Primary Progressive Apraxia of Speech: From Recognition to Diagnosis and Care.
Joseph R Duffy, Rene L Utianski, Keith A Josephs
PMID 34219857WHAT IT FOUND
Progressive apraxia of speech is a distinct neurodegenerative syndrome, not just aphasia.
It often precedes parkinsonism or supranuclear palsy. Treatment should prioritize communication strategies and partner training, as impairment-focused therapy has limited evidence.
Key findings
01Primary progressive apraxia of speech is a clinical syndrome dominated by apraxia of speech with no more than equivocal evidence of aphasia, distinct from primary progressive aphasia.
02Approximately 40% of patients with primary progressive apraxia of speech develop signs of progressive supranuclear palsy or corticobasal syndrome within five years of symptom onset.
03There is currently no disease-modifying pharmacologic treatment for primary progressive apraxia of speech, and the effect of impairment-focused speech therapy remains largely unknown.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a narrative review, not a systematic review or meta-analysis, so it may be subject to selection bias in the studies cited. The evidence base for PPAOS is still developing, with many findings based on case series or small cohorts. The review notes that diagnostic criteria and subtype distinctions are still being refined and may not be universally applied. Long-term outcomes and treatment efficacy are largely unknown due to the rarity of the condition and lack of controlled trials.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that impairment-focused speech therapy will restore function or slow progression, as the paper states its effect is largely unknown. Also, do not diagnose PPAOS if significant aphasia is present at onset; that would suggest AOS+PAA or PPA.