The logopenic form of primary progressive aphasia due to Alzheimer’s disease

Alzheimer’s disease (AD) is rarely diagnosed in our country, which is largely due to the poor awareness of doctors about its symptoms and clinical forms. The logopenic variant of primary progressive aphasia (lvPPA) represents a rare presentation of AD and is characterized by isolated language impairment in the early stages. A clinical case of a 70-year-old patient with lvPPA due to AD is presented. Despite the prevailance of speech impairment in her clinical picture, for long she was observed for cerebrovascular disease. Signs of severe brain atrophy according to MRI data and a significant decrease in the beta-amyloid content in the cerebrospinal fluid made it possible to diagnose AD as the cause of lvPPA. Timely diagnosis of lvPPA is difficult due to its clinical similarity to other forms of lvPPA. A hallmark of PPA is word-finding difficulty during speech production, resulting in slowed speech. Comprehension of spoken language, grammatical structure, and articulation remain preserved. This language deficit is associated with dysfunction of the “phonological loop”. Clinical, instrumental, and pathomorphological characteristics of different PPA variants are described to provide a more systematized view on lvPPA. Early diagnosis of lvPPA is important both for the timely prescription of available symptomatic treatments, implementation of non-pharmacological therapy, and for defining indications for pathogenetic therapy aimed at preventing progression of AD.

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