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Sleep talking and primary progressive aphasia: case study and autopsy findings in a patient with logopenic primary progressive aphasia and dementia with Lewy bodies
  1. Alexandra Clemans Apple1,2,
  2. Qinwen Mao3,4,
  3. Eileen Bigio3,4 and
  4. Borna Bonakdarpour3,5
  1. 1 Department of Neurology, University of California, San Francisco, CA, USA
  2. 2 Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
  3. 3 Mesulam Center for Cognitive Neurology and Alzheimer Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
  4. 4 Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
  5. 5 Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
  1. Correspondence to Alexandra Clemans Apple,{at}


This case study highlights the parasomnia behaviours of an individual with primary progressive aphasia, a type of dementia known for decline in language abilities. Despite a paucity of speech during the day, this individual had concurrent sleep talking at night; a combination which, to our knowledge, has never been reported before. Post-mortem pathology confirmed clinical suspicion of both Alzheimer and Lewy body diseases, both asymmetric to the left side. Given this rare left-sided asymmetrical pathology, we hypothesise that the relatively preserved right hemisphere may have allowed for access to intact overlearned phrases which usually originate from the right hemisphere to appear while asleep. A second hypothesis is also presented which postulates that bottom-up processing may have overridden top-down apathy during sleep and allowed for speech output in this case.

  • sleep disorders (neurology)
  • neuroimaging

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  • Contributors ACA contributed to case conceptualisation and writing of the manuscript. QM provided pathology diagnosis and figure preparation. EB contributed to the manuscript review and revision. BB contributed to case conceptualisation, clinical care of the patient in the case study and writing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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