The Box Task: A novel tool to differentiate the primary progressive aphasias. (6th August 2021)

• Record Type: Journal Article
• Authors: Foxe, David; Irish, Muireann; D'Mello, Mirelle; Barhon, Lucienne; Burrell, James R.; Kessels, Roy P.C.; Piguet, Olivier
• Is Part Of: European journal of neurology. Volume 28:Number 12(2021)
• Page Start: 3945
• Page End: 3954
• Publication Date: 2021-08-06
• Subjects: Alzheimers disease -- frontotemporal dementia -- neuropsychological testing -- visuospatial processing -- working memory; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.15035
• Languages: English
• ISSNs: 1351-5101

Abstract

Abstract: Objective: Differentiating the primary progressive aphasia (PPA) variants in clinical settings remains complex and challenging, especially for the logopenic (lv‐PPA) and non‐fluent variants (nfv‐PPA). Recent studies suggest that visuospatial memory is more compromised in lv‐PPA than in nfv‐PPA and is relatively spared in the semantic variant (sv‐PPA). Accordingly, assessment of visuospatial memory performance may assist in the differential diagnosis of PPA variants. Here, we investigated the utility of a novel computerised visuospatial working memory test—the Box Task—to differentiate the three PPA variants and typical Alzheimer's disease (AD). Methods: Eighteen lv‐PPA, 14 nfv‐PPA, 23 sv‐PPA, 33 AD patients, and 32 healthy controls matched for age and education were recruited. All participants completed the computerised Box Task and WMS‐III Spatial Span as measures of visuospatial working memory. Results: The lv‐PPA group made significantly more Box Task between‐search errors than nfv‐PPA, sv‐PPA and control groups. The AD group, however, displayed the greatest impairments on this measure relative to the PPA variants. Logistic regression analyses in lv‐PPA and nfv‐PPA demonstrated that the combination of Box Task between‐search error variables (i.e., 4‐ and 6‐box levels) could correctly classify 72% of lv‐PPA patients and nearly 79% of nfv‐PPA patients. Area under the receiver operator characteristics curve (AUC) analyses revealed the Box Task was more sensitive than Spatial Span at differentiating lv‐PPA from nfv‐PPA. Conclusions: Our findings suggest that a simple, computerised measure of visuospatial working memory—the Box Task—shows potential diagnostic utility in differentiating lv‐PPA from the other PPA variants. Abstract : Differentiating the primary progressive aphasia (PPA) variants in clinical settings remains challenging, especially for the logopenic (lv‐PPA) and non‐fluent variants (nfv‐PPA). Recent studies suggest that visuospatial memory is more compromised in lv‐PPA than in nfv‐PPA and is relatively spared in the semantic variant (sv‐PPA). This study found that a simple, computerised measure of visuospatial working memory—the Box Task—shows potential diagnostic utility in differentiating lv‐PPA from the other PPA variants.