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Primary progressive aphasia: PPA and the language network
Sonty SP, Mesulam MM, Thompson CK, Johnson NA, Weintraub S, Parrish TB, Gitelman DR.. Annals of neurology, 2003-01-01
Topic: Risk, prevention and care in population studies
Primary Progressive Aphasia (PPA) is a behaviorally focal dementia syndrome with deterioration of language functions but relative preservation of other cognitive domains for at least the first two years of disease. In this study, PPA patients with impaired word finding but intact comprehension of conversational speech and their matched control subjects were examined using voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI). fMRI compared signal changes during phonological and semantic language tasks with those during a control task (matching letters). PPA patients showed longer reaction times and reduced accuracy versus controls on the language tasks, but no performance differences on the control task. VBM demonstrated reduced gray matter in left superior temporal and inferior parietal regions in the PPA group. However, these patients showed a normal pattern of activation within the classical language regions. In addition, PPA patients showed activations, not seen in normals, in fusiform gyrus, precentral gyrus, and intra-parietal sulcus. These activations were found to correlate negatively with measures of naming and task performance. The additional activations in PPA may therefore represent a compensatory spread of language-related neural activity or a failure to suppress activity in areas normally inhibited during language tasks.
Key findings
- PPA patients showed longer reaction times and reduced accuracy versus controls on the language tasks, but no performance differences on the control task.
- VBM demonstrated reduced gray matter in left superior temporal and inferior parietal regions in the PPA group.
Why it matters
In people with primary progressive aphasia who had word-finding trouble but understood conversation, MRI showed less grey matter in left superior temporal and inferior parietal regions. Activity in the classical language areas looked normal, but patients also used extra areas (fusiform gyrus, precentral gyrus, intra-parietal sulcus) that controls did not, and more of that extra activity went with worse naming and task scores. The authors say this may be the brain compensating or failing to switch off areas it normally quiets. The study describes brain changes only and tests no treatment.
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Study details
- Evidence strengthLow
How this study scored 45/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of neurology) |
| Journal's citation record | 3 / 4 | Annals of Neurology: journal h-index 437 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 148 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 5.9 citations a year over 25 year(s) since 2003 |
| Impact for its field and year | 2 / 6 | Cited 2.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 6 other studies in this library |
| Still being cited | 2 / 4 | Cited 16 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Darren R. Gitelman: h-index 69 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Northwestern University: institution h-index 1,592 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12509846) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 45 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Sonty, S. P., Mesulam, M. M., Thompson, C. K., Johnson, N. A., Weintraub, S., Parrish, T. B., et al. (2003). Primary progressive aphasia: PPA and the language network. Annals of neurology. https://doi.org/10.1002/ana.10390
Vancouver
Sonty SP, Mesulam MM, Thompson CK, Johnson NA, Weintraub S, Parrish TB, et al. Primary progressive aphasia: PPA and the language network. Annals of neurology. 2003. doi:10.1002/ana.10390. PMID: 12509846.
BibTeX
@article{sonty2003-12509846,
author = {Sonty, S. P. and Mesulam, M. M. and Thompson, C. K. and Johnson, N. A. and Weintraub, S. and Parrish, T. B. and Gitelman, D. R.},
title = {{Primary progressive aphasia: PPA and the language network}},
journal = {Annals of neurology},
year = {2003},
doi = {10.1002/ana.10390},
pmid = {12509846},
url = {https://doi.org/10.1002/ana.10390}
}
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Later studies that cite this one
6 studies in the alzhub library list this one in their references.