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Non-Fluent Variant Primary Progressive Aphasia — SCE Neurology MCQ

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HardNeurodegenerative DiseaseNon-Fluent Variant Primary Progressive AphasiaSCE Neurology

A 65-year-old woman presents with progressive non-fluent speech (effortful, agrammatic, with speech sound errors), relatively preserved word comprehension, and intact memory. MRI brain shows left inferior frontal lobe and insular atrophy. What is the most likely diagnosis?

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Correct answer: D — Non-fluent/agrammatic variant primary progressive aphasia

Non-fluent/agrammatic variant primary progressive aphasia (nfvPPA) is characterised by effortful, halting speech with grammatical errors and/or speech sound errors (apraxia of speech). Comprehension of single words is preserved, but comprehension of grammatically complex sentences may be impaired. It is usually associated with tau pathology (FTLD-tau) and corresponds to left inferior frontal/insular atrophy. A: AD affects memory first. B: Broca's aphasia from stroke has acute onset. D: Semantic variant PPA has fluent speech but loss of word meaning. E: Logopenic PPA has word-finding pauses and phonological errors.

Reference: Gorno-Tempini et al. Classification of PPA (2011); NICE NG97 Dementia (2018)