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Systematic review of Clinicopathological Correlations in Logopenic progressive Aphasia

Sheng Yuan Kan

Systematic Review of Clinicopathological Correlations in Logopenic Progressive Aphasia: Logopenic aphasia (lvPPA) is characterised by impaired word-retrieval and sentence repetition. It is usually associated with AD pathology, but other pathologies have been reported. The objectives of this study was to estimate the prevalence of different neuropathology in autopsied lvPPA cases and evaluate the performance of new criteria in predicting Alzheimer’s Disease (AD) pathology in lvPPA patients. In this systematic review, we developed search strategies to identify studies which reported clinical cases of lvPPA and neuropathology investigation results. The included studies were analysed for reporting quality, demographics, clinical criteria and pathological diagnosis. Out of 2459 articles screened, 35 studies reported 200 lvPPA patients in total. Reporting quality were good for clinical criteria (100%) and neuropathology (91.4%), moderate for gender, age at onset and duration (60%) and poor for ethnicity (5.7%). The neuropathology findings in lvPPA are 74% AD, 20% Frontotemporal Lobar Degeneration (FTLD-TDP=14%, FTLD-Tau=6%), 2% Dementia with Lewy Bodies (DLB), 2% Creutzfeldt-Jakob disease (CJD) and 2% others. The positive predictive value of new criteria is 9% higher, but not statistically significant (p>0.05). This study confirmed the prevalence of different neuropathologies among lvPPA patients, with AD pathology being the most prevalent. We also showed that more studies are published using the new criteria and suggested the importance of multimodal diagnostic approach due to the low positive predictive value (77%) of the consensus clinical criteria..