原发性进行性失语中命名和语义知识的衰退模式。
Patterns of Decline in Naming and Semantic Knowledge in Primary Progressive Aphasia.
作者信息
Sebastian Rajani, Thompson Carol B, Wang Nae-Yuh, Wright Amy, Meyer Aaron, Friedman Rhonda B, Hillis Argye E, Tippett Donna C
机构信息
Department of Neurology, Johns Hopkins University School of Medicine, Phipps 446, 600 N. Wolfe Street, Baltimore, Maryland 21287 USA; Telephone (410) 614-2381;
Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E-3142, Baltimore, Maryland 21205-2179 USA; Telephone (410) 502-9142;
出版信息
Aphasiology. 2018;32(9):1010-1030. doi: 10.1080/02687038.2018.1490388. Epub 2018 Jun 28.
BACKGROUND
Individuals with primary progressive aphasia (PPA) and their caregivers want to know what to expect so that they can plan support appropriately. The ability to predict decline in naming and semantic knowledge, and advise individuals with PPA and their caregivers regarding future planning, would be invaluable clinically.
AIMS
The aims of this study were to investigate patterns of decline in naming and semantic knowledge in each of the clinical variants of PPA (logopenic variant PPA, lvPPA; nonfluent agrammatic PPA, nfaPPA; and semantic variant PPA, svPPA) and to examine the effects of other variables on rate of decline. We hypothesized that speech-language rehabilitation, higher education, and higher baseline test scores would be associated with slower decline, and older age with faster decline.
METHODS AND PROCEDURES
A total of ninety-four participants with PPA underwent language testing, including thirty six participants with lvPPA, thirty-one participants with nfaPPA, and twenty-seven participants with svPPA. All participant groups were similar in age and education. We focused on decline on three tests: the short form of the Boston Naming Test (BNT), the Hopkins Assessment of Naming Actions (HANA), and the short form of the Pyramids and Palm Trees Test (PPTT).
OUTCOME AND RESULTS
Across language tests, the most precipitous rates of decline (loss of points per month) occurred in nfaPPA, followed by svPPA, then lvPPA. Female sex, longer symptom duration, higher baseline test score, and speech-language rehabilitation were associated with slower decline.
CONCLUSIONS
PPA variants were distinguishable by rapidity of decline, with nfaPPA having the most precipitous decline. As hypothesized, higher baseline test scores and speech-language rehabilitation were associated with slower decline. Surprisingly, age and education were not important prognostically for individuals in this study. Further study of prognostically-relevant variables in PPA is indicated in this population.
背景
原发性进行性失语（PPA）患者及其照护者希望了解未来情况，以便能合理规划支持措施。预测命名和语义知识衰退情况，并就未来规划向PPA患者及其照护者提供建议，在临床上将非常有价值。
目的
本研究旨在调查PPA各临床亚型（语音变异型PPA，lvPPA；非流利性失语型PPA，nfaPPA；语义变异型PPA，svPPA）命名和语义知识的衰退模式，并研究其他变量对衰退速度的影响。我们假设言语语言康复、高等教育和较高的基线测试分数与衰退较慢相关，而年龄较大与衰退较快相关。
方法与过程
共有94名PPA患者接受了语言测试，其中36名lvPPA患者，31名nfaPPA患者，27名svPPA患者。所有参与者组在年龄和教育程度方面相似。我们重点关注三项测试的衰退情况：波士顿命名测试（BNT）简版、霍普金斯命名动作评估（HANA）和金字塔与棕榈树测试（PPTT）简版。
结果与结论
在各项语言测试中，衰退速度最快（每月失分）的是nfaPPA，其次是svPPA，然后是lvPPA。女性、症状持续时间较长、基线测试分数较高和言语语言康复与衰退较慢相关。
结论
PPA各亚型可通过衰退速度区分，nfaPPA衰退最为迅速。如我们所假设，较高的基线测试分数和言语语言康复与衰退较慢相关。令人惊讶的是，在本研究中，年龄和教育程度对患者的预后并不重要。该人群需要进一步研究PPA中与预后相关的变量。
Zotero 插件