Non-fluent primary progressive aphasia (nvfPPA) affects your ability to express yourself through speech. Your speech might become effortful and halting.

Non-fluent primary progressive aphasia (nvfPPA) affects the parts of the brain that control speech and language. This is a type of dementia that affects your ability to speak. It’s also called agrammatic variant of PPA.

People with nfvPPA often make grammatical errors when talking. For example, they may use tenses incorrectly and mix up the order of words in sentences. Speaking may become very effortful for them.

As with other types of PPA, nvfPPA typically progresses over time, meaning that the symptoms gradually get worse. Eventually, people with PPA might develop motor symptoms, including difficulty swallowing.

Although there’s no cure for nvfPPA, there are ways to manage the symptoms.

Aphasia is a condition that affects your ability to use and understand language. It can be caused by a sudden condition, like a stroke. But it can also happen gradually, as with certain forms of dementia.

NvfPPA is relatively rare, affecting 5 to 39 in 1 million people.

NvfPPA is one type of primary progressive aphasia (PPA), which is a kind of frontotemporal dementia.

The frontotemporal areas of your brain affect how you express and understand language. When these areas of the brain are damaged, it can affect your ability to speak and understand spoken words.

While some forms of frontotemporal dementia affect your behavior, nvfPPA primarily affects your speech and comprehension of spoken language. You might still be able to recall the meaning of individual words but have difficulty understanding complex sentences.

In the early stages of nvfPPA, someone might find that speaking is becoming increasingly difficult for them.

The symptoms of nvfPPA include:

  • difficulty constructing sentences
  • difficulty pronouncing words correctly
  • difficulty understanding long or complex sentences
  • effortful, slow speech
  • grammatical errors, including confusing verb tenses
  • often pausing to find words
  • omitting connecting words (like “to,” “and,” or “then”) or substituting them with the wrong word

In the early stages of nvfPPA, the person will still understand the meanings of individual words. Their behavior and physical abilities might not be affected. Also, they are still able to think, remember, and reason when it comes to non-language tasks.

However, the symptoms of nvfPPA tend to become worse over time.

Possible later symptoms of nvfPPA include:

  • becoming mute
  • difficulty swallowing
  • motor issues, like stiff movement or difficulty with balance

Not everybody with nvfPPA experiences all of these later symptoms.

The types of non-fluent aphasia include:

  • Broca’s aphasia: With Broca’s aphasia, speaking is very difficult, so you might use short phrases instead of long sentences. You can still understand others and know what you want to say. You might experience some weakness or paralysis of the limbs on one side of your body.
  • Transcortical motor aphasia: With this type, you can understand words but can’t communicate fluently, often using short phrases or taking a while to respond. You might also frequently repeat words and phrases.
  • Global aphasia: Considered a severe form, global aphasia causes difficulty understanding language as well as expressing yourself through speech.

Although these types of aphasia are all non-fluent, they aren’t always caused by dementia, and they aren’t all forms of PPA. For instance, Broca’s aphasia can be caused by a stroke or brain injury as well as dementia.

Both fluent and non-fluent aphasia affect speech.

If you have non-fluent aphasia, it will be difficult and effortful to speak, but you might still be able to understand most of what someone else is saying.

With fluent aphasia, your speech flows more easily, but the content of what you say makes no sense. You might use nonsensical words or invented words. People with fluent aphasia typically have trouble with comprehension more than people with non-fluent aphasia.

nvfPPA happens when dementia affects the frontotemporal area of the brain. These areas might atrophy (or shrink), which damages the nerve cells in the brain.

Risk factors for nvfPPA

The following factors might put you at risk of developing nvfPPA:

  • Age: Most cases of PPA start between the ages of 50 and 70, with an average age of 60. However, it’s possible for it to occur in older or younger people.
  • Family history of dementia or other neurological diseases: If you have a blood relative with PPA, you’re more likely to develop the condition.
  • Certain genetic mutations: NfvPPA has been associated with certain gene mutations, but according to research, these mutations are rarely the cause of nvfPPA.

Gender doesn’t seem to play a role: Men and women seem to be equally affected by nvfPPA.

There’s no cure for nvfPPA. Instead, the treatment for nvfPPA focuses on managing the symptoms to improve your quality of life for as long as possible.

The main treatment for PPA is speech-language therapy. This can help with:

  • improving your communication skills as much as possible
  • learning new ways to communicate; for example, through gestures or drawing pictures
  • learning to use assistive communication technology
  • treating difficulties with chewing and swallowing food

Your healthcare team might also suggest strategies such as:

  • keeping a pen and paper handy to help you communicate
  • carrying a card in your wallet that explains you have aphasia and what it means
  • joining a support group for people with aphasia
  • practicing speech and communication to strengthen your skills and improve your confidence
  • keeping your family members and loved ones in the loop about your condition and asking them for support
  • continuing to do the things that you enjoy — such as hobbies, social activities, exercise, and work — for as long as possible

These strategies can help you communicate and maintain your quality of life for as long as possible.

So far, there’s no medication that has been proven to be beneficial for people with nvfPPA.

People with aphasia are at risk for depression. In this case, your treatment team might suggest using antidepressant medication. Talk therapy and counseling can help you and your family members come to terms with your condition.

Transcranial direct current stimulation (tDCS) is currently being investigated for its potential to treat people with language disorders. This is a noninvasive and inexpensive treatment that could slow down the decline in language abilities. More research is needed.

What is the life expectancy for nvfPPA?

The life expectancy for people with nvfPPA can vary. In a recent study, people with nvfPPA lived an average of 7.69 years after the onset of their symptoms. Other research suggests that people with PPA may live an average of 8–10 years with the condition.

Non-fluent primary progressive aphasia (nvfPPA) affects your ability to express yourself through speaking.

The symptoms can get gradually worse over time, but speech-language therapy can help you retain your ability to communicate for as long as possible. Different coping strategies and communication techniques can help you maintain a good quality of life.

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