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FotorCreated“Primary Progressive Speech Abulia” [ Journal of Alzheimers Disease. 2015 Jun 25;46(3):737-45.] . This paper was written by former Behavioral Neurology Fellow, Nickolas J. Milano and Kenneth M. Heilman and was based on patients seen in their Memory Disorders Clinic.  Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by progressive language impairment. The three variants of PPA include the nonfluent/agrammatic, semantic, and logopenic types. The goal of this report is to describe a new form of PPA in two patients who had a loss of speech initiation, both propositional and automatic that was associated with bilateral medial frontal atrophy. Whereas these patients had a paucity of spontaneous and automatic speech their naming, repetition, reading, and writing were all normal. These cases of progressive dynamic aphasia are the first cases associated with predominantly bilateral medial frontal atrophy and thus represents a new variant of PPA.