Cognitive and Behavioral Neurology Unit, Department of Neurology, University of São Paulo, School of Medicine (FMUSP) and Federal University of ABC (UFABC), Mathematics, Computing and Cognition Center (CMCC), Brazil.
Alzheimer Dis Assoc Disord. 2012 Jan-Mar;26(1):36-43. doi: 10.1097/WAD.0b013e318218206e.
Early progressive nonfluent aphasia (PNFA) may be difficult to differentiate from semantic dementia (SD) in a nonspecialist setting. There are descriptions of the clinical and neuropsychological profiles of patients with PNFA and SD but few systematic comparisons.
We compared the performance of groups with SD (n=27) and PNFA (n=16) with comparable ages, education, disease duration, and severity of dementia as measured by the Clinical Dementia Rating Scale on a comprehensive neuropsychological battery. Principal components analysis and intergroup comparisons were used.
A 5-factor solution accounted for 78.4% of the total variance with good separation of neuropsychological variables. As expected, both groups were anomic with preserved visuospatial function and mental speed. Patients with SD had lower scores on comprehension-based semantic tests and better performance on verbal working memory and phonological processing tasks. The opposite pattern was found in the PNFA group.
Neuropsychological tests that examine verbal and nonverbal semantic associations, verbal working memory, and phonological processing are the most helpful for distinguishing between PNFA and SD.
在非专业环境中，早期进行性非流利性失语症（PNFA）可能难以与语义性痴呆（SD）区分开来。有描述 PNFA 和 SD 患者的临床和神经心理学特征的描述，但很少有系统比较。
我们比较了 SD 组（n=27）和 PNFA 组（n=16）的表现，这些组在年龄、教育程度、疾病持续时间和认知障碍严重程度（由临床痴呆评定量表测量）方面具有可比性，均接受了全面的神经心理学测试。使用主成分分析和组间比较。
一个 5 因素解决方案解释了 78.4%的总方差，并且对神经心理学变量有很好的分离效果。正如预期的那样，两组患者都表现为命名障碍，保留了视觉空间功能和心智速度。SD 患者在基于理解的语义测试中得分较低，而在言语工作记忆和语音处理任务中的表现更好。PNFA 组则出现相反的模式。
检查言语和非言语语义关联、言语工作记忆和语音处理的神经心理学测试最有助于区分 PNFA 和 SD。
