As someone who has PPA, I think the criteria postulated for the three types could be far too rigid especially when diagnosing someone like me who appears to have symptoms of each variant plus an MRI scan indicating PCA. My latest diagnosis was done at FRONTIERS Brain and Mind Centre at Sydney Uni in Nov 2023. I was first diagnosed with PPA IN 2017. To be fair to the neurologists there, they did not know what to make of it. In their detailed report they indicated examples of all three variants. What is more, I have been able to reverse many of my initial symptoms by following Dr Dale Bredesen's protocol. My latest neurological test score was 88/100. My initial score was 34/100. I am 80 yrs old with a PhD in Linguistics. The wonderful news is that there are others like me who have reversed the worst of their symptoms. So I think being too rigid is not at all helpful, especially when neuroplacicity is taken into account.
Hi Lea, forgive the late reply. It is actually quite common for symptoms of the three types of ppa to "merge" as time passes. You mentioned you were initially diagnosed in 2017. Going back in time, could you identify which one of the three PPAs you best fit? Did you have a FDG PET scan at any point in time, esp in the early days of your diagnosis? Cognitive experts match the clinical picture with the imaging to make a diagnoses early on. The bottom line is that the criteria is most useful for making an "early" diagnoses. This makes perfect sense, since as brain degeneration progresses, more areas of the brain are affected and sypmtomoloygy will begin to merge. When we see patients in later stages, the MRIs and PETs will show a more widespread disease as will the clinical picture. One impt point is that we cannot put "neurological testing" into a simple box. Quality assessments include many components, eg: memory & learning, language (broken down into further components as noted in this lecture), attention, visuospatial, executive function, processing speed, motor function, etc... even changes in behavior should be assessed. Sometimes, if the same test is given over time and if focused on only one of these cognitive components, such as "language", the pt comes to memorize the test and the answers over time. Remember, in PPA memory can be spared for many years. It must have been very difficult diagnosis for you to accept when you are such an accomplished Linguist. Your baseline aptitude is likely quite high, which is surely at least contributory to why you have apparently done so well over time. Personally, I don't believe in the Bredesen's protocol. However, I am happy you felt it worked for you. Thank you for your comment, and I am again so sorry to have missed it!
