Primary Progressive Aphasia

Primary progressive aphasia (PPA) is a neurological disorder characterized by progressive loss of language and communicative skills. It is caused by degeneration of the parts of brain responsible for speech and language functions.

Symptoms of PPA appears gradually, starting with difficulty in thinking of common words. As the condition progresses, the symptoms worsen until verbal communication is severely limited.

Other mental abilities may also decline with time in PPA. It is more commonly seen in people above 65 years. Medical history, neurological and neurophysiological examination help in the diagnosis of this disorder. Speech therapies help in improving the quality of life of the person with PPA.

Symptoms of primary progressive aphasia (PPA) include different language limitations. Patients usually note the initial symptoms and often ignore the same attributing it to anxiety or stress. Symptoms vary according to the extent and part of the brain affected.

There are three types of PPA: 

• Semantic variant PPA – people with this form of PPA have difficulty in comprehending words and sentences. They have deficiency in understanding and using single words. Understanding word meanings and naming common objects are also limited.
• Lopogenic variant PPA – they are unable to retrieve words, and repeat words and phrases. It is characterized by halted speech as they pause to find appropriate words.
• Nonfluent-agrammatic variant PPA – this form is characterized by difficulty in framing words, halted speech, errors in speech sounds, difficulty in comprehension, and erroneous use of grammar.

Primary progressive aphasia (PPA) is caused by progressive atrophy of the brain cells on the left side, including frontal, temporal, and parietal lobes. Degeneration of the brain cells responsible for the language skills are gradually lost.

Brain activity is limited in this condition. In some cases, scarring and abnormal protein build-up are also noticed. Learning disabilities and certain gene mutations increase the risk of this neurological disorder.

Diagnosis of primary progressive aphasia (PPA) is based on review of symptoms and tests. Progressive loss of communication skills and gradual loss of cognitive abilities are characteristic of PPA.

Speech evaluation, neurological examination, and neurophysiological evaluation are used to assess the language and comprehension skills, ability to recognize and name objects, and ability to recollect.

Blood tests check for infections and other medical conditions. Genetic test diagnose mutations that increase the risk of aphasia. Brain scans using MRI provide a clear image of brain atrophy. These images help to locate the area and extent of brain damage.

PET scans are useful in visualizing abnormalities in glucose metabolism and blood flow in brain.

There is no complete cure for primary progressive aphasia (PPA) and no medications to treat it. Language and communication disabilities can be improved by speech and language therapy.

Speech therapy helps to compensate and improve the loss of language skills. It helps to manage the condition and to improve the quality of life of the affected person.

There are no conventional methods to prevent the occurrence of primary progressive aphasia (PPA). Understanding and preventing the risk factors help to start the treatment early, and to manage the condition better.

Several alternative and homeopathic remedies exist for managing the symptoms of primary progressive aphasia (PPA).

Fish oil and phosphatidylserine supplements are used to restore brain function and improve learning.

Bacopa, ginkgo biloba, gotu kola, mucuna, melissa, scullcap, and vinpocetine are suggested in treating aphasia.

Arsenicum album, Lachesis, crotalus horridus, lycopodium, and nitricum acidum are recommended in homeopathy to treat different symptoms of PPA.

Lifestyle modifications are necessary in order to cope with primary progressive aphasia (PPA).

Family involvement is very important in the treatment of aphasia. Making languages simple and uncomplicated helps to communicate better with the patients.

Other tips include:

• Encourage communications
• Reduce distractions like TV or radio
• Include the patient in family matters
• Allow the person to talk
• Maintain a normal conversation

There are several complications associated with primary progressive aphasia (PPA).

PPA may lead to other cognitive deficiencies that affect day-to-day activities of the person.

Behavioral and social issues, blunted emotions, and inappropriate social behavior are also seen as complications.