Cortical atrophy was smallest in corticobasal degeneration/progressive supranuclear palsy and largest in TDP(A). Word comprehension impairments had strong predictive power for determining underlying neuropathology positively for TDP(C) and negatively for ADNC. Seventy-seven per cent of logopenics had ADNC, 56% of agrammatics had corticobasal degeneration/progressive supranuclear palsy or Pick’s disease and 89% of semantics had TDP(C). Each variant had a preferred but not invariant neuropathological correlate. They were classified as logopenic, agrammatic/non-fluent or semantic by quantitative algorithms. ![]() A subset of 68 right-handed participants entered longitudinal investigations. In 118 consecutive autopsies on patients with primary progressive aphasia, primary diagnosis was Alzheimer’s disease neuropathological changes (ADNC) in 42%, corticobasal degeneration or progressive supranuclear palsy neuropathology in 24%, Pick’s disease neuropathology in 10%, transactive response DNA binding proteinopathy type A in 10%, TDP(C) in 11% and infrequent entities in 3%. Primary progressive aphasia is a neurodegenerative disease that selectively impairs language without equivalent impairment of speech, memory or comportment.
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