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Nonfluent progressive aphasia and semantic dementia: A comparative neuropsychological study

Published online by Cambridge University Press:  26 February 2009

John R. Hodges  and
Karalyn Patterson
John R. Hodges
Affiliation:
University Neurology Unit, University of Cambridge, Cambridge CB2 2QQ, UK
Karalyn Patterson
Affiliation:
MRC Applied Psychology Unit, Cambridge CB2 2EF, UK
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Abstract

Two patients with nonfluent progressive aphasia, who have been studied longitudinally, are contrasted with a group of 5 patients with fluent progressive aphasia or semantic dementia. The most prominent feature of the nonfluent syndrome is the severe distortion of speech output with phonological errors and agrammatic sentence structure. This contrasts with the fluent, well articulated and syntactically correct, but empty, anomic speech found in semantic dementia. Performance on tests of comprehension separates the patient groups: The nonfluent patients show normal single-word comprehension, but marked impairment on tests of syntactic comprehension, while those with semantic dementia demonstrate the opposite pattern. Category fluency is severely defective in semantic dementia, but initial letter-based fluency is more impaired in the nonfluent syndrome. Performance on nonverbally mediated tests of semantic knowledge is impaired in semantic dementia only. The 2 forms of progressive aphasia have in common the sparing of perceptual and visuospatial skills, nonverbal problem solving abilities, and day-to-day (episodic) memory. Neuroradiological investigations have shown marked selective and striking inferolateral left temporal lobe atrophy in all 5 patients with semantic dementia. The changes in nonfluent progressive aphasia appear to be less focal and involve left perisylvian structures more diffusely. These 2 forms of progressive aphasia are, we argue, distinct in their manifestations. (JINS, 1996, 2, 511–524.)

Keywords

Nonfluent progressive aphasiaSemantic dementia
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 2 , Issue 6 , November 1996 , pp. 511 - 524
Copyright
Copyright © The International Neuropsychological Society 1996

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