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Semantic Variant Primary Progressive Aphasia — SCE Neurology MCQ

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ModerateNeurodegenerative DiseaseSemantic Variant Primary Progressive AphasiaSCE Neurology

A 60-year-old woman presents with 3 months of progressive word-finding difficulty and loss of word meaning. She cannot name common objects and does not understand the meaning of previously familiar words (e.g., 'hippopotamus', 'artichoke'). Her speech is fluent but empty. Episodic memory and visuospatial function are preserved. MRI shows bilateral (left > right) anterior temporal lobe atrophy. What is the most likely diagnosis?

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Correct answer: A — Semantic variant primary progressive aphasia

Semantic variant primary progressive aphasia (svPPA) is characterised by fluent but progressively empty speech with loss of single-word comprehension and object knowledge. Surface dyslexia and impaired face/object recognition may develop. It is usually associated with TDP-43 pathology and shows asymmetric anterior temporal atrophy (left > right). A: AD typically affects episodic memory first. B: nfvPPA has effortful, non-fluent speech. D: Logopenic PPA has word-finding difficulty but preserved single-word comprehension. E: PCA affects visuospatial function.

Reference: Gorno-Tempini et al. Classification of PPA (2011)