The following is a summary of “Brain total creatine differs between primary progressive aphasia (PPA) subtypes and correlates with disease severity,” published in the February 2023 issue of the Neurobiology of Aging by Hupfeld et al.

The three subtypes of a primary progressive aphasia (PPA) are known as logopenic (lvPPA), non-fluent (nfvPPA), and semantic (svPPA). PPA is an abbreviation for primary progressive aphasia (svPPA). Researchers used magnetic resonance spectroscopy (MRS) to determine the tissue-corrected metabolite levels in 61 PPA patients’ left inferior frontal gyrus (IFG) and right sensorimotor cortex (SMC). These regions are located in the brain.

Initially, the researcher wanted to explain the metabolite differences between the subtypes, and then the researchers wanted to investigate whether or not there is a connection between metabolites and the severity of the symptoms. In both the left IFG and the right SMC, the tCr varied depending on the subtype. This was true for both tissues. It was discovered that the levels of tCr were at their lowest in lvPPA and their highest in svPPA. The levels of tCr were able to accurately predict a diagnosis of either lvPPA or svPPA. A higher IFG tCr and a lower Glx were associated with a more severe sickness. This link was found to exist.

Anomalies in some cellular energy processes may be involved in the pathophysiology of svPPA. This is because tCr is involved in the energy metabolism of the brain. The symptoms are likely the result of changes to the equilibrium of cellular energy in linguistic areas. Likely, diminished cortical excitatory capacity in language regions (lower Glx) may contribute to the symptoms. Hence, tCr may help discriminate between the many subtypes of PPA, and both tCr and Glx may help understand the workings of PPA and track its development.

Source: sciencedirect.com/science/article/abs/pii/S0197458022002366