When you think about dementia-causing degenerative brain illnesses, you normally think of memory issues. Language issues, often known as aphasia, are sometimes the first symptom.
What exactly is aphasia?
Aphasia is a linguistic problem caused by brain damage. The most common cause is strokes (when a blood clot blocks an artery and a portion of the brain dies), but aphasia can also be caused by severe brain injuries, brain tumours, encephalitis, and nearly anything else that damages the brain, including neurodegenerative disorders.
What causes aphasia in people with neurodegenerative diseases?
Neurodegenerative diseases are illnesses that cause the brain to deteriorate over time. After an MRI scan has ruled out a brain tumor, the time course of aphasia may usually be used to determine whether it is caused by a neurodegenerative illness rather than a stroke or another cause: Strokes can happen in a matter of seconds or minutes. Encephalitis manifests itself over a period of hours to days. Symptoms of neurodegenerative illnesses appear throughout months to years.
The most prevalent neurodegenerative disease is Alzheimer's disease, but there are others, such as frontotemporal lobar degeneration. Different neurodegenerative illnesses create different symptoms and harm different areas of the brain. Primary progressive aphasia is a term used to describe when a neurological disease creates issues with the language first and foremost.
How can you know if you have primary progressive aphasia?
A cognitive-behavioural neurologist and/or a neuropsychologist who specializes in late-life diseases are usually the ones to identify primary progressive aphasia. A neurological examination, pencil-and-paper testing of thinking, memory, and language, blood tests to rule out vitamin deficiencies, thyroid disorders, infections, and other medical problems, and an MRI scan to look for strokes, tumours, and other abnormalities that can affect the brain's structure should all be included in the evaluation.
The following are some of the general criteria for primary progressive aphasia:
The most prominent clinical feature at the onset and early stages of the neurodegenerative disease is difficulty with language. These language problems are severe enough to impair day-to-day functioning. Other disorders that could cause language problems have been investigated and found to be absent.
Primary progressive aphasia is divided into three types.
Primary progressive aphasia is classified into several types depending on whatever part of the language is affected.
A variant of logopenic Word-finding difficulties is a symptom of primary progressive aphasia. People who have this variation have problems remembering basic phrases like table, chair, blue, knee, celery, and honesty. They do, however, understand what these phrases signify.
Semantic variant The difficulty in understanding what words imply is a symptom of primary progressive aphasia. Individuals with this variety may not know what a table or chair is, what colour blue is, where to find their knee, what celery is useful for, or what honesty means when given the term.
Nonfluent/agrammatic variant primary progressive aphasia is characterized by difficult, halting speech in which people know what they want to say but are unable to articulate it. When they do manage to get words out, their statements are frequently grammatically incorrect. Even if they understand the meaning of individual words, they may struggle to comprehend a statement with sophisticated grammar, such as "The lion was eaten by the tiger."
Different disorders induce different types of primary progressive aphasia.
These forms of primary progressive aphasia are not disorders in and of themselves. They are signs of an issue with the brain. Not sure what I'm talking about? Fever, headache, and chest pain are three further symptoms to consider. As you may be aware, each of these symptoms can be caused by a variety of diseases.
Alzheimer's disease is the most common cause of the logopenic type of primary progressive aphasia. Do you think that's surprising? This means that, while Alzheimer's disease usually starts with memory loss, it can also start with difficulty finding words in certain people. Memory issues usually appear after a few years. (If Alzheimer's disease doesn't start with memory issues, why do we name it that?) Because the pathology that we detect under the microscope when we analyze brain tissue is what defines Alzheimer's disease, not the symptoms.)
Frontotemporal lobar degeneration, specifically TDP-43 accumulation, is the most common cause of the semantic variant of primary progressive aphasia. TDP-43 is an abnormal protein that builds up in brain cells and eventually kills them.
Primary progressive nonfluent/agrammatic is likewise caused by frontotemporal lobar degeneration, however, this time tau pathology is the most common cause. Tau builds up inside cells, causing tangles that harm and destroy them.
Is it possible to treat primary progressive aphasia?
Primary progressive aphasia is treated through strategies and systems that assist people with these diseases to communicate more effectively.
Individuals with logopenic variant primary progressive aphasia may benefit from thinking of facts relating to the word they are seeking for. If they're looking for the term lion, for example, thinking of yellow, Africa, huge cat, mane, and other comparable words may assist.
Pantomiming the message you're attempting to convey, as well as using your tone of voice, facial expression, and body language can help you communicate with those who have semantic variant primary progressive aphasia.
Individuals with all types of primary progressive aphasia can benefit from using pictures, whether on paper or in a tablet-based application.
Unfortunately, there are no known cures for primary progressive aphasia, and no effective treatments have been identified. Most people who have primary progressive aphasia acquire other cognitive issues over time, which can lead to dementia.
Start by seeing your doctor if you think you (or a loved one) could have primary progressive aphasia. If your doctor has any concerns, he or she will refer you (or a loved one) to the appropriate specialist.