Montembeault M, Brambati S M, Joubert S, Boukadi M, Chapleau M, Laforce R Jr, Wilson M A, Macoir J, Rouleau I
Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada H3W 1W5; Département de psychologie, Université de Montréal, Montréal, QC, Canada H3C 3J7.
Centre de recherche du Centre hospitalier universitaire de Québec, Québec, QC, Canada G1J 1Z4; Faculté de médecine, Département de réadaptation, Université Laval, Québec, QC, Canada G1V 0A6.
Neuropsychologia. 2017 Jan 27;95:11-20. doi: 10.1016/j.neuropsychologia.2016.12.009. Epub 2016 Dec 7.
While the semantic variant of primary progressive aphasia (svPPA) is characterized by a predominant semantic memory impairment, episodic memory impairments are the clinical hallmark of Alzheimer's disease (AD). However, AD patients also present with semantic deficits, which are more severe for semantically unique entities (e.g. a famous person) than for common concepts (e.g. a beaver). Previous studies in these patient populations have largely focused on famous-person naming. Therefore, we aimed to evaluate if these impairments also extend to other semantically unique entities such as famous places and famous logos. In this study, 13 AD patients, 9 svPPA patients, and 12 cognitively unimpaired elderly subjects (CTRL) were tested with a picture-naming test of non-unique entities (Boston Naming Test) and three experimental tests of semantically unique entities assessing naming of famous persons, places, and logos. Both clinical groups were overall more impaired at naming semantically unique entities than non-unique entities. Naming impairments in AD and svPPA extended to the other types of semantically unique entities, since a CTRL>AD>svPPA pattern was found on the performance of all naming tests. Naming famous places and famous persons appeared to be most impaired in svPPA, and both specific and general semantic knowledge for these entities were affected in these patients. Although AD patients were most significantly impaired on famous-person naming, only their specific semantic knowledge was impaired, while general knowledge was preserved. Post-hoc neuroimaging analyses also showed that famous-person naming impairments in AD correlated with atrophy in the temporo-parietal junction, a region functionally associated with lexical access. In line with previous studies, svPPA patients' impairment in both naming and semantic knowledge suggest a more profound semantic impairment, while naming impairments in AD may arise to a greater extent from impaired lexical access, even though semantic impairment for specific knowledge is also present. These results highlight the critical importance of developing and using a variety of semantically-unique-entity naming tests in neuropsychological assessments of patients with neurodegenerative diseases, which may unveil different patterns of lexical-semantic deficits.
虽然原发性进行性失语的语义变异型（svPPA）以主要的语义记忆障碍为特征，但情景记忆障碍是阿尔茨海默病（AD）的临床标志。然而，AD患者也存在语义缺陷，对于语义独特的实体（如名人）而言，这种缺陷比对于常见概念（如水獭）更为严重。此前针对这些患者群体的研究主要集中在名人命名上。因此，我们旨在评估这些损伤是否也扩展到其他语义独特的实体，如著名地点和著名标志。在本研究中，对13名AD患者、9名svPPA患者和12名认知未受损的老年受试者（对照组）进行了非独特实体的图片命名测试（波士顿命名测试）以及三项语义独特实体的实验测试，以评估名人、地点和标志的命名情况。两个临床组在命名语义独特实体方面总体上比命名非独特实体受损更严重。AD和svPPA的命名损伤扩展到了其他类型的语义独特实体，因为在所有命名测试的表现上发现了对照组>AD组>svPPA组的模式。在svPPA中，著名地点和名人的命名似乎受损最严重，并且这些患者对这些实体的特定和一般语义知识均受到影响。虽然AD患者在名人命名方面受损最为显著，但仅其特定语义知识受损，而一般知识得以保留。事后神经影像学分析还表明，AD患者的名人命名损伤与颞顶叶交界处的萎缩相关，该区域在功能上与词汇通达有关。与先前的研究一致，svPPA患者在命名和语义知识方面的损伤表明存在更严重的语义损伤，而AD患者的命名损伤可能在更大程度上源于词汇通达受损，尽管特定知识的语义损伤也存在。这些结果凸显了在神经退行性疾病患者的神经心理学评估中开发和使用各种语义独特实体命名测试的至关重要性，这可能揭示不同模式的词汇 - 语义缺陷。
