Neurodegenerative disease showing language/speech impairment: the symptoms and the approach

<p>Language and speech symptoms due to neurodegenerative diseases should be divided into two groups; one is the specific impairment of language or speech system itself, the other is the impairment following general cognitive dysfunction such as dementia. The former includes primary progressive aphasia (PPA), the latter includes Alzheimer's dementia and so on. Six Elementary language/speech impairments: apraxia of speech (AOS), phonemic paraphasia, impairment of sentence production, word finding difficulties, word comprehension difficulties, repetition impairment are important and useful for the diagnosis of PPA and its subclassification into three subtypes. Regarding naPPA, the syndrome of primary progressive AOS (PPAOS) should be classified as a specific disease called 4 repeat tauopathy. As to lpvPPA, the logopenic type indicates dysfunction in the vicinity of the angular gyrus and the phonological type indicated dysfuntion in the region of supramarginal gyrus to posterior central gyrus. MLSE (Mini Linguistic State Examination) has been developed for the diagnosis of PPA. Recent criteria of PSP and CBD includes naPPA and/or PPAOS. The patients with Alzheimer's disease (AD) could show anomia, sometimes with agraphia of Kanji (Japanese orthogram), or transcortical sensory aphasia. The patients with frontal variant AD could show anomia. Many reports show that appropriate rehabilitations and transcranial direct stimulation or repetitive transcranial magnetic stimulation are effective for PPA.</p>