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Background and Purpose Tere are three distinct subtypes of primary progressive aphasia (PPA): the nonfuent/agrammatic variant (nfvPPA), the semantic variant (svPPA), and the logopenic variant (lvPPA). We sought to characterize the pattern of [ 18 F]-THK5351 retention across all three subtypes and determine the topography of [ 18 F]-THK5351 retention correlated with each neurolinguistic score. Methods We enrolled 50 participants, comprising 13 PPA patients (3 nfvPPA, 5 svPPA, and 5 lvPPA) and 37 subjects with normal cognition (NC) who underwent 3.0-tesla magnetic resonance imaging, [ 18 F]-THK5351 positron-emission tomography scans, and detailed neuropsychological tests. Te PPA patients additionally participated in extensive neurolinguistic tests. Voxel-wise and region-of-interest-based analyses were performed to analyze [ 18 F]-THK5351 retention. Results Te nfvPPA patients exhibited higher [ 18 F]-THK5351 retention in the the lef inferior frontal and precentral gyri. In svPPA patients, [ 18 F]-THK5351 retention was elevated in the anteroinferior and lateral temporal cortices compared to the NC group (lef>right). Te lvPPA patients exhibited predominant [ 18 F]-THK5351 retention in the inferior parietal, lateral temporal, and dorsolateral prefrontal cortices, and the precuneus (lef>right). [ 18 F]-THK5351 retention in the lef inferior frontal area was associated with lower fuency scores. Comprehension was correlated with [ 18 F]-THK5351 retention in the lef temporal cortices. Repetition was associated with [ 18 F]-THK5351 retention in the lef inferior parietal and posterior temporal areas, while naming difculty was correlated with retention in the lef fusiform and temporal cortices. Conclusions Te pattern of [ 18 F]-THK5351 retention was well matched with clinical and radiological fndings for each PPA subtype, in agreement with the anatomical and functional location of each language domain.

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