Ichimi N, Hashimoto M, Matsushita M, Yano H, Yatabe Y, Ikeda M
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Japan.
East Asian Arch Psychiatry. 2013 Sep;23(3):120-5.
To examine the relationship between primary progressive aphasia (PPA) and neurodegenerative dementia.
Subjects were selected from 1723 consecutive patients who had undergone a medical examination at the Kumamoto University Hospital Dementia Clinic, Japan, from April 2007 to October 2012. First, patients with semantic dementia (SD) and patients with progressive non-fluent aphasia were diagnosed by clinical diagnostic criteria for frontotemporal lobar degeneration. Next, in the same cohort, patients with PPA were diagnosed according to the recent international consensus criteria. The relationship and clinical symptoms including language and psychiatric symptoms in each patient group were then compared.
In all, 12 of 27 SD patients fulfilled both SD and semantic variant PPA criteria (SD+PPA+ group), whereas the other 15 who met the SD criteria could not be included in the semantic variant PPA group due to prominent behavioural disturbances (SD+PPA- group). No significant differences in clinical characteristics and language functions were found between these 2 groups. Neuropsychiatric symptoms were more severe in the SD+PPA- group.
The results suggest the possibility that SD and semantic variant PPA may be identical, regardless of different severities of behavioural disturbance. When considering the language disorder of neurodegenerative dementia, it may be more important to diagnose the subtype of language disorder the patient has than to emphasise isolated language deficits.
探讨原发性进行性失语(PPA)与神经退行性痴呆之间的关系。
研究对象选自2007年4月至2012年10月在日本熊本大学医院痴呆门诊接受体检的1723例连续患者。首先,根据额颞叶变性的临床诊断标准,对语义性痴呆(SD)患者和进行性非流畅性失语患者进行诊断。接下来,在同一队列中,根据最近的国际共识标准对PPA患者进行诊断。然后比较每个患者组之间的关系以及包括语言和精神症状在内的临床症状。
27例SD患者中,有12例同时符合SD和语义变异型PPA标准(SD+PPA+组),而其他15例符合SD标准的患者由于明显的行为障碍而不能纳入语义变异型PPA组(SD+PPA-组)。这两组在临床特征和语言功能方面未发现显著差异。SD+PPA-组的神经精神症状更严重。
结果表明,无论行为障碍的严重程度如何,SD和语义变异型PPA可能是相同的。在考虑神经退行性痴呆的语言障碍时,诊断患者所患语言障碍的亚型可能比强调孤立的语言缺陷更为重要。