Ash Sharon, Moore Peachie, Vesely Luisa, Gunawardena Delani, McMillan Corey, Anderson Chivon, Avants Brian, Grossman Murray
Department of Neurology, University of Pennsylvania School of Medicine.
J Neurolinguistics. 2009 Jul 1;22(4):370-383. doi: 10.1016/j.jneuroling.2008.12.001.
We investigated the cognitive and neural bases of impaired speech fluency, a central feature of primary progressive aphasia. Speech fluency was assessed in 35 patients with frontotemporal lobar degeneration (FTLD) who presented with progressive non-fluent aphasia (PNFA, n=11), semantic dementia (SemD, n=12), or a social and executive disorder without aphasia (SOC/EXEC, n=12). Fluency was quantified as the number of words per minute in an extended, semi-structured speech sample. This was related to language characteristics of the speech sample and to neuropsychological measures. PNFA patients were significantly less fluent than controls and other FTLD patients. Fluency correlated with grammatical expression but not with speech errors or executive difficulty. SemD and SOC/EXEC patients were also less fluent than controls. In SemD, fluency was associated with semantically limited content. In SOC/EXEC, fluency was associated with executive limitations. Voxel-based morphometry analyses of high-resolution MRI related fluency to gray matter volume in left inferior frontal, insula, and superior temporal regions for the entire cohort of FTLD patients. This region overlapped partially distinct atrophic areas in each FTLD subgroup. It thus appears to play a crucial role in speech fluency, which can be interrupted in different ways in different FTLD subgroups.
我们研究了言语流畅性受损的认知和神经基础，言语流畅性受损是原发性进行性失语的一个核心特征。我们对35例额颞叶变性（FTLD）患者的言语流畅性进行了评估，这些患者表现为进行性非流畅性失语（PNFA，n = 11）、语义性痴呆（SemD，n = 12）或无失语的社交和执行功能障碍（SOC/EXEC，n = 12）。流畅性通过一个扩展的、半结构化言语样本中的每分钟单词数来量化。这与言语样本的语言特征以及神经心理学测量相关。PNFA患者的流畅性显著低于对照组和其他FTLD患者。流畅性与语法表达相关，但与言语错误或执行困难无关。SemD和SOC/EXEC患者的流畅性也低于对照组。在SemD中，流畅性与语义受限的内容相关。在SOC/EXEC中，流畅性与执行功能受限相关。基于体素的形态学分析利用高分辨率MRI将整个FTLD患者队列的流畅性与左侧额下回、岛叶和颞上回的灰质体积相关联。该区域在每个FTLD亚组中部分重叠且萎缩区域不同。因此，它似乎在言语流畅性中起着关键作用，而在不同的FTLD亚组中，言语流畅性可能以不同方式受到干扰。
