Cargando…
Unclassified fluent variants of primary progressive aphasia: distinction from semantic and logopenic variants
Primary progressive aphasia, a neurodegenerative syndrome, presents mainly with language impairment. Both semantic and logopenic variants are fluent variants of primary progressive aphasia. Before the research criteria of primary progressive aphasia were proposed, progressive fluent aphasias, such a...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9171501/ https://www.ncbi.nlm.nih.gov/pubmed/35686225 http://dx.doi.org/10.1093/braincomms/fcac015 |
_version_ | 1784721680815357952 |
---|---|
author | Watanabe, Hiroyuki Hikida, Sakura Ikeda, Manabu Mori, Etsuro |
author_facet | Watanabe, Hiroyuki Hikida, Sakura Ikeda, Manabu Mori, Etsuro |
author_sort | Watanabe, Hiroyuki |
collection | PubMed |
description | Primary progressive aphasia, a neurodegenerative syndrome, presents mainly with language impairment. Both semantic and logopenic variants are fluent variants of primary progressive aphasia. Before the research criteria of primary progressive aphasia were proposed, progressive fluent aphasias, such as progressive anomic aphasia, transcortical sensory aphasia and Wernicke’s aphasia, were reported as classical progressive fluent aphasias seen in Alzheimer’s disease. However, since the research criteria of primary progressive aphasia were established, classical fluent variants (other than semantic and logopenic variants) have been neglected and have not been included in the current classification of primary progressive aphasia. This study aimed to determine whether unclassified fluent variants (other than semantic and logopenic variants) can be manifestations of primary progressive aphasia. This study also reconfirmed the characteristics of classical progressive fluent aphasia, such as progressive anomic aphasia, progressive transcortical sensory aphasia and progressive Wernicke’s aphasia as unclassified fluent variants of primary progressive aphasia, using comparison with the current model of primary progressive aphasia. Twelve consecutive patients with an unclassified fluent variant other than semantic or logopenic variant underwent language, neurological, neuropsychological and neuroimaging (MRI and single-photon emission computed tomography) testing. Based on comprehensive language tests, we redefined the diagnoses as primary progressive anomic aphasia (n = 8), primary progressive transcortical sensory aphasia (n = 3) and primary progressive Wernicke’s aphasia (n = 1). Anomic aphasia was characterized by anomia but preserved repetition and comprehension; transcortical sensory aphasia by relatively preserved repetition but poor word comprehension; and Wernicke’s aphasia by poor repetition and word comprehension. In patients with anomic aphasia, voxel-based morphometry of MRI data revealed cortical atrophy, which was most prominent in the temporoparietal lobes, with no obvious lateralization; in two-thirds of patients with transcortical sensory aphasia and in one patient with Wernicke’s aphasia, it revealed atrophy, predominantly in the left temporoparietal lobe. Statistical analysis of single-photon emission computed tomography using three-dimensional stereotactic surface projections revealed patterns of left-sided hypoperfusion in the majority of patients. The temporal and parietal lobes were involved in all cases; the degree of hypoperfusion was higher in patients with transcortical sensory aphasia or Wernicke’s aphasia than in patients with anomic aphasia. The present study demonstrated the clinical and imaging features of 12 patients with an unclassified fluent variant of primary progressive aphasia, which we redefined as primary progressive anomic aphasia, primary progressive transcortical sensory aphasia and primary progressive Wernicke’s aphasia. Classical fluent variants other than semantic and logopenic variants can be found in primary progressive aphasia. |
format | Online Article Text |
id | pubmed-9171501 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-91715012022-06-08 Unclassified fluent variants of primary progressive aphasia: distinction from semantic and logopenic variants Watanabe, Hiroyuki Hikida, Sakura Ikeda, Manabu Mori, Etsuro Brain Commun Original Article Primary progressive aphasia, a neurodegenerative syndrome, presents mainly with language impairment. Both semantic and logopenic variants are fluent variants of primary progressive aphasia. Before the research criteria of primary progressive aphasia were proposed, progressive fluent aphasias, such as progressive anomic aphasia, transcortical sensory aphasia and Wernicke’s aphasia, were reported as classical progressive fluent aphasias seen in Alzheimer’s disease. However, since the research criteria of primary progressive aphasia were established, classical fluent variants (other than semantic and logopenic variants) have been neglected and have not been included in the current classification of primary progressive aphasia. This study aimed to determine whether unclassified fluent variants (other than semantic and logopenic variants) can be manifestations of primary progressive aphasia. This study also reconfirmed the characteristics of classical progressive fluent aphasia, such as progressive anomic aphasia, progressive transcortical sensory aphasia and progressive Wernicke’s aphasia as unclassified fluent variants of primary progressive aphasia, using comparison with the current model of primary progressive aphasia. Twelve consecutive patients with an unclassified fluent variant other than semantic or logopenic variant underwent language, neurological, neuropsychological and neuroimaging (MRI and single-photon emission computed tomography) testing. Based on comprehensive language tests, we redefined the diagnoses as primary progressive anomic aphasia (n = 8), primary progressive transcortical sensory aphasia (n = 3) and primary progressive Wernicke’s aphasia (n = 1). Anomic aphasia was characterized by anomia but preserved repetition and comprehension; transcortical sensory aphasia by relatively preserved repetition but poor word comprehension; and Wernicke’s aphasia by poor repetition and word comprehension. In patients with anomic aphasia, voxel-based morphometry of MRI data revealed cortical atrophy, which was most prominent in the temporoparietal lobes, with no obvious lateralization; in two-thirds of patients with transcortical sensory aphasia and in one patient with Wernicke’s aphasia, it revealed atrophy, predominantly in the left temporoparietal lobe. Statistical analysis of single-photon emission computed tomography using three-dimensional stereotactic surface projections revealed patterns of left-sided hypoperfusion in the majority of patients. The temporal and parietal lobes were involved in all cases; the degree of hypoperfusion was higher in patients with transcortical sensory aphasia or Wernicke’s aphasia than in patients with anomic aphasia. The present study demonstrated the clinical and imaging features of 12 patients with an unclassified fluent variant of primary progressive aphasia, which we redefined as primary progressive anomic aphasia, primary progressive transcortical sensory aphasia and primary progressive Wernicke’s aphasia. Classical fluent variants other than semantic and logopenic variants can be found in primary progressive aphasia. Oxford University Press 2022-02-02 /pmc/articles/PMC9171501/ /pubmed/35686225 http://dx.doi.org/10.1093/braincomms/fcac015 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Guarantors of Brain. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Watanabe, Hiroyuki Hikida, Sakura Ikeda, Manabu Mori, Etsuro Unclassified fluent variants of primary progressive aphasia: distinction from semantic and logopenic variants |
title | Unclassified fluent variants of primary progressive aphasia: distinction from semantic and logopenic variants |
title_full | Unclassified fluent variants of primary progressive aphasia: distinction from semantic and logopenic variants |
title_fullStr | Unclassified fluent variants of primary progressive aphasia: distinction from semantic and logopenic variants |
title_full_unstemmed | Unclassified fluent variants of primary progressive aphasia: distinction from semantic and logopenic variants |
title_short | Unclassified fluent variants of primary progressive aphasia: distinction from semantic and logopenic variants |
title_sort | unclassified fluent variants of primary progressive aphasia: distinction from semantic and logopenic variants |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9171501/ https://www.ncbi.nlm.nih.gov/pubmed/35686225 http://dx.doi.org/10.1093/braincomms/fcac015 |
work_keys_str_mv | AT watanabehiroyuki unclassifiedfluentvariantsofprimaryprogressiveaphasiadistinctionfromsemanticandlogopenicvariants AT hikidasakura unclassifiedfluentvariantsofprimaryprogressiveaphasiadistinctionfromsemanticandlogopenicvariants AT ikedamanabu unclassifiedfluentvariantsofprimaryprogressiveaphasiadistinctionfromsemanticandlogopenicvariants AT morietsuro unclassifiedfluentvariantsofprimaryprogressiveaphasiadistinctionfromsemanticandlogopenicvariants |