Seckin ZI, Duffy JR, Strand EA, et al. - In patients with primary progressive apraxia of speech (PPAOS) researchers sought to evaluate the evolution of parkinsonian features who were followed yearly for at least six years. Out of a large cohort of 46 PPAOS patients, they followed eight annually for > 6-years in multiple NIH-funded grants. At each visit, patients were evaluated for parkinsonian and other characteristics, including bradykinesia, tremor, rigidity, postural instability, apraxia, ocular motor function and cognition, and research criteria for the diagnosis of PSP and CBS were applied. In all eight patients (100%), a Parkinson plus syndrome developed. The earliest characteristic was bradykinesia, followed by rigidity and postural instability. Tremor was not a significant feature. A Parkinson plus syndrome can eventually develop in PPAOS, indicating that PPAOS may be an early presentation of a Parkinson plus disorder.