q-ball tractography, resting state and activation functional MRI will be used to investigate alterations in structural and functional connectivity in the language networks in PPA and correlate them with linguistic deficits; and in Aim 3 we will apply multivariate statistical methods to study the progression of PPA and associate longitudinal multidisciplinary data with clinical outcomes or post-mortem pathological findings. We will identify patterns of progression typical of each PPA variant and explore whether results from a comprehensive longitudinal assessment can predict pathological subtypes, in-vivo. Evidence gathered from this research will increase our knowledge about the neural basis of speech and language functions and provide crucial data for the diagnosis of neurodegenerative diseases in their early stages, when treatment can be most effective.

Public Health Relevance

The research focuses on speech and language symptoms that are the manifestation of fatal neurodegenerative diseases. We will study these linguistic deficits and their neural correlates using the most modern cognitive and neuroimaging techniques, with the goal of improving early differential diagnosis and ultimately treatment of these devastating disorders. Results from this study will also further our knowledge regarding the neural basis of language.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
4R01NS050915-12
Application #
9085417
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Babcock, Debra J
Project Start
2004-07-15
Project End
2017-06-30
Budget Start
2016-07-01
Budget End
2017-06-30
Support Year
12
Fiscal Year
2016
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Neurology
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94118
Henry, Maya L; Hubbard, H Isabel; Grasso, Stephanie M et al. (2018) Retraining speech production and fluency in non-fluent/agrammatic primary progressive aphasia. Brain 141:1799-1814
Ossenkoppele, Rik; Rabinovici, Gil D; Smith, Ruben et al. (2018) Discriminative Accuracy of [18F]flortaucipir Positron Emission Tomography for Alzheimer Disease vs Other Neurodegenerative Disorders. JAMA 320:1151-1162
Mandelli, Maria Luisa; Welch, Ariane E; Vilaplana, Eduard et al. (2018) Altered topology of the functional speech production network in non-fluent/agrammatic variant of PPA. Cortex 108:252-264
Pressman, Peter S; Shdo, Suzanne; Simpson, Michaela et al. (2018) Neuroanatomy of Shared Conversational Laughter in Neurodegenerative Disease. Front Neurol 9:464
Caverzasi, Eduardo; Mandelli, Maria Luisa; Hoeft, Fumiko et al. (2018) Abnormal age-related cortical folding and neurite morphology in children with developmental dyslexia. Neuroimage Clin 18:814-821
Watson, Christa L; Possin, Katherine; Allen, I Elaine et al. (2018) Visuospatial Functioning in the Primary Progressive Aphasias. J Int Neuropsychol Soc 24:259-268
Seo, Sang Won; Thibodeau, Marie-Pierre; Perry, David C et al. (2018) Early vs late age at onset frontotemporal dementia and frontotemporal lobar degeneration. Neurology 90:e1047-e1056
Santos-Santos, Miguel A; Rabinovici, Gil D; Iaccarino, Leonardo et al. (2018) Rates of Amyloid Imaging Positivity in Patients With Primary Progressive Aphasia. JAMA Neurol 75:342-352
Bergeron, David; Gorno-Tempini, Maria L; Rabinovici, Gil D et al. (2018) Prevalence of amyloid-? pathology in distinct variants of primary progressive aphasia. Ann Neurol 84:729-740
Miller, Zachary A; Rosenberg, Lynne; Santos-Santos, Miguel A et al. (2018) Prevalence of Mathematical and Visuospatial Learning Disabilities in Patients With Posterior Cortical Atrophy. JAMA Neurol 75:728-737

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