Classifying and Monitoring Primary Progressive Aphasia in the Greek Population: A “Mini Linguistic State Examination (MLSE)” Tool

Abstract

Background and Objectives: Difficulties in language production and comprehension constitute clinical symptoms characterizing patients diagnosed with Primary Progressive Aphasia (PPA). Thorough assessment of language domains can detect specific deficits commonly observed in different PPA variants, but brief and practical instruments capable of screening for language impairment are lacking. The present study aimed to examine the ability of the Mini Linguistic State Examination (MLSE) to distinguish between healthy individuals and PPA patients, as well as to differentiate among PPA subtypes, within Greek clinical practice. Materials and Methods: Τhe Mini Linguistic State Examination (MLSE), a 15-min detailed examination of different language domains, was administered to a group of clinically diagnosed PPA patients and a group of healthy participants. In addition, PPA patients completed a neuropsychological test battery assessing memory, language, executive, and visuospatial functions. Patterns of patients’ brain perfusion were also explored with single-photon emission computed tomography. Results: Comparisons between PPA patients and healthy controls revealed significant differences across all MLSE domains (all p < 0.001), and receiver operating characteristic analyses demonstrated excellent diagnostic accuracy, with AUC values exceeding 0.90 across language domains and perfect classification for the total MLSE score (AUC = 1.00, p < 0.001). Conclusions: These findings indicate that the MLSE is able to detect distinct patterns of deficits and to provide a comprehensive overview of patients’ linguistic profiles, supporting its clinical utility and diagnostic potential for differentiating PPA variants.